痛风清解汤及红楼中药膏联合西药治疗急性痛风性关节炎的优势证型及对相关优势炎性因子的影响

The Advantages of Tongfengqingjie Decoction and Honglou Chinese herbal Ointment Combined with Western Medicine in Treatment of Acute Gouty Arthritis and its Effect on Related Inflammatory Factors

目的:探讨痛风清解汤及红楼中药膏联合西药治疗急性痛风性关节炎的优势证型及对相关优势炎性因子的影响。方法:回顾性选取2015年10月至2018年5月汕头市中医医院收治的急性痛风性关节炎患者150例,根据诊疗方式分为观察A组(中药痛风清解汤+红楼中药膏+西药治疗湿热型急性痛风关节炎)、观察B组(中药痛风清解汤+红楼中药膏+西药治疗痰瘀互结型急性痛风关节炎)和对照组(西药治疗组),每组50例。观察三组患者的临床疗效,相关炎性因子肿瘤坏死因子α(TNF-α)、白细胞介素1β(IL-1β)、白细胞介素6(IL-6)、白细胞介素-8(IL-8)、环氧化酶-2(COX-2)及前列腺素E2(PGE2)水平变化。结果:观察A组患者的总有效率明显高于观察B组、对照组,观察B组患者的总有效率明显高于对照组,差异均有统计学意义(P<0.05)。治疗后,三组患者TNF-α、IL-1β、IL-6、IL-8、COX-2及PGE2水平较治疗前明显降低,差异均有统计学意义(P<0.05);观察A组患者TNF-α、IL-1β及IL-8水平明显低于观察B组、对照组,且观察B组患者明显低于对照组,差异均有统计学意义(P<0.05);观察A组、观察B组患者的IL-6、COX-2及PGE2水平明显低于对照组,差异均有统计学意义(P<0.05)。结论:痛风清解汤及红楼中药膏优势治疗湿热型急性痛风关节炎,与相关炎性因子水平变化密切相关,主要通过下调TNF-α、IL-1β及IL-8水平而达到其优势治疗效果。

OBJECTIVE: To probe into the advantages of Tongfengqingjie decoction and Honglou Chinese herbal ointment combined with western medicine in treatment of acute gouty arthritis and its effect on related inflammatory factors.METHODS: 150 patients with acute gouty arthritis admitted into Shantou Hospital of Traditional Chinese Medicine from Oct.2015 to May 2018 were retrospectively selected and divided into observation group A (was given Tongfengqingjie decoction+Honglou Chinese herbal ointment+western medicine in treatment of damp-heat type of acute gouty arthritis),observation group B (was given Tongfengqingjie decoction + Honglou Chinese herbal ointment+western medicine in treatment of acute gouty arthritis of intermin-gled phlegm and blood stasis) and control group (was treated with western medicine) according to different treatment methods,with 50 cases in each group.The clinical efficacy and changes of inflammatory factor (TNF-α,IL-1β,IL-6,IL-8,COX-2 and PGE 2) levels of three groups were observed.RESULTS: The total effective rate of observation group A was significantly higher than that of observation group B and control group,and that of observation group B was significantly higher than control group,with statistically significant differences( P <0.05).After treatment,the TNF-α,IL-1β,IL-6,IL-8,COX-2 and PGE 2 levels of the three groups were significantly lower than those of before treatment,with statistically significant differences( P <0.05);the TNF-α,IL-1β and IL-8 levels of observation group A was significantly lower than those of observation group B and control group,and those of observation group B was significantly lower than control group,with statistically significant differences( P <0.05);the IL-6,COX-2 and PGE 2 levels of observation group A and observation group B were significantly lower than those of control group,with statistically significant differences( P <0.05).CONCLUSIONS: Tongfengqingjie decoction and Honglou Chinese herbal ointment combined with western medicine in treatment of acute gouty arthritis is closely related to the changes of inflammatory related factors,mainly by down-regulating the inflammatory related factors of TNF-α,IL-1β and IL-8 to achieve its superior therapeutic effect.