清热散结法治疗湿热蕴结型痛风性关节炎临床研究

Clinical Study on Method of Clearing Heat and Dissipating Masses for Gouty Arthritis of Damp-heat Accumulation Type

目的:观察清热散结法治疗湿热蕴结型痛风性关节炎的临床疗效。方法:将湿热蕴结型痛风性关节炎患者98例作为研究对象,随机分为治疗组和对照组各49例。对照组给予依托考昔治疗,治疗组在对照组治疗的基础上联合清热散结法中药汤剂治疗,对比2组治疗后的临床疗效及血清尿酸(UA)、C-反应蛋白(CRP)、白细胞介素-1β(IL-1β)水平。结果:与治疗前相比,治疗后2组临床症状、体征积分均下降,差异有统计学意义(P<0.05);治疗后2组间进行对比,治疗组各项积分改善情况均优于对照组,差异有统计学意义(P<0.05)。治疗组临床总有效率为93.9%,对照组临床总有效率为75.5%,2组比较,差异有统计学意义(P<0.05)。与治疗前比较,2组治疗后血清UA、CRP、IL-1β水平均下降,差异有统计学意义(P<0.05)。治疗后,治疗组血清UA、CRP、IL-1β水平低于对照组(P<0.05)。结论:清热散结法联合依托考昔治疗湿热蕴结型痛风性关节炎临床疗效确切,较单用依托考昔能更好的改善患者的症状、体征,降低患者血清UA、CRP、IL-1β水平,提高临床疗效。

Objective:To observe the clinical effect of method of clearing heat and dissipating masses for gouty arthritis of damp-heat accumulation type.Methods:A total of 98 cases of patients with gouty arthritis of damp-heat accumulation type were selected as the study subjects,and were randomly divided into the treatment group and the control group,49 cases in each group.The control group was treated with etoricoxib,and the treatment group was additionally treated with Chinese herbal decoction with method of clearing heat and dissipating masses based on the treatment of the control group.The clinical effect and the levels of uric acid(UA),C-reactive protein(CRP) and interleukin-1β(IL-1β) in serum in the two groups after treatment were compared.Results:After treatment,the scores of clinical symptoms and signs in the two groups were decreased when compared with those before treatment,the difference being significant(P<0.05);the improvement of each score in the treatment group was superior to that in the control group,the difference being significant(P<0.05).The total clinical effective rate was 93.9% in the treatment group and 75.5% in the control group,the difference being significant(P<0.05).After treatment,the levels of UA,CRP and IL-1β in serum in the two groups were decreased when compared with those before treatment,the difference being significant(P<0.05).After treatment,the levels of UA,CRP and IL-1β in serum in the treatment group were lower than those in the control group(P<0.05).Conclusion:The therapy of method of clearing heat and dissipating masses combined with etoricoxib has definite clinical effect in treating gouty arthritis of damp-heat accumulation type.Compared with simple etoricoxib,it can better improve the symptoms and signs of patients,reduce the levels of UA,CRP and IL-1β in serum and enhance the clinical effect.