涤浊汤联合中药足浴治疗脾虚湿阻型慢性痛风临床观察

Clinical Observation of Dizhuo Decoction(涤浊汤)Combined with Chinese Herbal Foot Bath in Treating Chronic Gout of Spleen Deficiency and Dampness Obstruction Pattern

目的:观察涤浊汤联合中药足浴治疗脾虚湿阻型慢性痛风的临床疗效。方法:将72例慢性痛风患者随机分为研究组与对照组各36例,对照组给予非布司他片+碳酸氢钠片治疗,研究组在对照组的基础上给予内服涤浊汤+中药足浴治疗。比较两组患者治疗前后的中医证候积分、疼痛视觉模拟评分(VAS)及血尿酸(BUA)、红细胞沉降率(ESR)、高敏C反应蛋白(hs-CRP)水平,评定临床疗效并观察痛风急性发作情况,随访2个月的复发情况。结果:研究组的临床总有效率88.89%明显优于对照组69.44%(P<0.05);两组患者治疗后4周、8周和12周的VAS评分均较治疗前显著降低,且研究组明显低于对照组(P<0.05);研究组治疗后的BUA、ESR及hs-CRP水平显著低于对照组(P<0.05);研究组的痛风急性发作率11.11%,明显低于对照组33.33%(P<0.05);随访2个月,研究组的痛风复发率16.67%,明显低于对照组38.89%(P<0.05);两组在治疗过程中均未出现明显不良反应及并发症。结论:涤浊法联合中药足浴治疗脾虚湿阻型慢性痛风患者的疗效显著,能有效改善临床症状,促进BUA排泄,减轻患者疼痛,减少痛风的急性发作及复发率,且安全可靠,值得临床进一步研究探讨。

Objective:To observe the clinical effect of Dizhuo Decoction(涤浊汤)combined with Chinese herbal foot bath on chronic gout of spleen deficiency and dampness obstruction pattern.Methods:Total 72 patients with chronic gout were randomly divided into the study group and the control group,each with 36 cases.The control group was treated with febuxostat tablets and sodium bicarbonate tablets,and the study group was given internally taken Fuzhuo Decoction combined with Chinese medicine foot bath treatment.Syndrome scores of traditional Chinese medicine,visual analogue scores(VAS),blood uric acid(BUA),ery-throcyte sedimentation rate(ESR),high-sensitivity C-reactive protein(hs-CRP)levels of the two groups of patients before and after treatment were compared and the acute attack of gout was observed,The patients were followed up for 2 months to observe the recurrence.Results:The total clinical effective rate of the study group was 88.89%,which was significantly better than that of the control group(69.44%)(P<0.05);the VAS scores of the two groups of patients at 4 weeks,8 weeks,and 12 weeks after treatment were significantly lower than before treatment,and the study group was significantly better than the control group(P<0.05);the BUA,ESR and hs-CRP contents of the study group after treatment were significantly lower than those of the control group(P<0.05);the acute gout attack rate of the study group was 11.11%,significantly lower than that of the control group(33.33%)(P<0.05);After 2 months of follow-up,the gout recurrence rate of the study group was 16.67%,which was significantly lower than that of the control group(38.89%)(P<0.05);no obvious adverse reactions and complications occurred during the treatment in both groups.Conclusions:Dizhuo Decoction combined with Chinese herbal foot bath is effective in treating patients with chronic gout of spleen deficiency and dampness obstruction pattern.It can effectively improve clinical symptoms,promote BUA excretion,reduce patients'pain,reduce the acute attack and recurrence rate of gout,and is safe and reliable,worthy of further clinical study and discussion.