加味四妙汤联合桃花膏外敷治疗上消化道出血合并痛风临床观察

Clinical Observation on Treatment of Upper Gastrointestinal Hemorrhage Complicated with Gout with Jia Wei SiMiao Decoction and Taohua Ointment

目的:在常规西医治疗及加味四妙汤基础上,联合桃花膏外敷治疗上消化道出血合并痛风急性发作,探讨中西医结合治疗方案在上消化道出血合并痛风急性发作中的治疗作用。方法:收集2016年1月至2019年1月中山市中医院急诊留观患者共31例,符合上消化道出血及痛风的诊断标准,治疗组16例,对照组15例。在使用质子泵抑制剂(PPI)、止血、补液、碱化尿液等西医基础治疗上,治疗组予内服加味四妙汤联合桃花膏外敷,对照组予内服加味四妙汤。比较两组治疗前后关节肿痛评分、炎症指标的变化。结果:治疗组治疗总有效率为93.7%,对照组治疗总有效率为80.0%,两组比较差异有统计学意义(P<0.05)。治疗组关节肿痛评分、CRP改善优于对照组,两组PCT未见明显变化。结论:在西医基础治疗上,加味四妙汤联合外敷桃花膏能较好地缓解上消化道出血合并痛风急性发作的临床症状,缩短疗程。

Objective:On the basis of routine western medicine treatment and Jia Wei Si Miao decoction,combined with Taohua Ointment external application to treat upper gastrointestinal hemorrhage with acute gout attack,to explore the therapeutic effect of integrated traditional chinese and western medicine on upper gastrointestinal hemorrhage with acute gout attack.Methods:From January 2016to January 2019,a total of 31cases of emergency observation patients in Zhongshan Hospital of Traditional Chinese Medicine were collected.They met the diagnostic criteria of upper gastrointestinal bleeding and gout.There were 16cases in the treatment group and 15cases in the control group.In the basic treatment of western medicine,such as proton pump inhibitor(PPI),hemostasis,rehydration and alkaline urine,the treatment group was treated with Jia Wei Si Miao Decoction and Taohua Ointment,while the control group was treated with Jia Wei Si Miao decoction.The changes of joint swelling and pain score and inflammation index before and after treatment were compared between the two groups.Results:1.The effective rate of the treatment group was 93.7%,while that of the control group was 80.0%,with statistical significance(P<0.05).2.The improvement of joint swelling and pain score and CRP in the treatment group was better than that in the control group.There was no significant change in PCT in the two groups.Conclusion:In the basic treatment of western medicine,Jia Wei Si Miao Decoction combined with Taohua Ointment can better alleviate the clinical symptoms of upper gastrointestinal bleeding combined with acute gout attack and shorten the course of treatment.