降酸方联合非布司他治疗急性顽固性痛风性关节炎的临床观察

Clinical observation of Jiangsuan recipe combined with febuxostat in the treatment of acute refractory gouty arthritis

目的观察自拟降酸方联合非布司他治疗急性顽固性痛风性关节炎的临床疗效。方法选择2017年1月~2019年9月门诊收治的确诊为急性痛风性关节炎的患者100例,分为西药组和中西药组,西药组给予非布司他片,80 mg,每日1次口服,20 d为1个疗程。中西药组在西药组基础上给予降酸方,每日两次,20 d为1个疗程,早晚饭后半小时温服。比较两组治疗前和治疗20 d后血尿酸、C反应蛋白及疼痛评分,评估两组有效率。并比较中西药组治疗前和治疗3个月后的疼痛改善情况。结果治疗前两组UA、CRP和VAS比较,差异无统计学意义(P>0.05)。治疗20 d后两组UA、CRP和VAS均低于治疗前,两组比较差异有统计学意义(P<0.05)。中西药组愈显率为100%,明显好于西药组的14%(P<0.05)。治疗前疼痛功能分级优0例,良4例,可38例,差8例。治疗3个月后优21例,良29例,可0例,差0例。治疗前CI(0.699,0.777),治疗后CI(0.224,0.300),值小的疗效好。结论自拟降酸方联合非布司他能显著降低血尿酸及C反应蛋白,并降低疼痛评分,明显优于单纯非布司他治疗,对于急性顽固性痛风性关节炎疗效显著,费用低廉,可以长期使用,值得临床推广。

Objective To observe the clinical efficacy of self-made Jiangsuan recipe combined with febuxostat in the treatment of acute refractory gouty arthritis.Methods A total of 100 patients with acute gouty arthritis who were diagnosed and treated in the outpatient clinic from January 2017 to September 2019 were selected and divided into western medicine group and Chinese medicine and western medicine group.The western medicine group was given febuxostat tablets of 80 mg,orally once a day for a course of 20 days.On the basis of western medicine group,the Chinese medicine and western medicine group was given Jiangsuan recipe,twice a day for a course of 20 days,and served with warm water half an hour after breakfast and dinner.The serum uric acid,C-reactive protein,and pain scores were compared before treatment and after 20 days of treatment in the two groups,and the effectiveness of the two groups was evaluated.The pain improvement was compared before treatment and after 3 months of treatment in the Chinese medicine and western medicine group.Results There was no statistically significant difference in UA,CRP and VAS between the two groups before treatment(P>0.05).After 20 days of treatment,the UA,CRP and VAS in the two groups were lower than those before treatment,and the differences between the two groups were statistically significant(P<0.05).The healing rate in the Chinese medicine and western medicine group was 100%,which was significantly better than that of 14%in the western medicine group(P<0.05).Before treatment,the pain function grading was excellent in 0 case,good in 4 cases,fair in 38 cases,and poor in 8 cases.After three months of treatment,21 cases were excellent,29 cases were good,0 case was fair,and 0 case was poor.Compared between the CI before treatment(0.699,0.777)and the CI after treatment(0.224,0.300),the smaller the value,the better the therapeutic effect.Conclusion Self-made Jiangsuan recipe combined with febuxostat can significantly reduce serum uric acid and C-reactive protein,and reduce pain score,which is significantly better than the application of febuxostat alone.For acute refractory gouty arthritis,this recipe has a significant efficacy,with low cost and feasibility for long-term use,which is worthy of clinical promotion.