妙苓仙子汤治疗湿热蕴结型痛风性关节炎急性发作期的疗效观察

Efficacy of Miaoling Xianzi decoction for syndrome of accumulated dampness-heat of acute gouty arthritis

目的观察妙苓仙子汤治疗湿热蕴结型痛风性关节炎急性发作期的临床疗效。方法将90例湿热蕴结型痛风性关节炎急性发作期患者随机分为3组。中药组予妙苓仙子汤,对照组予秋水仙碱,联合组予妙苓仙子汤联合秋水仙碱,每组30例。3组疗程均为1个月,观察关节疼痛评分、关节肿胀评分、关节功能评分、中医证候积分以及尿酸(UA)、炎症指标、肾功能和不良反应;统计对照组、联合组的秋水仙碱减量所需时间。结果①治疗后联合组关节疼痛、肿胀、功能评分均低于中药组、对照组(P<0.05),中药组、对照组两组的评分差异无统计学意义(P>0.05)。②治疗后中药组、联合组的中医证候积分低于对照组(P<0.05)。③中药组、联合组降尿酸(UA)疗效明显优于对照组(P<0.01),3组的白细胞(WBC)、红细胞沉降率(ESR)、C反应蛋白(CRP)、血肌酐(SCR)、血尿素氮(BUN)水平差异均无统计学意义(P>0.05)。④中药组、联合组不良反应发生率低于对照组(P<0.05)。⑤联合组的秋水仙碱减量所需时间少于对照组(P<0.05)。结论妙苓仙子汤治疗湿热蕴结型痛风性关节炎急性发作期在抗炎止痛疗效上不劣于秋水仙碱,同时具有降尿酸作用,且不良反应发生概率较小。

Objective To observe the clinical effect of the Miaoling Xianzi decoction for the syndrome of accumulated dampness-heat of acute gouty arthritis.Methods Ninety patients with the syndrome of accumulated dampness-heat of acute gouty arthritis were randomly divided into three groups.The tradition-medicine group was treated with Miaoling Xianzi decocti〗on.The modern-medicine group was treated with colchicine.The tradition-modern medicine group was treated with Miaoling Xianzi decoction and colchicine.There were 30 cases in each group,which was followed up for 1 month,and recorded joint pain score,joint swelling score,joint function score,TCM symptom score,uric acid(UA)level,inflammatory cytokines,kidney function and adverse reactions before and after treatment in each group.Calculate the time required for the reduction of colchicine in the modern-medicine group and the tradition-modern medicine group.Results(1)After treatment,the joint pain score,joint swelling score,and joint function score of the traditionmodern medicine group were lower than tradition-medicine group and modern-medicine group(P<0.05).There was no significant difference between thetradition-medicine group and modern-medicine group(P>0.05).(2)After treatment,the improvement of TCM symptoms of the tradition-medicine group and the tradition-modern medicine group is better than that of modern-medicine group(P<0.05).(3)The efficacy of uric acid(UA)of the tradition-medicine group and the tradition-modern medicine group was significantly better than the modern-medicine group(P<0.01).There was no statistical difference in the White blood cells(WBC),Erythrocyte sedimentationrate(ESR),C-reactive protein(CRP),Serum creatinine(SCR)and Blood urea nitrogen(BUN)in three groups(P>0.05).(4)The adverse reaction rate of the tradition-medicine group and the tradition-modern medicine group were significantly lower than the modern-medicine group(P<0.05).(5)The time required for colchicine reduction in the tradition-modern medicine group was less than the modern-medicine group(P<0.05).Conclusion Miaoling Xianzi decoction is not inferior to anti-inflammation and to relieve pain than colchicine in the treatment for accumulated dampness-heat of acute gouty arthritis,with the effect of lower uric acid and lower probability of adverse reactions.