千金涤浊汤联合隔姜艾灸辅助治疗痛风伴高尿酸血症脾虚湿阻证33例临床观察

Clinical observation on 33 cases of migratory arthralgia accompanied with hyperuricemia with insufficiency of the spleen and obstruction of dampness syndrome treated by Qianjin Dizhuo Tang(千金涤浊汤)combined with ginger-partition moxibustion as adjuncti

目的观察千金涤浊汤联合隔姜艾灸辅助治疗痛风伴高尿酸血症(HUA)脾虚湿阻证的临床疗效。方法将66例痛风伴HUA脾虚湿阻证患者采用随机数字表法分为治疗组和对照组,各33例。对照组给予非布司他片和碳酸氢钠片口服,治疗组在对照组治疗方法的基础上给予千金涤浊汤联合隔姜艾灸治疗。2组均连续治疗1个月为1个疗程,3个疗程后比较2组的临床疗效、痛风急性发作率、不良反应发生率,治疗前后的中医证候积分及血清血尿酸、白细胞介素(IL)-1β、IL-6和肿瘤坏死因子-α(TNF-α)水平。结果对照组总有效率为69.70%(23/33),治疗组为90.91%(30/33),2组比较差异有统计学意义(P<0.05);治疗后2组中医证候积分及血清血尿酸、IL-1β、IL-6和TNF-α水平均明显降低,与同组治疗前比较差异有统计学意义(P<0.05或P<0.01),且治疗组各项指标降低更明显,与对照组治疗后比较差异均有统计学意义(P<0.05或P<0.01);对照组痛风急性发作率为27.27%(9/33),治疗组为6.06%(2/33),2组比较差异有统计学意义(P<0.01);对照组总不良反应发生率为24.24%(8/33),治疗组为6.06%(2/33),2组比较差异有统计学意义(P<0.01)。结论千金涤浊汤联合隔姜艾灸辅助治疗痛风伴HUA脾虚湿阻证临床疗效显著,可有效改善患者的临床症状,促进血尿酸排泄,降低机体炎性因子,减少痛风的急性发作及药物不良反应,值得临床推广应用。

Objective To observe the clinical efficacy of Qianjin Dizhuo Tang(千金涤浊汤)combined with ginger-partition moxibustion in adjunctive treatment of migratory arthralgia accompanied with hyperuricemia(HUA)with insufficiency of the spleen and obstruction of dampness syndrome.Methods Sixty-six cases of migratory arthralgia accompanied with HUA with insufficiency of the spleen and obstruction of dampness syndrome were divided into treatment group and control group according to random number table method,with 33 cases in each.The control group was given oral administration of febuxostat tablets and sodium bicarbonate tablets,while the treatment group was given Qianjin Dizhuo Tang combined with ginger-partition moxibustion based on the therapeutic method of the control group.The 2 groups were both given consecutive treatment for 1 month as 1 course of treatment.After 3 courses,the clinical efficacy,the acute incidence rate of migratory arthralgia,the incidence of adverse reactions,the TCM symptom score,the levels of serum blood uric acid,interleukin(IL)-1β,IL-6 and tumor necrosis factor-α(TNF-α)before and after treatment of the 2 groups were compared.Results The total effective rate of the control group was 69.70%(23/33),that of the treatment group was 90.91%(30/33),and the difference between the 2 groups was statistically significant(P<0.05).After treatment,TCM symptom score,the levels of serum blood uric acid,IL-1β,IL-6 and TNF-αall significantly decreased,and the difference was statistically significant compared with the same group before treatment(P<0.05 or P<0.01),moreover,various indexes of the treatment group decreased more significantly,and the difference was statistically significant compared with those of the control group after treatment(P<0.05 or P<0.01).The acute incidence rate of migratory arthralgia in the control group was27.27%(9/33),that of the treatment group was 6.06%(2/33),and the difference was statistically significant between the 2 groups(P<0.01).The total adverse reactions rate of the control group was 24.24%(8/33),that of the treatment group was 6.06%(2/33),and the difference was statistically significant between the 2 groups(P<0.01).Conclusion It has marked clinical efficacy and can effectively improve the clinical symptoms of patients,promote the excretion of blood uric acid,reduce the inflammatory factors of the body,reduce the acute attack of migratory arthralgia,and the adverse drug reactions to use Qianjin Dizhuo Tang combined with ginger-partition moxibustion in adjunctive treatment of migratory arthralgia accompanied with HUA with insufficiency of the spleen and obstruction of dampness syndrome.It is worthy of clinical promotion and application.