四妙汤联合中药外敷治疗痛风性关节炎临床观察

Clinical Observation on Simiao Decoction Combined with External Application of Traditional Chinese Medicine in the Treatment of Gouty Arthritis

目的系统性评价四妙汤联合中药外敷治疗对痛风性关节炎患者的临床效果。方法选取自2018年5月—2019年5月于抚顺市中医院内三科病房住院并接受治疗的痛风性关节炎患者60例,入组病例均采用信封法随机分为对照组和试验组。对照组30例,应用四妙汤内服治疗,试验组30例,在对照组基础上联合关节中药外敷治疗,观察2组患者治疗前后骨关节中医证候积分、关节肿痛缓解时间及血尿酸水平变化情况。结果经临床治疗,试验组中医证候评分(6.13±2.81)分,症状缓解时间(1.72±0.56)d,血尿酸(452.59±52.45)μmol/L,对照组中医证候评分(10.43±3.16)分,症状缓解时间(3.12±0.73)d,血尿酸(512.64±67.26)μmol/L,试验组均优于对照组,组间差异有统计学意义(P <0.05)。结论四妙汤联合关节中药外敷治疗可有效改善机体嘌呤代谢紊乱,加速血尿酸排泄并抑制骨关节的尿酸盐结晶沉积,快速消除关节肿痛症状的同时,提高患者关节功能恢复,疏风清热、消肿止痛、舒筋活血、通经活络,中药内外联合应用疗效显著,值得临床推广。

Objective To systematically evaluate the clinical effects of Simiao decoction combined with external application of traditional Chinese medicine on patients with gouty arthritis.Methods 60 patients with gouty arthritis were enrolled.The enrolled patients were randomly divided into control group and experimental group by envelope method.Thirty patients in the control group were treated with Simiao fecoction orally,and 30 patients in the experimental group were treated with Chinese herbal medicine on the basis of the control group.The TCM syndromes score of bone and joint,the relief time of joint swelling and pain and the changes of blood uric acid level were observed before and after treatment in the 2 groups.Results After clinical treatment,in the the experimental group,TCM syndrome score was(6.13±2.81)points,symptom relief time was(1.72±0.56)d,serum uric acid was(452.59±52.45)mol/L.In the control group,TCM syndrome score was(10.43±3.16)points,symptom relief time was(3.12±0.73)d,serum uric acid was(512.64±67.26)mol/L,the experimental group was better than the control group,and the difference between the groups was statistically significant(P<0.05).Conclusion Simiao decoction combined with external Chinese herbal medicine can effectively improve the body’s metabolic disorder,accelerate blood uric acid excretion and inhibit the deposition of urate crystals of bones and joints,which is worthy of clinical promotion.