中药外敷内服治疗急性痛风性关节炎的临床观察

Clinical observation in the treatment of acute gouty arthritis by external application and oral administration of traditional Chinese medicine

目的观察三黄膏外敷联合当归活血液内服治疗急性痛风性关节炎瘀热阻滞型的临床疗效。方法选取2018年12月至2019年12月在长沙市中医医院门诊治疗的急性痛风性关节炎患者68例,采用随机数字表法分为对照组和治疗组,每组各34例。对照组口服秋水仙碱和塞来昔布;治疗组外敷三黄膏和内服当归活血液。治疗7 d,观察两组治疗前与治疗1、4、7 d后关节疼痛视觉模拟评分法(VAS)和关节肿胀评分;两组临床疗效;治疗前后尿酸(UA)、红细胞沉降率(ESR)、C反应蛋白(CRP)水平;两组不良反应发生情况。结果治疗7 d后,两组临床疗效比较,差异无统计学意义(P>0.05),但治疗组的总有效率(97.1%)高于对照组的总有效率(88.2%)。治疗1 d后,两组VAS评分与治疗前比较均改善(P<0.05),但两组间比较差异无统计学意义(P>0.05);治疗组与治疗前比较关节肿胀好转(P<0.05),对照组关节肿胀无明显变化(P>0.05)。治疗4、7 d后,两组关节肿胀和VAS评分与治疗前比较均继续改善(P<0.05);治疗组均优于对照组(P<0.05)。治疗后,两组ESR、CRP、UA均下降,且治疗组低于对照组,差异有统计学意义(P<0.05)。结论三黄膏外敷联合当归活血液内服治疗急性痛风性关节炎起效快,疗效好。

Objective To observe the clinical efficacy of external application of Sanhuang Ointment combined with oral administration of Danggui Huoxue Liquid in the treatment of acute gouty arthritis with syndrome of blockade of static blood and heat.Methods A total of 68 patients with acute gouty arthritis admitted to the outpatient department of Changsha Hospital of Traditional Chinese Medicine from December 2018 to December 2019 were selected and divided into the control group(n=34)and the treatment group(n=34)according to the random number table method.Colchicine and celecoxib were taken orally in the control group,while external application of Sanhuang Ointment combined with oral administration of Danggui Huoxue Liquid was taken orally in the treatment group.After 7 days of treatment,visual analogue scale(VAS)of joint pain and scores of joint swelling were observed before and after 1,4 and 7 days of treatment;The clinical effect of two groups;Meanwhile,the levels of uric acid(UA),erythrocyte sedimentation rate(ESR)and c-reactive protein(CRP)before and after treatment were observed before and after treatment;The adverse reactions of the two groups.Results After 7 days of treatment,there was no statistically significant difference in clinical efficacy between the treatment group and the control group(P>0.05),but the total efficacy rate of the treatment group was 97.1%,which was higher than 88.2%of the control group.After 1 day of treatment,VAS scores of both groups were improved compared with before treatment(P<0.05),but there was no significant difference between the two groups(P>0.05).The joint swelling in the treatment group was improved compared with before treatment(P<0.05),while there was no significant difference in the joint swelling in the control group(P>0.05).After 4 and 7 days of treatment,scores of joint swelling and VAS of both groups continued to be improved compared with before treatment(P<0.05).The treatment group were all superior to the control group(P<0.05).After treatment,ESR,CRP and UA decreased in both groups,and the treatment group was lower to the control group,with statistically significant difference(P<0.05).Conclusion External application of Sanhuang Ointment combined with oral administration of Danggui Huoxue Liquid works rapidly and effectively in treating acute gouty arthritis.