微针刀联合白虎桂枝汤对急性痛风性关节炎的疗效及炎症因子的影响

Therapeutic Efficacy of Micro-needle Knife Combined with Bai Hu Gui Zhi Decoction for Acute Gouty Arthritis and Its Effects on Inflammatory Factors

目的观察微针刀联合白虎桂枝汤加减治疗急性痛风性关节炎的疗效及其对炎症因子的影响。方法纳入急性痛风性关节炎患者134例,随机分为治疗组和对照组,每组67例。对照组予口服白虎桂枝汤加减,治疗组在对照组治疗基础上予微针刀治疗。观察两组治疗前后关节疼痛、关节压痛、关节肿胀、关节活动障碍的变化,记录每日疼痛评分、疼痛缓解时间和疼痛消失时间,治疗前后分别检测血尿酸(UA)、C-反应蛋白(CRP)、红细胞沉降率(ESR)、白细胞介素(IL)-1b、IL-6、IL-8和肿瘤坏死因子(TNF)-a。结果两组治疗后关节疼痛、关节压痛、关节肿胀、活动障碍评分均较治疗前明显降低(P<0.05),且治疗组治疗后的上述评分均低于对照组(P<0.05)。治疗组疼痛缓解时间和疼痛消失时间均短于对照组(P<0.05)。两组治疗后血ESR、CRP、UA、IL-1b、IL-6、IL-8和TNF-a水平均较治疗前降低(P<0.05),且治疗组治疗后血ESR、CRP、UA、IL-1b、IL-6、IL-8和TNF-a水平均低于对照组(P<0.05)。治疗组临床总有效率优于对照组,差异有统计学意义(P<0.05)。结论微针刀联合白虎桂枝汤治疗急性痛风性关节炎可有效改善患者临床症状,缓解和消除疼痛,并抑制相关炎症反应。

Objective To observe the therapeutic efficacy of micro-needle knife plus modified Bai Hu Gui Zhi decoction in treating acute gouty arthritis and its effects on inflammatory factors.Method A total of 134 patients with acute gouty arthritis were recruited and randomized into a treatment group and a control group,with 67 cases in each group.The control group was intervened by oral administration of modified Bai Hu Gui Zhi decoction,while the treatment group was given additional micro-needle knife treatment.Joint pain and tenderness,joint swelling and joint motor dysfunction were observed before and after treatment in the two groups;daily pain score,pain reducing time and pain releasing time were recorded;serum uric acid(UA),C-reactive protein(CRP),erythrocyte sedimentation rate(ESR)of red blood cells(RBCs),interleukin(IL)-1β,IL-6,IL-8 and tumor necrosis factor(TNF)-αwere also detected before and after treatment.Result The scores of joint pain,tenderness,swelling and motor dysfunction declined significantly after intervention in both groups(P<0.05),and were lower in the treatment group than in the control group(P<0.05).The lengths of time taken for pain to reduce and release were shorter in the treatment group than those in the control group(P<0.05).The levels of serum ESR,CRP,UA,IL-1β,IL-6,IL-8 and TNF-αdecreased after treatment in the two groups(P<0.05),and were lower in the treatment group than in the control group(P<0.05).The total effective rate was higher in the treatment group than in the control group,and the difference was statistically significant(P<0.05).Conclusion Micro-needle knife plus Bai Hu Gui Zhi decoction can effectively improve the clinical symptoms,reduce and release pain,and inhibit relevant inflammatory responses in treating acute gouty arthritis.