黄芩清热除痹胶囊配合中药外敷治疗急性痛风性关节炎的效果及对细胞因子的影响

Effects of Huangqin Qingre Chubi Capsule united with Furong Ointment on the efficacy and cytokines of acute gouty arthritis

目的观察黄芩清热除痹胶囊(Huangqin Qingre Chubi capsule,HQC)口服配合芙蓉膏(Furong Ointment,FRO)外敷治疗急性痛风性关节炎(AGA)患者的临床疗效及对细胞因子的影响。方法选取2017年1月至2019年3月安徽中医药大学第一附属医院风湿免疫科92例AGA患者,按随机数字表法分为治疗组与对照组各46例,对照组使用非甾类消炎止痛药,治疗组在此基础上加用HQC口服配合FRO外敷肿痛关节区,疗程为7 d,同时选择46名健康组。应用ELISA法检测血清白细胞介素-1β(IL-1β)、肿瘤坏死因子α(TNF-α)、白细胞介素-4(IL-4)、白细胞介素-10(IL-10),仪器法检测红细胞沉降率(ESR),生化仪检测超敏C反应蛋白(hs-CRP),并观察患者视觉模拟评分法(VAS)评分、关节肿胀评分、中医证候积分。结果(1)治疗组总有效率93.48%,对照组为76.09%,治疗组明显优于对照组(P<0.05);(2)两组患者治疗后VAS评分、关节肿胀、中医证候积分、ESR、hs-CRP均明显降低(P<0.05或P<0.01);与对照组相比,治疗组VAS评分、关节肿胀、ESR、hs-CRP均明显降低(P<0.05或P<0.01);(3)与健康组相比,AGA患者TNF-a、IL-1β显著升高,IL-4、IL-10显著降低(P<0.01);(4)两组患者治疗后TNF-a、IL-1β显著降低,IL-4、IL-10显著升高(P<0.01);与对照组相比,治疗组TNF-a显著降低,IL-10显著升高(P<0.05或P<0.01)。结论HQC口服配合FRO外敷治疗AGA疗效显著,不仅能显著改善患者临床症状,而且能明显降低炎性反应。

Objective To observe the efficacy and cytokines of using Huangqin Qingre Chubi capsule orally united with Furong Ointment external application to treat acute gouty arthritis(AGA)patients.Methods 92 AGA patients were assigned randomly to treatment group and control group.Both groups were given non-steroidal anti-inflammatory drugs,and the treatment group were given Huangqin Qingre Chubi capsule orally united with Furong Ointment external application on swelling joints.And a healthy normal group of 46 cases was established.Enzyme linked immunosorbent assay(ELISA)were employed to measure the expression levels of IL-1β,TNF-α,IL-4,IL-10.Erythrocyte sedimentation rate(ESR)was detected by Instrument method.C-reactive protein were detected by automatic biochemical analyzer.Observed VAS,Joint swelling score and TCM syndrome score in two groups of patients.Results The total effective rate was 93.48%in the treatment group and 76.09%in the control group,which was significantly better than that in the control group(P<0.05).VAS,Joint swelling score,TCM syndrome score,ESR and hs-CRP were significantly decreased after treatment in two groups(P<0.01),VAS,Joint swelling score,ESR and hs-CRP were more significantly decreased compared with after control group(P<0.05 or P<0.01).Compared with normal control group,level of IL-1βand TNF-ɑwere significantly increased,IL-4 and IL-10 were significantly decreased(P<0.01);TNF-a and IL-1βwere significantly decreased,IL-4 and IL-10 were significantly increased after treatment in two groups(P<0.05 or P<0.01).Conclusion Huangqin Qingre Chubi capsule orally united with Furong Ointment external application is effective in treating AGA,which could not only significantly improve the clinical symptoms of the patients,but also significantly reduce the inflammatory response.