清热利湿汤治疗湿热蕴结型急性痛风性关节炎的疗效

Qingre Lishi Decoction in the treatment of damp-heat accumulation type acute gout arthritis

目的观察清热利湿汤治疗湿热蕴结型急性痛风性关节炎的临床疗效。方法将2017年2月至2018年2月天水市中医医院门诊及住院治疗的104例急性痛风性关节炎患者随机分为治疗组和对照组,每组各52例。两组均给予西药常规治疗,在此基础上,对照组给予双氯芬酸钠缓释片治疗,治疗组予以清热利湿汤治疗。比较治疗前后两组疗效、临床症状体征及实验室指标尿酸(UA)、白细胞计数(WBC)、中性粒细胞百分比(N%)、红细胞沉降率(ESR)、hs-CRP的变化。结果两组患者治疗后关节肿胀指数、VAS评分均较治疗前低,且治疗组低于对照组,差异有统计学意义(P<0.01)。与治疗前相比,两组治疗后UA、ESR、hs-CRP、N%均降低(P<0.01),治疗组WBC降低(P<0.05);与对照组对比,治疗组UA、WBC明显降低(P<0.01),其余指标差异均无统计学意义(P>0.05)。治疗组总有效率明显高于对照组,差异有统计学意义(94.23%vs 78.84%,P<0.05)。结论对湿热蕴结型急性痛风性关节炎患者清热利湿汤抗炎止痛疗效显著,可改善临床症状体征,降低血清尿酸水平。

Objective To investigate the clinical effect of Qingre Lishi Decoction in the treatment of damp-heat accumulation acute gout arthritis.Methods A total of 104 acute gout arthritis with damp-heat accumulation type who received treatment from February 2017 to February 2018 at Tianshui Hospital of Chinese Medicine were selected and divided into treatment group and control group(n=52,each).Both groups was treated with routine western medicine treatment.Control group was given extra diclofenac sodium sustained release tablets.Treatment group was given Qingre Lishi Decoction.The curative effect, clinical symptoms and signs, laboratory indexes [uric acid(UA), WBC count, neutrophil percentage(N%),erythrocyte sedimentation rate(ESR) and hs-CRP] were compared between the two groups before and after treatment.Results The joint swelling index and VAS score of the two groups decreased after the treatment, and those in treatment group were lower than control group(P<0.01).Compared with before treatment, UA, ESR,hs-CRP and N% were decreased in both groups after treatment(P<0.01).After the treatment, WBC count in treatment group decreased(P<0.05). UA and WBC in the treatment group was significantly lower than that in the control group(P<0.01).There was no significant difference in other indexes(P>0.05).The total effective rate of the treatment group was significantly higher than that of the control group(94.23% vs 78.84%,P<0.05).Conclusion Qingre Lishi Decoction has a significant curative effect of anti-inflammation and pain relief in the treatment of damp-heat accumulation type acute gout arthritis, which could improve clinical symptoms and signs and reduce serum UA level.