黄连素辅助治疗急性痛风性关节炎的疗效及对炎性因子水平的影响

Clinical efficacy of berberine in treatment of acute gouty arthritis and its effect on serum levels of inflam-mation factors

目的探讨黄连素辅助治疗急性痛风性关节炎(AGA)的临床疗效及对炎性因子水平的影响。方法选取64例AGA患者,随机分成两组,每组32例。对照组口服依托考昔片,观察组在对照组基础上口服黄连素片。观察两组临床疗效、不良反应及复发率,比较两组治疗前后关节炎积分、C反应蛋白(CRP)、血沉(ESR)、血尿酸(UA)及炎性因子[白细胞介素-1β(IL-1β)、环氧合酶-2(COX-2)、核苷酸结合寡聚化结构域样受体3(NALP3)及转化生长因子-β(TGF-β)]水平。结果观察组总有效率为93.75%,较对照组(81.25%)明显增高(P<0.05);观察组与对照组不良反应总发生率(6.25%、9.38%)差异无统计学意义(P>0.05);观察组复发率(10.00%)明显低于对照组的(23.08%),差异有统计学意义(P<0.05)。两组治疗后关节炎积分均较治疗前显著降低(P<0.05),且观察组明显低于对照组(P<0.05)。两组治疗后CRP、ESR、UA水平均较治疗前明显下降(P<0.05),且观察组CRP、ESR、UA水平均低于对照组(P<0.05)。两组治疗后IL-1β、COX-2、NALP3、TGF-β水平均较治疗前明显降低(P<0.05),且观察组IL-1β、COX-2、NALP3、TGF-β水平均低于对照组(P<0.05)。结论黄连素辅助治疗AGA临床疗效显著,具有较好的安全性,能有效降低患者CRP、ESR、UA水平,有效减轻炎症反应。

Objective To explore the clinical efficacy of berberine in the treatment of acute gouty arthritis(AGA)and its effect on the serum levels of inflammation factors.Methods A total of 64 AGA patients were randomly divided into control group(n=32)treated with etoricoxib and observation group(n=32)treated with etoricoxib plus berberine.The clinical efficacy,adverse reactions and recurrent rate of the two groups were observed.Arthritis scores,the serum levels of CRP,ESR,UA,and inflammation factors(IL-1β,COX-2,NALP3 and TGF-β)were compared before and after treatment.Results The total effective rate in the observation group was 93.75%,which was significantly higher than that of the control group(81.25%)(P<0.05).There was no statistical difference in the total incidence of adverse reactions between the two groups(6.25%vs.9.38%,P>0.05).The recurrent rate in the observation group was lower than that of the control group(10.00%vs.23.08%,P<0.05).After treatment,the arthritis scores in the two groups were significantly lower than those before treatment(P<0.05),and the scores in the observation group were lower than those in the control group(P<0.05).Compared with that before treatment,the level of CRP,ESR and UA of the two groups were significantly decreased after treatment(P<0.05),and the level of these indexes in the observation group was lower than that in the control group(P<0.05).Compared with that before treatment,the level of IL-1β,COX-2,NALP3 and TGF-βof the two groups were significantly decreased after treatment(P<0.05),and the level of these indexes in the observation group was lower than that in the control group(P<0.05).Conclusion There is good efficiacy in AGA patients treated with with berberine and it is safe.It can reduce not only the level of CRP,ESR and UA,but also the inflammatory response effectively.