加味四妙汤对痛风急性发作患者血清炎症因子及NALP3表达水平的影响

Effect of Simiao Decoction on Serum Inflammatory Factors and NALP3 Expression in Patients with Acute Gout Attack

【目的】探讨加味四妙汤对痛风急性发作患者血清炎症因子及核苷酸结合寡聚化结构域样受体3(NALP3)表达水平的影响。【方法】选取2019年2月至2020年1月本院住院确诊的痛风性关节炎急性发作期患者102例,随机分为观察组及对照组,两组患者各51例。两组患者均进行基本生活的干预,对照组患者使用秋水仙碱治疗,观察组患者在此基础上加用加味四妙汤治疗,每日1剂;两组患者均连续治疗14d。比较两组患者治疗前后白介素-6(IL-6)、白介素-8(IL-8)、白介素-1β(IL-1β)、血尿酸及NALP3水平变化。【结果】治疗后,观察组患者总有效率为92.16%(47/51),显著高于对照组的74.51%(38/51),且差异有统计学意义(P<0.05);治疗后,观察组患者IL-6、IL-8、IL-1β、血尿酸及NALP3水平均低于对照组及治疗前(P<0.05)。观察组患者治疗后中医证候评分及关节局部症状评分低于治疗前及对照组(P<0.05);治疗后两组患者不良反应发生率相比较差异无统计学意义(P>0.05)。【结论】痛风急性发作患者使用加味四妙汤进行治疗能有效缓解关节症状,降低炎症反应及尿酸水平,抑制血清NALP3炎性体的活化,有一定临床意义。

【Objective】To investigate the effect of Simiao Decoction on the expression level of inflammatory cytokines and nucleotide binding oligomerization domain-like receptor 3(NALP3)in patients with acute attack of gout.【Methods】A total of 102 patients with acute onset of gouty arthritis,who were diagnosed in the inpatient department of our hospital from February 2019 to January 2020,were selected and divided into the observation group and the control group according to the random number table method,with 51 patients in each group.Patients in the control group were treated with colchicine,while patients in the observation group were additionally treated with supplemented Simiao decoction(1 dose per day).Both groups were treated for 14 days continuously.The levels of interleukin-6(IL-6),interleukin-8(IL-8),interleukin-1(IL-1)and NALP3 before and after treatment were compared between the two groups.【Results】The total effective rate in the observation group was 92.16%(47/51),which was significantly higher than that of 74.51%(38/51)in the control group(P<0.05).After treatment,the levels of IL-6,IL-8,IL-1,serum uric acid and NALP3 in the observation group were lower than those in the control group and before treatment(P<0.05).The scores of TCM syndromes and local joint symptoms in the observation group were lower than those in the control group and before treatment(P<0.05).There was no statistically significant difference in the incidence of adverse reactions after treatment between the two groups(P>0.05).【Conclusion】The treatment of acute gout patients with flavored Simiao decoction can effectively relieve joint symptoms,reduce inflammatory response and uric acid level,and inhibit the activation of serum NALP3 inflammatory body,which is of certain clinical significance.