脚痹十味流气饮对急性痛风性关节炎寒湿痹阻型患者临床症状及血清TNF-α、IL-6、CRP、SUA水平的影响

Effect of Jiaobi Shiwei Liuqi Decoction on clinical symptoms and serum tumor necrosis factor-α, interleukin-6,C-reactive protein, and serum uric acid levels in patients with acute gouty arthritis of cold-dampness obstruction type

目的探讨脚痹十味流气饮对急性痛风性关节炎寒湿痹阻型患者临床症状及血清肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、C反应蛋白(CRP)、血尿酸(SUA)水平的影响。方法回顾性分析南方医科大学南方医院白云分院和广州中医药大学第一附属医院白云医院2019年6月至2020年8月收治的92例急性痛风性关节炎寒湿痹阻型患者的临床资料,按治疗方式的不同分为观察组和对照组,每组46例,对照组患者给予口服双氯芬酸钠肠溶片治疗,观察组在对照组治疗的基础上给予脚痹十味流气饮治疗,两组疗程均为1周。参照中药新药临床研究指导原则,评价两组患者治疗前及治疗1周后的临床症状评分,检测并比较两组患者治疗前及治疗1周后的血清TNF-α、IL-6、CRP、SUA水平,并评估治疗期间不良反应的发生情况。结果治疗前,两组患者的关节活动障碍、急性红肿、压痛、疼痛评分比较差异均无统计学意义(P>0.05);治疗1周后,观察组患者的关节活动障碍、急性红肿、压痛、疼痛评分分别为(1.74±0.52)分、(1.17±0.32)分、(0.84±0.13)分、(4.13±0.57)分,明显低于对照组的(2.81±0.30)分、(1.64±0.28)分、(1.25±0.17)分、(5.35±0.62)分,差异均有统计学意义(P<0.05);治疗前,两组患者的血清TNF-α、IL-6、CRP、SUA水平比较差异均无统计学意义(P>0.05);治疗1周后,观察组患者的血清TNF-α、IL-6、CRP、SUA水平分别为(37.82±5.35)pg/mL、(28.14±6.95)pg/mL、(6.73±2.50)mg/L、(335.14±60.79)μmol/L,明显低于对照组的(46.37±6.09)pg/mL、(32.06±8.05)pg/mL、(11.15±3.78)mg/L、(417.06±67.05)μmol/L,差异均有统计学意义(P<0.05);观察组患者的不良反应发生率为6.52%,略低于对照组的15.22%,但差异无统计学意义(P>0.05)。结论脚痹十味流气饮能显著改善急性痛风性关节炎寒湿痹阻型患者的临床症状,有效降低血清TNF-α、IL-6、CRP、SUA表达水平,值得临床推广应用。

Objective To explore the effects of Jiaobi Shiwei Liuqi Decoction on clinical symptoms and serum levels of tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),C-reactive protein(CRP),and serum uric acid(SUA)in patients with acute gouty arthritis of cold-dampness obstruction type.Methods The clinical data of 92 patients with acute gouty arthritis of cold-dampness obstruction type admitted by Baiyun Hospital of the First Affiliated Hospital of Guangzhou University of Chinese Medicine from June 2019 to August 2020 were analyzed retrospectively.They were divided into an observation group and a control group according to the different treatment methods,with 46 cases in each group.The control group was given treatment with diclofenac Sodium Enteric-coated Tablets,while the observation group was treated with Jiaobi Shiwei Liuqi Decoction on the basis of the control group.Both groups were treated for 1 week.According to the guiding principles of clinical research of new traditional Chinese Medicine,the clinical symptom scores between the two groups before and 1 week after treatment were evaluated.The levels of serum TNF-α,IL-6,CRP,and SUA between the two groups before and 1 week after treatment were detected and compared,and the occurrence of adverse reactions during treatment was evaluated.Results Before treatment,there was no significant difference in the scores of joint movement disorder,acute swelling,tenderness,and pain between the two groups(P>0.05).One week after treatment,the joint dysfunction,acute redness,tenderness,and pain scores in the observation group were(1.74±0.52)points,(1.17±0.32)points,(0.84±0.13)points,(4.13±0.57)points,which were significantly lower than(2.81±0.30)points,(1.64±0.28)points,(1.25±0.17)points,and(5.35±0.62)points in the control group(P<0.05).Before treatment,there was no significant difference in serum TNF-α,IL-6,CRP,and SUA levels between the two groups(P>0.05).One week after treatment,the serum TNF-α,IL-6,CRP,and SUA levels in the observation group were(37.82±5.35)pg/mL,(28.14±6.95)pg/mL,(6.73±2.50)mg/L,(335.14±60.79)μmol/L,which were significantly lower than(46.37±6.09)pg/mL,(32.06±8.05)pg/mL,(11.15±3.78)mg/L,(417.06±67.05)μmol/L in the control group(P<0.05).The incidence of adverse reactions in the observation group was 6.52%,which was slightly lower than 15.22%in the control group,with no statistically significant difference(P>0.05).Conclusion Jiaobi Shiwei Liuqi Decoction can sig-nificantly improve the clinical symptoms of patients with acute gouty arthritis of cold dampness obstruction type,and ef-fectively reduce serum TNF-α,IL-6,CRP,SUA levels,which is worthy of clinical application.