针灸联合蠲痹汤对湿热瘀阻型痛风的疗效及部分机制的研究

The therapeutic effect of acupuncture plus the Juanbi decoction on gout of the dampness-heat and blood stasis type and its partial mechanism

目的:探讨针灸联合蠲痹汤对湿热瘀阻型痛风的疗效及其作用机制。方法:将150例湿热瘀阻型痛风患者按数字随机原则分成两组,每组75例。对照组常规宣教,并口服止痛药物和降尿酸药物,研究组在对照组基础上加用针灸联合蠲痹汤治疗,均治疗10 d。观察两组炎症指标、免疫球蛋白、疼痛视觉模拟评分法(Visual Analogue Scale,VAS)评分、数字分级法(Numeric Rating Scales,NRS)-11评分、疗效变化。结果:两组治疗后VAS评分、NRS-11评分明显下降,其中研究组评分低于对照组(P<0.05)。研究组临床总有效率显著优于对照组(P<0.05)。两组治疗后C反应蛋白、白细胞介素-1β、血尿酸、红细胞沉降率、环氧合酶-2、免疫球蛋白(Immunoglobulin,Ig)A、IgE、IgM、IgG水平均较治疗前显著下降(P<0.05),研究组下降幅度均高于对照组(P<0.05)。结论:针灸联合蠲痹汤能抑制炎症反应,改善免疫功能,从而缓解疼痛,提高疗效。

Objective:To explore the therapeutic effect of acupuncture plus the Juanbi decoction(蠲痹汤)on gout of the dampness-heat and blood stasis type and its partial mechanism.Methods:150 cases were randomly divided into two groups,75 cases in each group.The control group received routine education,oral analgesic and uric-lowering medications for 10 days.The study group was treated by acupuncture plus the Juanbi decoction for 10 days.Results:The VAS score and NRS-11 score in the two groups were all decreased significantly after treatment,and in the study group were lower than the control group(P<0.05).The total efficiency in the study group was significantly better than the control group(P<0.05).The levels of C-reactive protein,interleukin-1β,serum uric acid,erythrocyte sedimentation rate,cyclooxygenase-2,IgA,IgE,IgM and IgG in the two groups after treatment were significantly lower than those before treatment(P<0.05),and the decreased range in the study group was bigger than the control group(P<0.05).Conclusion:Acupuncture plus the Juanbi decoction on gout of the dampness-heat and blood stasis type can inhibit inflammation,and improve immune function,thereby relieving pain and improving curative effects.