清热祛湿汤治疗湿热蕴结型痛风性关节炎疗效观察

Curative effect of Qingre Qushi Decoction in the treatment of gouty arthritis of damp-heat accumulation syndrome

目的观察清热祛湿汤治疗湿热蕴结型痛风性关节炎的临床疗效。方法选取2019年8月至2021年12月首都医科大学附属北京中医医院风湿科门诊湿热蕴结型痛风性关节炎患者80例,按照随机数字表法分为治疗组和对照组,各40例。对照组采用口服非布司他、控制饮食等常规治疗,治疗组在对照组基础上联合中药清热祛湿汤治疗,连续治疗4周。比较2组治疗前后中医证候各项评分及总分,比较血清白细胞介素6(IL-6)、C反应蛋白(CRP)、血尿酸(UA)水平变化,评估2组临床疗效,并记录治疗期间不良反应发生情况。结果治疗后2组中医证候各项评分及总分均较本组治疗前降低(P<0.05),且治疗组治疗后均低于对照组(P<0.05)。治疗后2组血UA及血清IL-6、CRP水平均较本组治疗前降低(P<0.05),且治疗组治疗后均低于对照组(P<0.05)。治疗组总有效率90%(36/40),对照组总有效率70%(28/40),治疗组疗效优于对照组(P<0.05)。2组不良反应总发生率比较差异无统计学意义(P>0.05)。结论清热祛湿汤治疗湿热蕴结型痛风性关节炎能够减轻关节疼痛、肿胀症状,降低血UA及相关炎症指标,临床疗效确切,且不增加不良反应。

Objective To observe the clinical efficacy of Qingre Qushi Decoction in the treatment of gouty arthritis(GA)of damp-heat accumulation type.Methods Eighty GA patients(damp-heat accumulation syndrome)from August 2019 to December 2021 in the Department of Rheumatology,Beijing Hospital of Traditional Chinese Medicine,Capital Medical University were selected as the study subjects.They were randomly divided into the treatment group and the control group,40 cases in each.The control group received conventional treatment such as oral febuxostat and diet control.On the basis of the control group,the treatment group was treated with the traditional Chinese medicine(TCM)Qingre Qushi Decoction for 4 weeks.The TCM Syndrome Indexes of Damp-Heat Accumulation Type Gouty Arthritis before and after Treatment were compared.The serum interleukin-6(IL-6),C-reactive protein(CRP),uric acid(UA),were assessed.The comprehensive clinical efficacy of the two groups was evaluated and the incidencee of adverse reactions during treatment was recorded.Results After treatment,the TCM syndrome scores in the two groups were lower than those before treatment(P<0.05),and which were lower in the treatment group than in the control group(P<0.05).Serum UA,IL-6 and CRP levels were lower than those in this group before treatment(P<0.05),and the treatment group was more common(P<0.05);the total effective rate in the treatment group was better than that in the control group(90%[36/40]vs 70%[28/40],[P<0.05],respectively);there was no significant difference in the total incidence of adverse reactions between the two groups(P>0.05).Conclusion For GA patients(damp-heat accumulation symptom),Qingre Qushi Decoction can reduce joint pain and swelling symptoms,reduce serum UA and other related inflammatory indicators,improve clinical efficacy,without increasing adverse reactions.