化浊解毒方联合硝黄通络散外敷治疗急性痛风性关节炎(湿热蕴结证)患者的临床观察

Clinical Study on the Treatment of Acute Gouty Arthritis Patients(Accumulated Dampness-heat Syndrome)with Huazhuo Jiedu Decoction Combined with External Application of Xiaohuang Tongluo Powder

目的 观察化浊解毒方联合硝黄通络散外敷治疗急性痛风性关节炎(湿热蕴结证)的临床疗效。方法 将96例急性痛风性关节炎患者随机分为两组各48例。对照组采用化浊解毒方治疗,观察组给予化浊解毒方联合硝黄通络散外敷治疗,两组疗程均为2周。比较两组疗效、临床症状、血清尿酸(UA)、血沉(ESR)和炎症因子差异。结果 观察组治疗总有效率为93.75%,高于对照组的75.00%(P<0.05);两组治疗后中医证候积分、疼痛程度、活动受限、关节肿胀评分、血清UA、ESR、白细胞介素-1(IL-1)、白细胞介素-6(IL-6)和肿瘤坏死因子-α(TNF-α)水平较治疗前降低(P<0.05),两组比较,观察组治疗后中医证候积分、疼痛程度、活动受限、关节肿胀评分血清UA、ESR、IL-1、IL-6、TNF-α水平低于对照组(P<0.05)。结论 化浊解毒方联合硝黄通络散外敷可促使急性痛风性关节炎患者临床症状消退,抑制炎症反应,提高临床治疗效果。

Objective:To explore the clinical efficacy of Huazhuo Jiedu Decoction combined with external application of Xiaohuang Tongluo Powder in the treatment of acute gouty arthritis(accumulated dampness-heat syndrome).Methods:A total of 96 patients with acute gouty arthritis were selected and divided randomly into two groups with 48 cases in each group.The control group was treated with Huazhuo Jiedu Decoction for 2 weeks,and the observation group was treated with Huazhuo Jiedu Decoction combined with Xiaohuang Tongluo Powder for 2 weeks.The effects,clinical symptoms,serum uric acid(UA),erythrocyte sedimentation rate(ESR)and inflammatory factors were compared between the two groups.Results:The total effective rate of observation group(93.75%)was higher than that of control group(75.00%)(P<0.05).TCM symptom score,pain degree,mobility limitation,joint swelling score,serum UA,ESR,interleukin(IL)-1,IL-6 and tumor necrosis factor-α(TNF-α)levels in both groups after treatment were lower than those before treatment(P<0.05).The levels of serum UA,ESR,IL-1,IL-6 and TNF-αin the observation group were lower than those in the control group after treatment(P<0.05).Conclusion:Huazhuo Jiedu Decoction combined with Xiaohuang Tongluo Powder can relieve the clinical symptoms of acute gouty arthritis patients,inhibit inflammation,thus improving clinical effect.