栀黄止痛散联合双氯芬酸二乙胺乳膏剂治疗急性痛风性关节炎

Zhihuang Zhitong Powder Combined with Diclofenac Diethylamine Cream in Treatment of Acute Gouty Arthritis

目的:观察栀黄止痛散联合双氯芬酸二乙胺乳膏剂(扶他林)外用治疗急性痛风性关节炎(acute gouty arthritis,AGA)的临床疗效及其对相关炎症因子影响。方法:60例AGA患者随机分对照组和观察组,各30例。对照组给予扶他林外用,观察组在对照组治疗基础上给予栀黄止痛散局部外用,两组均连续治疗7 d。比较两组患者治疗前后疼痛视觉模拟量表(visual analog scale,VAS)评分、患者总体评分(patient global assessment,PGA)、疼痛数字评价量表(numerical rating scale,NRS)评分及中医证候评分,红细胞沉降率(erythrocyte sedimentation rate,ESR)、C-反应蛋白(C-reactive protein,CRP)、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)、白细胞介素-1β(interlenkin 1β,IL-1β)、干扰素-γ(interferon-gamma,IFN-γ)、白细胞介素-4(interlenkin 4,IL-4)水平以及临床疗效、不良反应。结果:观察组有效率为96.7%,对照组有效率为80.0%,两组比较,差异有统计学意义(χ^(2)=6.30,P=0.003)。与对照组治疗后比较,观察组VSA(Z=-5.35,P=0.00)、NRS(Z=-5.32,P=0.00)、中医证候评分(Z=-6.74,P=0.00)、ESR(Z=-2.50,P=0.01)、CRP(t=49.066,P=0.00)、TNF-α(Z=-5.24,P=0.00)、IL-1β(Z=-6.2,P=0.00)显著降低(P<0.05),PGA(Z=-3.42,P=0.00)、IFN-γ(Z=-3.66,P=0.00)、IL-4(t=4.89,P=0.00)显著升高(P<0.05)。两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:栀黄止痛散联合扶他林治疗急性痛风性关节炎疗效显著,可显著改善AGA患者临床症状,可能与调节相关炎症因子相关。

Objective:To observe the clinical efficacy of Zhihuang Zhitong Powder combined with diclofenac diethylamine emulgel in treatment of acute gouty arthritis(AGA)and its influence on related inflammatory factors.Methods:60 patients with AGA were randomly divided into control group and observation group,30 cases in each group.The control group was given diclofenac diethylamine emulgel for external use,and the observation group was given Zhihuang Zhitong Powder for local external use in addition to that of the treatment of the control group.Both groups were treated continuously for 7 days.Visual analog scale(VAS)scores,patient global assessment(PGA)scores and numerical rating scale scores before and after treatment were compared between the two groups.NRS score and TCM syndrome score,erythrocyte sedimentation rate(ESR),C-reactive protein(CRP),tumor necrosis factor-α(TNF-α),interlenkin 1β(IL-1β),interferon-gamma(IFN-γ),interlenkin 4(IL-4)levels,clinical efficacy and adverse reactions.Results:The effective rate was 96.7%in the observation group and 80%in the control group,and the difference between the two groups was statistically significant(χ^(2)=6.30,P=0.003).Compared with the control group after treatment,VSA(Z=-5.35,P=0.00),NRS(Z=-5.32,P=0.00),TCM syndrome score(Z=-6.74,P=0.00),ESR(Z=-2.50,P=0.01),CRP(t=49.066,P=0.00),TNF-α(Z=-5.24,P=0.00),IL-1β(Z=-6.2,P=0.00)were significantly decreased(P<0.05),PGA(Z=-3.42,P=0.00),IFN-γ(Z=-3.66,P=0.00),IL-4(t=4.89,P=0.00)was significantly increased(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion:Zhihuang Zhitong Powder combined with diclofenac diethylamine emulgel can significantly improve the clinical symptoms of AGA patients,which may be related to the regulation of related inflammatory factors.