四妙勇安汤加减联合依托考昔治疗2型糖尿病并痛风急性发作临床分析

Clinical analysis on modified Simiao Yong’an Decoction combined with etocoxib in treatment of acute attack of gout caused by type 2 diabetes

目的观察四妙勇安汤加减联合依托考昔对2型糖尿病并痛风急性发作(T2DMGAA)的治疗效果。方法将我院75例T2DMGAA患者随机分为研究组38例与对照组37例。对照组采用依托考昔治疗,研究组采用四妙勇安汤加减联合依托考昔治疗。比较两组临床疗效、中医证候评分、疼痛视觉模拟法(VAS)评分、尿酸(UA)、空腹血糖(FPG)、餐后2 h血糖(2 hPG)、糖化血红蛋白(HbA1c)、白细胞介素-6(IL-6)、白细胞计数(WBC)、血沉(ESR)水平及不良反应情况。结果治疗后,研究组总有效率高于对照组(P<0.05);两组中医证候评分、VAS评分、UA、FPG、2 hPG、HbA1c、IL-6、WBC、ESR水平均低于治疗前,研究组上述各项指标均低于对照组(P<0.05);两组总不良反应率比较无统计学意义(P>0.05)。结论四妙勇安汤加减联合依托考昔治疗T2DMGAA患者疗效较好,可显著改善症状体征,对糖代谢有良好的调节作用,下调UA、炎症因子水平,降低疼痛程度,未增加不良反应率。

Objective To observe the therapeutic effect of modified Simiao Yong’an Decoction combined with etocoxib on type 2 diabetes with acute gout attack(T2DMGAA).Methods Seventy-five T2DMGAA patients were randomly divided into study group of 38 cases and control group of 37 cases.Control group was treated with etoposide,while study group was treated with modified Simiao Yong’an Decoction on the basis of control group.The clinical efficacy,TCM syndrome scores,Visual Analogue Scale(VAS)score,uric acid(UA),fasting blood glucose(FPG),postprandial 2-hour blood glucose(2 hPG),glycated hemoglobin(HbA1c),and interleukin-6(IL-6),white blood cell count(WBC),erythrocyte sedimentation rate(ESR)levels and overall adverse reaction rates were compared between the two groups.Results After treatment,the total effective rate of study group was higher than that of control group(P<0.05);TCM syndrome scores,VAS scores,UA,FPG,2 hPG,HbA1c,IL-6,WBC,and ESR levels in both groups were lower than before treatment,and were lower in study group than control group(P<0.05);there was no statistically significant difference in the total adverse reaction rates between the two groups(P>0.05).Conclusion Modified Simiao Yong’an Decoction combined with etoricoxib has a good curative effect on T2DMGAA,which can significantly improve symptoms and signs,regulate glucose metabolism,down-regulate UA and inflammatory factors levels,reduce pain,and does not increase the rate of adverse reactions.