竹叶石膏汤联合西药治疗急性痛风性关节炎随机平行对照研究

Randomized Parallel Controlled Study of Zhuye Shigao Decoction(竹叶石膏汤) in the Treatment of Acute Gouty Arthritis

[目的]观察竹叶石膏汤联合西药治疗急性痛风性关节炎疗效。[方法]使用随机平行对照方法,将70例门诊患者按就诊顺序号方法随机分为两组。对照组35例秋水仙碱,0.5mg/次,2次/d,连服2d;塞来昔布,0.2g/次,1次/d,连服6d。治疗组35例竹叶石膏汤(竹叶10g,石膏~生30g,半夏~法、沙参各10g,土茯苓30g,大枣10g,甘草6g),水煎200mL/次,2次/d,肿痛盛加乳香、没药;热盛加金银花、山慈菇;伤阴加石斛、玄参;上肢痛加羌活、姜黄;下肢痛加牛膝、独活;湿重加猫须草、车前草;疼痛明显加威灵仙;西药治疗同对照组。连续治疗6d为1疗程。观测临床表现、血尿酸、血沉、C反应蛋白、不良反应。治疗1疗程(6d),判定疗效。[结果]治疗组有效22例,进步10例,无效3例,总有效率91.43%;对照组有效5例,进步17例,无效13例,总有效率62.86%;治疗组疗效优于对照组(P<0.05)。血沉、C反应蛋白、血尿酸两组均有改善(P<0.01),治疗组改善优于对照组(P<0.05,P<0.01)。不良反应发生率治疗组低于对照组(P<0.05)。[结论]竹叶石膏汤联合西药治疗急性痛风性关节炎,疗效满意,无严重不良反应,值得推广。

[Objective]To observe the therapeutic effect of Jiawei Zhuye Shigao decoction on acute gouty arthritis.[Method]Seventy outpatients were randomly divided into two groups according to the order number of visits by randomized parallel control method.The control group consisted of 35 colchicines,0.5 mg/time,twice a day for 2 days,celecoxib,0.2 g/time,once a day for 6 days.35 cases in the treatment group were treated with Zhuye Shigao decoction(Zhuye 10 g,Shengshigao 30 g,Fabanxia,Shashen each 10 g,Tufuling 30 g,Dazao 10 g,Gancao 6 g),decocted 200 mL/time,twice a day,swelling and pain with frankincense and myrrh;heat plus honeysuckle,lobata;Shangyin addition to Dendrobium,Radix Scrophulariae;in the upper limb pain plus Qianghuo,curcuma;in the lower limb pain plus Achyranthes bidentata bidentata,Herba plantain;in the wet with significant pain plus Weilingxian;western medicine treatment with the control group.Continuous treatment for 6 days is a course of treatment.Clinical manifestations,serum uric acid,erythrocyte sedimentation rate,C-reactive protein and adverse reactions were observed.One course of treatment(6 days)was used to determine the curative effect.[Result]In the treatment group,22 cases were effective,10 cases were progressive,3 cases were ineffective,and the total effective rate was 91.43%.In the control group,5 cases were effective,17 cases were progressive and 13 cases were ineffective,the total effective rate was 62.86%.The curative effect of the treatment group was better than that of the control group(P<0.05).The erythrocyte sedimentation rate(ESR),C-reactive protein(CRP)and serum uric acid(UA)were improved in both groups(P<0.01),and the improvement in the treatment group was better than that in the control group(P<0.05,P<0.01).The incidence of adverse reactions in the treatment group was lower than that in the control group(P<0.05).[Conclusion]Zhuye Shigao decoction has satisfactory curative effect on acute gouty arthritis,without serious adverse reactions,and is worthy of promotion.