中西医结合分期治疗慢性期痛风性关节炎30例临床观察  

Clinical Observation on 30 Cases of Chronic Gouty Arthritis with Integrated Chinese and Western Medicine Staged Treatments

作　　者：梁慧英[1] 廖琳[1] 何善智[1] 冯兴华[2] 

机构地区：[1]中山市人民医院 [2]中国中医科学院广安门医院

出　　处：《中医杂志》2015年第2期136-139,共4页Journal of Traditional Chinese Medicine

摘　　要：目的观察中西医结合分期方案治疗慢性期痛风性关节炎的临床疗效。方法将60例慢性期痛风性关节炎患者随机分为对照组和治疗组各30例。对照组首诊时予洛索洛芬钠片每次60 mg、每天3次,秋水仙碱片每次0.5 mg、每天3次;间歇期予苯溴马隆片每次50 mg,每天1次;急性发作期予洛索洛芬钠片(每次60 mg,每天3次)+秋水仙碱片(每次0.5 mg,每天3次)+苯溴马隆片(每次50 mg,每天1次)。治疗组在对照组基础上首诊时及急性发作期予清热利湿方药,间歇期予健脾利湿方药,每日1剂。两组疗程均为24周。观察两组治疗前后急性发作时关节疼痛视觉模拟(VAS)评分、过去24周内关节炎急性发作次数、血尿酸水平、过去24周患者自我感觉的总体评价(PGA)评分。结果治疗组患者治疗后疼痛VAS评分与治疗前比较显著降低,PGA评分升高(P<0.05),对照组治疗后PGA评分较本组治疗前明显升高(P<0.05);治疗组VAS评分、PGA评分较对照组改善明显(P<0.05)。两组患者治疗后血尿酸水平、痛风性关节炎急性发作次数均较本组治疗前明显降低(P<0.05),治疗组改善更明显(P<0.05)。结论中西医结合分期方案可有效减少慢性期痛风性关节炎的急性发作次数,减轻发作时关节疼痛程度,降低血尿酸水平,改善患者生活质量。Objective To observe the clinical efficacy of integrated Chinese and western medicine staged treatments on gouty arthritis. Methods Sixty patients with gout were randomly divided into a control group and a treatment group,with 30 patients in each. The control group was given loxoprofen sodium tablets 60 mg and colchicine tablets 0. 5 mg,3 times per day when first treated; benzbromarone tablets 50 mg,1 time per day during the intermission;loxoprofen sodium tablets 60 mg,3 times per day,colchicine tablets 0. 5 mg,3 times per day,and benzbromarone tablets 50 mg,1 time a day during acute attacks. On the basis of the medications in the control group,the treatment group was added with herbal decoctions with the effect of clearing heat and dampness when first treated; those with effect of tonifying spleen and expelling dampness during the intermission; and those with effect of clearing heat and dampness during acute attacks,one dose per day. The course was 24 weeks for both groups. Joint pain VAS score,the number of acute attacks happened in the last 24 weeks,blood levels of uric acid,and the overall assessments in the past 24 weeks（ PGA score） were recorded before and after treatment. Results After treatment,VAS score was significantly lower and PGA score was higher in the treatment group（ P〈0. 05）; and PGA score in the control group was significantly higher（ P〈0. 05）. The improvement of VAS score and PGA score in the treatment group was more significant compared with that in the control group（ P〈0. 05）. After treatment,the blood levels of uric acid and the number of acute attacks in the two groups were significantly lower than before（ P〈0. 05）,especially in the treatment group（ P〈0. 05）. Conclusion Integrated Chinese and western medicine stage treatments can effectively reduce the acute attacks of chronic gouty arthritis,extend the intermissions,relieve pain and lower blood level of uric acid,and improve the quality of patient＇s life.

关 键 词：痛风性关节炎 关节疼痛 血尿酸 

分 类 号：R589.7[医药卫生—内分泌]