清热利湿逐瘀方治疗痛风性关节炎临床观察  

Clinical Observation of Qingre Lishi Zhuyu Decoction in Treating Gouty Arthritis

作　　者：祁志敏[1] 牟成林[1] 王华[1] 王春煦[1] 沈向楠 范少希 黄晓松[1] 赵建[1] 

机构地区：[1]河北省中医院,石家庄050011

出　　处：《中国实验方剂学杂志》2016年第21期147-151,共5页Chinese Journal of Experimental Traditional Medical Formulae

基　　金：河北省中医药管理局科研计划项目(2015020)

摘　　要：目的:观察清热利湿逐瘀方治疗痛风性关节炎的临床疗效,并探讨其作用机制。方法:将河北省中医院骨科2014年9月—2015年9月收治的痛风性关节炎患者(210例)按随机数字表法分为治疗组和对照组,每组105例,对照组采用秋水仙碱、右旋酮洛芬氨丁三醇片等西药治疗,治疗组采用中药清热利湿逐瘀方治疗,比较两组患者治疗前后主要症状、体征积分和血沉(ESR),尿酸(UA),C-反应蛋白(CRP),白细胞介素-1β(IL^(-1)β)改善情况;比较两组主要症状、体征缓解时间和总有效率;对两组随访3个月,比较3个月内复发率。结果:疗程结束后治疗组总有效率明显高于对照组(P<0.05);治疗组主要症状,体征积分,ESR,UA,CRP,IL^(-1)β改善情况显著优于对照组(P<0.01),治疗组关节疼痛、红肿缓解时间明显低于对照组(P<0.05),治疗组不良反应发生率,3个月内复发率明显低于对照组(P<0.05)。结论:清热利湿逐瘀方治疗痛风性关节炎可有效减轻炎症反应,改善临床症状,降低复发率,疗效显著,安全性好。Objective： To observe the clinical efficacy of Qingre Lishi Zhuyu decoction in treating gouty arthritis,and investigate its action mechanism. Method： The 210 patients with gouty arthritis admitted to Orthopedic Department of Heibei Hospital of Traditional Chinese Medicine from September,2014 to September,2015 were divided into treatment group and control group according to the digital random table method,with 105 cases in each group. Patients in control group received western medicines colchicine,dextral ketone ibuprofen tromethamine tablets,while patients in treatment group were treated with Qingre Lishi Zhuyu decoction. The improvement in scores of main symptoms and signs,erythrocyte sedimentation rate（ ESR）,uric acid（ UA）,Creactive protein（ CRP）,and interleukin 1β（ IL^（-1）β） after treatment were compared between two groups,the relief time for main symptoms and signs,as well as the total effective rate were compared between two groups. Patients of two groups were followed up for 3 months,and the recurrence rate within three months were compared between two groups. Result： The total effective rate of treatment group was higher than that of control group after treatment（ P〈0. 05）,scores of main symptoms and signs,ESR,UA,CRP,IL^（-1）β improvement in treatment group were better than those of control group（ P〈0. 01）,alleviate time of joint pain and swelling in treatment group was less than that of control group（ P〈0. 05）,the incidence of adverse reactions and the recurrence rate within 3 months were lower than those of control group（ P〈0. 05）. Conclusion： Qingre Lishi Zhuyu decoction can effectively alleviate inflammation,improve clinical symptoms,and reduce the recurrence rate in treating gouty arthritis,with significant clinical efficacy and good safety.

关 键 词：痛风性关节炎 清热利湿逐瘀方 血沉 尿酸 C-反应蛋白 白细胞介素-1Β 

分 类 号：R287[医药卫生—中药学]