自拟痛风消经验汤剂对急性痛风性关节炎患者血清UA、ESR、IL-1β、TNF-α、COX-2水平的影响  

Clinical Research on Influence of UA,ESR,IL-1β,TNF-α and COX-2 Levels for Treating Patients of Acute Gouty Arthritis with Xiaofeng Decoction

作　　者：倪洪岗[1] 杨娟[1] 李莉[1] 

机构地区：[1]贵阳中医学院第二附属医院,贵阳贵州550003

出　　处：《辽宁中医杂志》2017年第3期525-528,共4页Liaoning Journal of Traditional Chinese Medicine

基　　金：贵州省中管局资助课题(QZYY-2014-014)

摘　　要：目的:观察自拟痛风消经验汤剂治疗急性痛风性关节炎患者的临床效果,并探讨其对患者血清UA、ESR、IL-1β、TNF-α、COX-2水平的影响。方法:选择2013年4月—2016年2月本院收治的急性痛风性关节炎患者136例,随机分为对照组和观察组各68例。对照组患者给予秋水仙碱治疗;观察组患者则加用自拟痛风消经验汤剂内服治疗,两组均连续治疗7 d。对比两组治疗的临床效果,评价治疗前后疼痛视觉模拟评分VAS变化,记录疼痛的缓解时间,监测治疗前后血尿酸(UA)、血沉(ESR)、白细胞介素-1β(IL-1β)、肿瘤坏死因子-α(TNF-α)、环氧合酶-2(COX-2)水平变化。结果:观察组的有效率92.6%高于对照组的77.9%,差异性显著(χ2=5.862,P<0.05);观察组患者经治疗后的疼痛改善优于对照组,其痛感VAS评分显著低于对照组,疼痛缓解时间与对照组相比明显缩短,差异性显著(P<0.05);观察组患者经治疗后UA、ESR、IL-1β、TNF-α、COX-2水平显著低于对照组患者,差异性显著(P<0.05)。结论:自拟痛风消经验汤剂治疗急性痛风性关节炎疗效肯定,利于促进关节痛感的缓解,其机制与调控UA、ESR、IL-1β、TNF-α、COX-2等细胞因子水平以抑制炎症过程有一定的相关性,凸显出中医辨治急性关节炎性病变的优势与特色,值得临床深入探究。Objective： To investigate the clinical efficacy of treating acute gouty arthritis patients with self-made Xiaofeng Decoction and explore the influence of UA,ESR,IL-1β,TNF-α and COX-2 levels. Methods： A total of 136 patients of acute gouty arthritis were randomly divided into a control group of 68 cases and an observation group of 68 cases from April 2013 to February 2016. Patients in the control group were treated with colchicine while those in the observation group were treated with self-made Xiaofeng Decoction,7 days for treatment. The research was aimed at comparing the effectiveness,evaluating the pain with VAS,recording the pain relief time and monitoring the levels change of UA,ESR,IL-1β,TNF-α and COX-2. Results：The efficiency of patients in the observation group was 92. 6%,which was higher than the control group＇s 77. 9%. The difference was very remarkable（ χ^2= 5. 862,P〈0. 05）. The improvement of pain for patients in the observation group was better than that of the control group and the VAS score after treatment was lower than that of the control group and the pain relief time was shorter than that of the control group. The difference was very remarkable（ P〈0. 05）. The levels of UA,ESR,IL-1β,TNF-α and COX-2 went down after treatment. The degree of change in the observation group was more pronounced than that of the control group（ P〈0. 05）. Conclusion： Treating acute gouty arthritis patients with self-made Xiaofeng Decoction has good effect. It is good to alleviate the pain. The mechanism may be associated with regulation of serum inflammatory factor levels of UA,ESR,IL-1β,TNF-α and COX-2 to inhibit the inflammatory process,worthy of clinical use and deep research.

关 键 词：急性痛风性关节炎 自拟痛风消经验汤剂 细胞因子水平 临床研究 

分 类 号：R285.5[医药卫生—中药学]