解毒泄浊益肾汤联合苯溴马隆片治疗湿热蕴结型痛风性关节炎疗效及对血TLR2、TLR4、MyD88水平的影响  

Therapeutic effect of Jiedu Xiezhuo Yishen decoction combined with benzbromarone tablets on gouty arthritis of damp-heat accumulation and bind syndrome and its effect on blood TLR2,TLR4 and MyD88

作　　者：何玲 丁明桥 雷慧敏 焦群茹 祝丹妮 李娅 李华 HE Ling;DING Mingqiao;LEI Huimin;JIAO Qunru;ZHU Danni;LI Ya;LI Hua(The Fifth Hospital of Wuhan City,Wuhan 430050, Hubei, China)

机构地区：[1]湖北省武汉市第五医院,湖北武汉430050

出　　处：《现代中西医结合杂志》2020年第19期2085-2088,2130,共5页Modern Journal of Integrated Traditional Chinese and Western Medicine

基　　金：武汉市卫生和计划生育委员会2016-2018年度中医药一般项目(WZ16C24)。

摘　　要：目的探讨解毒泄浊益肾汤联合苯溴马隆片治疗湿热蕴结型痛风性关节炎疗效及对血Toll样受体2(TLR2)、Toll样受体4(TLR4)及髓样分化因子88(MyD88)水平的影响。方法将2017年7月—2018年7月在武汉市第五医院诊治的80例湿热蕴结型痛风性关节炎患者随机分为2组,对照组40例给予苯溴马隆片治疗,观察组40例在对照组基础上给予解毒泄浊益肾汤治疗,连续治疗4周后观察2组中医症状积分及血TLR2、TLR4、MyD88水平、疼痛缓解情况,统计2组疗效及不良反应发生情况。结果2组治疗后关节疼痛、受累关节、关节压痛、关节肿胀、关节灼热、关节屈伸不利、伴随症状评分及血TLR2、TLR4、MyD88水平、VAS评分均明显低于治疗前(P均<0.05),且观察组均明显低于对照组(P均<0.05);观察组止痛起效时间明显短于对照组(P<0.05);观察组治疗后总有效率显著高于对照组(P<0.05);2组不良反应发生率比较差异无统计学意义(P>0.05)。结论解毒泄浊益肾汤联合苯溴马隆片治疗湿热蕴结型痛风性关节炎疗效较佳,可能通过降低血TLR2、TLR4、MyD88水平而发挥治疗作用。Objective It is to explore the therapeutic effect of Jiedu Xiezhuo Yishen decoction combined with benzbromarone tablets on gouty arthritis of damp-heat accumulation and bind syndrome and its effects on the levels of blood toll-like receptor 2(TLR2),toll-like receptor 4(TLR4)and marrow mike differentiation factor 88(MyD88).Methods 80 patients with gouty arthritis of damp-heat accumulation and bind syndrome diagnosed and treated in the Fifth Hospital of Wuhan from July 2017 to July 2018 were randomly divided into 2 groups,40 patients in the control group were treated with benzbromarone tablets,40 patients in the observation group were given Jiedu Xiezhuo Yishen decoction on the basis of the control group.After 4 weeks of continuous treatment,the TCM syndrome scores,blood TLR2,TLR4,MyD88 levels and pain relief were observed in the two groups.The efficacy and adverse reactions occurred of the two groups were counted.Results After treatment,the TCM syndrome scores of joint pain,affected joints,joint tenderness,joint swelling,joint burning sensation,joint flexion and extension negative,complicating symptom the levels of blood TLR2,TLR4,MyD88,VAS scores were significantly lower than those before treatment in the two groups,and these indexes were lower while the analgesic onset time was shorter in the observation group than those in the control group(P<0.05);the total effective rate of the observation group after treatment was significantly higher than that in the control group(P<0.05);there was no statistical significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion Jiedu Xiezhuo Yishen decoction combined with benzbromarone tablets has better curative effect on gouty arthritis of damp-heat accumulation and bind syndrome.It may play a therapeutic role by reducing the level of blood TLR2,TLR4 and MyD88.

关 键 词：解毒泄浊益肾汤 苯溴马隆片 痛风性关节炎 TOLL样受体2 Toll样受体4 髓样分化因子88 

分 类 号：R589.7[医药卫生—内分泌]