中药内服外敷治疗痛风急性发作伴胃肠损害的疗效观察  

Clinical Observation on Treatment of Acute Gouty Attack Accompanying by Gastrointestinal Lesions with Internal and External Application of Chinese Herbs

作　　者：闫光耀 张剑勇[2] YAN Guang-Yao;ZHANG Jian-Yong(The Fourth Clinical Medical School of Guangzhou University of Chinese Medicine,Shenzhen 518033 Guangdong,China;Shenzhen Traditional Chinese Medicine Hospital,Shenzhen 518033 Guangdong,China)

机构地区：[1]广州中医药大学第四临床医学院,广东深圳518033 [2]深圳市中医院,广东深圳518033

出　　处：《广州中医药大学学报》2020年第8期1460-1466,共7页Journal of Guangzhou University of Traditional Chinese Medicine

基　　金：深圳市科技计划项目(编号:JCYJ20170817094922513);深圳市医疗卫生三名工程(编号:SZSM201612080)。

摘　　要：【目的】探讨痛风泰颗粒加味内服配合双柏散外敷治疗湿热内蕴型急性痛风性关节炎伴胃肠损害的临床疗效。【方法】将75例湿热内蕴型急性痛风性关节炎伴胃肠损害患者随机分为对照1组(中药内服组)、对照2组(中药外敷组)和观察组(中药内服+外敷组)3组,每组各25例。对照1组给予痛风泰颗粒加味内服治疗,对照2组给予双柏散外敷治疗,观察组给予痛风泰颗粒加味内服和双柏散外敷治疗,疗程为2周。观察3组患者治疗前后中医证候积分、关节疼痛视觉模拟量表(VAS)评分及血尿酸(BUA)、红细胞沉降率(ESR)、C反应蛋白(CRP)水平的变化情况,并评价3组患者的临床疗效。【结果】(1)治疗2周后,观察组的总有效率为88.0%(22/25),对照1组为76.0%(19/25),对照2组为60.0%(15/25),观察组的疗效明显优于两对照组,差异均有统计学意义(P<0.05)。(2)治疗后,3组患者的中医证候积分和关节疼痛VAS评分均较治疗前明显降低(P<0.05),且观察组对中医证候积分和关节疼痛VAS评分的降低作用均明显优于两对照组,差异均有统计学意义(P<0.05)。(3)治疗后,3组患者的BUA、ESR及CRP水平均较治疗前明显降低(P<0.05),且观察组对BUA、ESR及CRP水平的降低作用均优于两对照组,组间比较,除对照1组的BUA外,差异均有统计学意义(P<0.05)。【结论】痛风泰颗粒加味内服联合双柏散外敷治疗湿热内蕴型急性痛风性关节炎伴胃肠损害的临床疗效确切,可有效改善患者症状,降低炎症反应,提高生活质量,减少副作用。Objective To investigate the clinical effect of oral use of modified Tongfengtai Granules combined with external use of Shuangbo Powder for the treatment of acute gouty arthritis accompanying by gastrointestinal lesions with the syndrome of damp-heat internal retention. Methods Seventy-five patients with acute gouty arthritis accompanying by gastrointestinal lesions with the syndrome of damp-heat internal retention were randomly divided into control group 1,control group 2,and observation group,25 cases in each group. The control group 1 was given oral use of modified Tongfengtai Granules,control group 2 was given external use of Shuangbai Powder,and observation group was given oral use of modified Tongfengtai Granules combined with external use of Shuangbo Powder. The treatment for the 3 groups covered 2 weeks. Before and after treatment,the scores traditional Chinese medicine(TCM)syndrome, scores of visual analogue scale(VAS)for the pain of the joints, blood uric acid(BUA)level,erythrocyte sedimentation rate(ESR)and C-reactive protein(CRP)level in the 3 groups were observed. And the clinical effects of the three groups after treatment were also evaluated. Results(1)After 2 weeks of treatment,the total effective rate in the observation group was 88.0%(22/25),in the control group 1 was 76.0%(19/25),and in the control group 2 was 60.0%(15/25). The clinical efficacy of the observation group was superior to that in the two control groups,and the difference was statistically significant(P < 0.05).(2)After treatment,the TCM syndrome scores and VAS scores for the pain of the joints in the 3 groups were lower than those before treatment(P<0.05),and the observation group had stronger effect on decreasing the TCM syndrome scores and VAS scores for the pain of the joints than the two control groups,the differences being statistically significant(P <0.05).(3)After treatment,BUA,ESR and CRP levels in the 3 groups were lower than those before treatment(P<0.05),and the observation group had stronger effect on decreasing the BU

关 键 词：急性痛风性关节炎 胃肠损害 湿热内蕴型 痛风泰颗粒 双柏散 

分 类 号：R259.897[医药卫生—中西医结合]