除湿解毒汤合羌活胜湿汤加减治疗急性痛风性关节炎(湿热蕴结证)的临床研究  

Efficacy of Chushi Jiedu Decoction combined with Qiangnhuo Shenshi Decoction in Treating Acute Gouty Arthritis with Syndrome of Dampness Heat Accumulation

作　　者：熊雨墨 李瑛[2] 马毅 黄伟[1,2] 胡昊 Xiong Yumo;Li Ying;Ma Yi;Huang Wei;Hu Hao(Hubei Provincial Hospital of Traditional Chinese Medicine,Hubei,Wuhan 430065,China)

机构地区：[1]湖北省中医院,湖北武汉430065 [2]湖北中医药大学,湖北武汉430065

出　　处：《中国中医急症》2021年第6期1053-1056,共4页Journal of Emergency in Traditional Chinese Medicine

基　　金：湖北省中医院人才引进启动基金项目(20191011);湖北省教育厅科学技术研究计划重点项目(D20192005)。

摘　　要：目的观察除湿解毒汤合羌活胜湿汤加减治疗急性痛风性关节炎(湿热蕴结证)的疗效以及对血清高迁移率族蛋白B1(HMGB1)和糖基化终产物受体(RAGE)水平的影响。方法患者78例按随机数字表法分为对照组与观察组各39例。对照组予美洛昔康分散片,观察组在对照组治疗基础上予除湿解毒汤合羌活胜湿汤加减治疗。两组疗程均为2周。比较两组症状体征评分、血沉(ESR)、C反应蛋白(CRP)、尿酸(UA)、临床疗效及血清HMGB1和RAGE水平。结果治疗后,观察组症状体征评分及ESR、CRP、UA均明显低于对照组(P<0.01);观察组总有效率为92.31%,显著高于对照组的71.79%(P<0.05);观察组治疗后血清HMGB1和RAGE水平明显低于对照组(P<0.01)。结论除湿解毒汤合羌活胜湿汤加减治疗急性痛风性关节炎(湿热蕴结证)的疗效显著,能改善相关症状体征,降低ESR、CRP、UA水平,下调HMGB1和RAGE水平。Objective:To investigate the efficacy of Chushi Jiedu Decoction combined with Qiangnhuo Shenshi Decoction in treating acute gouty arthritis with syndrome of dampness heat accumulation and its influence on se⁃rum levels of high mobility group box 1 protein(HMGB1)and receptor for advanced glycation end products(RAGE).Methods:78 acute gouty arthritis patients were selected and divided into the control group and observa⁃tion group by random number table method,39 patients in each group.The control group was treated with meloxi⁃cam dispersible tablets,and the observation group was treated with Chushi Jiedu Decoction combined with Qiangn⁃huo Shenshi Decoction.The course of treatment was 2 weeks for both groups.Scores of symptoms and signs,levels of erythrocyte sedimentation rate(ESR),C-reactive protein(CRP),blood uric acid(BUA),the clinical efficacy,se⁃rum levels of HMGB1 and RAGE were compared between the two groups.Results:After treatment,scores of symptoms and signs and levels of ESR,CRP,and BUA in the observation group were significantly lower than those in the control group(P<0.01).The total effective rate of the observation group was significantly higher than that of the control group(P<0.05).After treatment,serum HMGB1 and RAGE levels in the observation group were significantly lower than those in the control group(P<0.01).Conclusion:The efficacy of Chushi Jiedu De⁃coction combined with Qiangnhuo Shenshi Decoction in treating acute gouty arthritis with syndrome of dampness heat accumulation is significant;it can improve symptoms and signs and reduce levels of ESR,CRP,and UA.Down-regulation of serum levels of HMGBl and RAGE may be related with its efficacy.

关 键 词：急性痛风性关节炎 除湿解毒汤 羌活胜湿汤 湿热蕴结证 

分 类 号：R589.7[医药卫生—内分泌]