仙藤祛痹汤联合小剂量秋水仙碱片治疗湿热蕴结型急性痛风性关节炎的临床研究  

Clinical study of Xianteng Qubi Decoction combined with low-dose colchicine tablets for acute gouty arthritis of damp-heat accumulation type

作　　者：和大中 庞娟 李勃 HE Dazhong;PANG Juan;LI Bo(Department of Traditional Chinese Medicine,Special Medical Center of the Chinese Armed Police Force,Tianjin 300162;不详)

机构地区：[1]中国人民武装警察部队特色医学中心中医科,天津300162 [2]天津市河东区东新街社区卫生服务中心,天津300162 [3]天津第一中心医院中西医结合科,天津300162

出　　处：《河北中医》2021年第11期1854-1857,1861,共5页Hebei Journal of Traditional Chinese Medicine

摘　　要：目的观察仙藤祛痹汤联合小剂量秋水仙碱片治疗湿热蕴结型急性痛风性关节炎的临床疗效。方法将92例湿热蕴结型急性痛风性关节炎患者按照随机数字表法分为2组,对照组46例予小剂量秋水仙碱片治疗,治疗组46例在对照组基础上加用仙藤祛痹汤治疗。2组均治疗1周后统计疗效,比较2组中医证候评分(关节红肿、硬结疼痛、发热、舌红苔黄顾、脉滑数)、疼痛视觉模拟评分法(VAS)、奎森功能演算指数(Lequesne)评分变化比较2组治疗前后血尿酸(UA)、红细胞沉降率(ESR)、白细胞介素1β(IL-1β)、环氧合酶2(COX-2)、转化生长因子β(TGF-β)水平变化,比较2组治疗期间不良反应发生情况。结果治疗组总有效率100%(46/46),临床控制率58.70%(27/46),不良反应发生率10.87%(5/46),对照组分别为95.65%(44/46)、23.91%(11/46)、21.74%(10/46),治疗组总有效率和不良反应发生率与对照组比较差异均无统计学意义(P>0.05),但治疗组临床控制率高于对照组(P<0.05)。2组治疗后中医证候关节红肿、硬结疼痛、发热、舌红苔黄厚、脉滑数评分与本组治疗前比较均降低(P<0.05),且治疗组治疗后均低于对照组(P<0.05)。2组治疗后疼痛VAS、Lequesne评分与本组治疗前比较均降低(P<0.05),且治疗组治疗后均低于对照组(P<0.05)。与本组治疗前比较,2组治疗后血UA、ESR、IL-1β、COX-2水平均降低(P<0.05),TGF-β水平均升高(P<0.05),且治疗组治疗后各指标改善均优于对照组(P<0.05)。结论仙藤祛痹汤联合小剂量秋水仙碱片治疗湿热蕴结型急性痛风性关节炎临床疗效确切,可明显改善患者中医证候表现,缓解疼痛症状,控制血UA水平,降低ESR、IL-1β、COX-2水平,提高TGF-β水平,抑制炎性反应,提高临床控制率,安全可靠。Objective To observe the clinical efficacy of Xianteng Qubi Decoction combined with low-dose colchicine tablets for acute gouty arthritis(AGA)of damp-heat accumulation type.Methods Totally 92 patients with AGA(damp-heat accumulation type)were divided into equal group according to the random number table,control group received colchicine tablets,and treatment group additionally received Xianteng Qubi Decoction based on control group.The treatment period was 1 week,aiming to compare traditional Chinese medicine(TCM)syndrome(joint swelling,harden pain,fever,pale yellow tongue,thin,rapid,slippery pulse)scores,visual analogue scale(VAS)for pain,Lequesne Algofunctional Index(LAI),serum uric acid(UA),erythrocyte sedimentation rate(ESR),interleukin-1beta(IL-1β),cyclooxygenase-2(COX-2),transforming growth factorβ(TGF-β);the curative effect and adverse reaction were counted.Results The difference was not statistically significant in the total effective rates and incidence of adverse reactions between groups[100%(46/46)vs 95.65%(44/46),10.87%(5/46)vs 21.74%(10/46),(P<0.05),respectively];the clinical control rate was 58.70%(27/46)in treatment group,higher than that of 23.91%(11/46)in control group(P<0.05).After treatment,TCM syndrome scores in groups were decreased(P<0.05),which were lower in treatment group compared with cortrol group(P<0.05);VAS and LAI in groups were decreased(P<0.05),treatment group was lower than control group(P<0.05);serum UA,ESR,IL-1β,COX-2 in groups were decreased(P<0.05),while TGF-βwas increased(P<0.05),improvement of serum UA,ESR,IL-1β,COX-2,TGF-βin treatment group were significantly better(P<0.05).Conclusion For patients with AGA(damp-heat accumulation type),Xianteng Qubi Decoction combined with low-dose colchicine tablets has definite curative effect,which is obviously capable of improving TCM syndromes and clinical control rate,relieving pain symptoms,controlling serum UA,reducing ESR,IL-1β,COX-2,increasing TGF-β,inhibiting inflammatory response,and with safe and reliable.

关 键 词：关节炎 痛风性 急性病 抗痛风药(中药) 湿热 辨证论治 中西医结合疗法 

分 类 号：R257[医药卫生—中医内科学] R971.1[医药卫生—中医学]