中医综合治疗急性痛风性关节炎(湿热蕴结证)的疗效观察  

Observation on Clinical Efficacy of Comprehensive Treatment of TCM in the Acute Gouty Arthritis of Damp-heat Accumulation Type

作　　者：瞿佶[1] 俞泓波 蔡程辰[1] 刘苗苗 吴弢[1] Qu Ji;Yu Hongbo;Cai Chengchen;Liu Miaomiao;Wu Tao(Shanghai Huadong Hospital,Shanghai 200040,China)

机构地区：[1]上海市华东医院,上海200040

出　　处：《中国中医急症》2022年第5期843-846,共4页Journal of Emergency in Traditional Chinese Medicine

基　　金：上海市进一步加快中医药事业发展三年行动计划项目[ZY(2018-2020)-ZYBZ-12]。

摘　　要：目的观察中医综合治疗急性痛风性关节炎(湿热蕴结证)的临床疗效。方法患者60例采用随机数字表法分为中医治疗组与西药组各30例。西药组使用双氯芬酸钠进行治疗,中医治疗组在西药组基础上实施中医综合治疗方法,包括口服自拟萆薢痛风汤、儿茶软膏外敷、健脾助运手法按摩、刺络放血和耳穴贴压。比较治疗1周后两组疗效,对比治疗前后中医证候积分变化、尿酸(UA)水平、关节疼痛程度(VAS),观察治疗前后两组肝肾功能,并统计治疗不良反应。结果治疗1周后,中医治疗组治疗有效率明显高于西药组(P<0.05);两组中医证候积分、UA水平、VAS评分较治疗前均有显著降低(P<0.05),且中医治疗组明显低于西药组(P<0.05);两组肝肾功能异常情况和不良反应发生率差异均无统计学意义(P>0.05)。结论自拟萆薢痛风汤为主的中医综合治疗方案治疗湿热蕴结型急性痛风性关节炎疗效显著,能有效改善患者临床症状,缓解关节疼痛,降低UA水平,且安全性较高。Objective:To observe the clinical efficacy of comprehensive treatment of TCM in the acute gouty arthritis of damp-heat accumulation type.Methods:A total of 60 patients with acute gouty arthritis of damp-heat accumulation type were selected and divided into traditional Chinese medicine(TCM)treatment group and western medicine group,30 cases in each group.The western medicine group was given diclofenac sodium for treatment,and on this basis,the TCM treatment group implemented the comprehensive TCM treatment method based on selfdesigned Bixie Tongfeng Decoction,Ercha Ointment,tonifying spleen to transport massage,blood-letting puncutre and auricuar point sticking.The efficacy after 1 week of treatment and changes in TCM syndromes scores,uric acid(UA)level and joint pain degree[Visual Analogue Scale(VAS)]before treatment and after 1 week of treatment were compared between the two groups.The liver function and kidney function of the two groups were observed before treatment and after 1 week of treatment,and the adverse reactions were statistically analyzed in the two groups within 1 week of treatment.Results:After 1 week of treatment,the effective rate of treatment in TCM treatment group was significantly higher than that in western medicine group(P<0.05).The scores of TCM syndromes,UA level and VAS score in the two groups were significantly reduced compared with those before treatment(P<0.05),and the above indicators of TCM treatment group were significantly lower than those of western medicine group(P<0.05).There were no statistical differences in the incidence rates of abnormal liver-kidney functions and adverse reactions between the two groups(P>0.05).Conclusion:Comprehensive TCM treatment method based on self-designed Bixie Tongfeng Decoction has a significant efficacy in treating acute gouty arthritis of damp-heat accumulation.It can effectively improve the clinical symptoms,relieve the joint pain and reduce the level of UA,and it has high safety and high clinical application value.

关 键 词：急性痛风性关节炎 湿热蕴结型 中医综合治疗 萆薢痛风汤 尿酸 肝肾功能 

分 类 号：R589.7[医药卫生—内分泌]