四妙丸加减联合四黄水蜜外敷治疗湿热蕴结型痛风性关节炎的效果  

Effect of Gouty Arthritis with Damp Heat Accumulation Treated by Modified Simiao Wan and External Application of Sihuang Shuimi

作　　者：柯雅思 林辉宇 陈君兰 叶沿坡[1] 朱良伟[1] KE Yasi;LIN Huiyu;CHEN Junlan;YE Yanpo;ZHU Liangwei(Department of Nephrology,Quanzhou Traditional Chinese Medicine Hospital,Quanzhou 362000,China)

机构地区：[1]福建省泉州市中医院肾病科,福建泉州362000

出　　处：《中国医药指南》2023年第17期129-131,共3页Guide of China Medicine

基　　金：福建中医药校管课题(XB2020074)。

摘　　要：目的观察四妙丸加减联合四黄水蜜封包外敷对湿热蕴结型急性痛风性关节炎的临床疗效及血清IL-6水平的影响。方法选取2020年8月至2023年1月泉州市中医院收治的72例湿热蕴结型痛风急性发作患者,按照随机对照原则分为对照组和观察组,各36例。两组均以基础治疗加用秋水仙碱,观察组加用四妙丸加减方口服及四黄水蜜中药封包外敷。治疗2周后,比较两组疼痛缓解时间、关节疼痛指数与功能评分、治疗前后中医证候评分。比较两组治疗前后血尿酸(SUA)、炎症指标(CRP、IL-6、WBC)水平。结果治疗后,观察组总有效率为97.22%,优于对照组的77.78%(P<0.05);治疗后两组疼痛缓解时间、关节疼痛指数与功能评分及中医证候评分均较治疗前下降(P<0.05),且观察组下降幅度显著优于对照组(P<0.05)。治疗后两组SUA、CRP、IL-6、WBC均较治疗前下降(P<0.05),且观察组下降幅度显著优于对照(P<0.05)。结论四妙丸加减联合四黄水蜜外敷治疗湿热蕴结型痛风急性发作安全可靠,能更好地缓解患者的疼痛症状,抑制炎性反应,降低患者的血尿酸水平。Objective To observe the clinical curative effect of modified simiao pills combined with external application of sihuang shuimi packets on patients with acute gout attack with damp-heat accumulation type,and the influence of serum IL-6 levels on them.Methods Select 72 patients with acute gout attack with damp-heat accumulation type from August 2020 to January 2023 in Quanzhou Hospital of Traditional Chinese Medicine,and divide them into control group and observation group according to the principle of random and comparison,with 36 cases in each group.Both groups were given basic treatment with colchicine,and the observation group were treated additional oral modified simiao pills and sihuang shuimi traditional Chinese medicine for external application.After 2 weeks of treatment,the pain relief time,joint pain index and function score,TCM syndrome scores before and after treatment were compared between the two groups,and the uric acid(UA)and inflammatory indexes(CRP,IL-6,WBC)were compared between the two groups before and after treatment.Results After treatment,the total effective rate in the observation group was 97.22%which was better than 77.78%in the control group(P<0.05).After treatment,the pain relief time,joint pain index,function score and TCM syndrome score of the two groups decreased compared with those before treatment(P<0.05),and the decline rate of the observation group was significantly better than that of the control group(P<0.05),After treatment,SUA,CRP,IL-6,and WBC in the two groups were all decreased compared with those before treatment(P<0.05),and the decline rate in the Guancha group was significantly better than that in the control group(P<0.05).Conclusion Modified simiao pills combined with external application of sihuang shuimi is safe and reliable in the treatment of acute gout attack with damp-heat accumulation type,which can better relieve the pain symptoms of patients,inhibit the inflammatory response and reduce SUA level of patients.

关 键 词：痛风性关节炎 清热利湿 白细胞介素-6 血尿酸 

分 类 号：R684.3[医药卫生—骨科学]