清热祛湿通络方联合西医常规治疗湿热蕴结型急性痛风性关节炎临床研究  

Clinical study of Qingre Qushi Tongluo Formula combined with conventional Western medicine on acute gouty arthritis with damp-heat accumulation type

作　　者：夏圣杰 周巧莲 史柏强 邓理 邓君朴 XIA Shengjie;ZHOU Qiaolian;SHI Baiqiang;DENG Li;DENG Junpu(Department of Renal Surgery,Yixing Traditional Chinese Medicine Hospital,Yixing,Jiangsu 214200;Traditional Chinese Medicine Pharmacy,Yixing Traditional Chinese Medicine Hospital,Yixing,Jiangsu 214200;Department of Surgery with TCM,Yixing Traditional Chinese Medicine Hospital,Yixing,Jiangsu 214200)

机构地区：[1]江苏省宜兴市中医院肾外科,江苏宜兴214200 [2]江苏省宜兴市中医院中药房,江苏宜兴214200 [3]江苏省宜兴市中医院中医外科,江苏宜兴214200

出　　处：《河北中医》2023年第10期1680-1684,共5页Hebei Journal of Traditional Chinese Medicine

摘　　要：目的观察清热祛湿通络方联合西医常规治疗湿热蕴结型急性痛风性关节炎(AGA)患者的临床疗效。方法将104例湿热蕴结型AGA患者按照随机数字表法分为2组,对照组51例予西医常规治疗,治疗组53例在对照组基础上联合清热祛湿通络方治疗。2组均治疗1周后统计疗效,比较2组治疗前后中医症状(包括关节疼痛、关节红肿、关节发热、口渴、小便短黄及心烦不安)评分、实验室指标[包括血尿酸(UA)、红细胞沉降率(ESR)、C-反应蛋白(CRP)、白细胞介素1β(IL-1β)及肿瘤坏死因子α(TNF-α)]及血液流变学指标[包括全血黏度(高切)、全血黏度(低切)及全血还原黏度]水平变化情况,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96.23%(51/53),不良反应总发生率13.21%(7/53),对照组总有效率84.31%(43/51),不良反应总发生率29.41%(15/51),治疗组总有效率高于对照组(P<0.05),不良反应总发生率低于对照组(P<0.05)。与本组治疗前比较,2组治疗后中医症状关节疼痛、关节红肿、关节发热、口渴、小便短黄、心烦不安评分及总分均降低(P<0.05),且治疗组治疗后关节疼痛、关节红肿、关节发热、小便短黄评分及总分均低于对照组(P<0.05)。与本组治疗前比较,2组治疗后实验室指标UA、ESR、CRP、IL-1β及TNF-α水平均降低(P<0.05),且治疗组治疗后UA、ESR、CRP、IL-1β及TNF-α水平均低于对照组(P<0.05)。与本组治疗前比较,2组治疗后血液流变学指标全血黏度(高切)、全血黏度(低切)及全血还原黏度水平均降低(P<0.05),且治疗组治疗后血液流变学指标全血黏度(高切)、全血黏度(低切)及全血还原黏度水平均低于对照组(P<0.05)。结论清热祛湿通络方联合西医常规治疗湿热蕴结型AGA疗效确切,可有效改善患者中医症状,降低UA水平,减少不良反应的发生,其作用机制可能与抑制炎性反应、改善血液流变学指标有关。Objective To observe the clinical efficacy of Qingre Qushi Tongluo Formula combined with conventional Western medicine in the treatment of acute gouty arthritis(AGA)with damp-heat accumulation type.Methods Totally 104 patients with AGA(damp-heat accumulation type)were randomized to receive conventional western medicine(the control group,n=51)or Qingre Qushi Tongluo Formula+conventional Western medicine(the treatment group,n=53)for 1 week to statistically analyze the efficacy.The traditional Chinese medicine(TCM)symptoms scores including joint pain,joint swelling,joint fever,thirst,short yellow urine and upset,laboratory indexes including uric acid(UA),erythrocyte sedimentation rate(ESR),C-reactive protein(CRP),interleukin-1β(IL-1β)and tumor necrosis factor-α(TNF-α),and hemorheology indexes including whole blood viscosity(WBV)at high shear and low shear rates,and whole blood reduced viscosity were included as comparisons before and after treatment between the two groups.The adverse reaction was assessed.Results The total effective rate in the treatment group was significantly higher than that in the control group(96.23%[51/53]vs 84.31%[43/51],P<0.05),and the total incidence of adverse reactions in the treatment group was significantly lower than that in the control group(13.21%[7/53]vs 29.41%[15/51],P<0.05).After treatment,the each dimension scores and total score of TCM symptoms in the two groups decreased significantly(P<0.05),and the decrease in the treatment group was more common(P<0.05).The levels of UA,ESR,CRP,IL-1βand TNF-αin the two groups were decreased(P<0.05),and the decrease was more significant in the treatment group(P<0.05).The levels of WBV at high shear and low shear rates decreased significantly(P<0.05),and the decrease was more pronounced in the treatment group(P<0.05).Conclusion For patients with AGA(damp-heat accumulation type),Qingre Qushi Tongluo Formula combined with conventional Western medicine has a definite curative effect.It can effectively improve TCM symptoms,reduce UA level and

关 键 词：关节炎 痛风 抗痛风药 中西医结合疗法 湿热蕴结 

分 类 号：R684.3[医药卫生—骨科学]