泄化浊瘀方对急性痛风性关节炎患者血清炎症因子、氧化应激及相关基质金属蛋白酶表达的影响  

Effect of Xiehua Zhuoyu Decoction on the Expression of Serum Inflammatory Factors,Oxidative Stress and Related Matrix Metalloproteinase in Acute Gouty Arthritis

作　　者：姜丹 卢嘉琦 李晓倩[1] 吴坚[1] Jiang Dan;Lu Jiaqi;Li Xiaoqian;Wu Jian(Nantong Affiliated Hospital of Nanjing University of Chinese Medicine,Jiangsu,Nantong 226001,China)

机构地区：[1]南京中医药大学南通附属医院,江苏南通226001

出　　处：《中国中医急症》2023年第10期1805-1809,共5页Journal of Emergency in Traditional Chinese Medicine

基　　金：江苏省中医药管理局科研项目(2019039);江苏省南通市科技计划项目(MSZ19213);江苏省南通市中医医疗联盟课题(TZYK202002)。

摘　　要：目的 观察泄化浊瘀方联合芙黄膏外用治疗急性痛风性关节炎(AGA)(湿热蕴结证)的临床疗效及对血清炎症因子、氧化应激及基质金属蛋白酶的影响。方法 将100例患者随机分为对照组与观察组各50例。对照组口服美洛昔康片联合双氯芬酸二乙胺乳胶外用;观察组给予泄化浊瘀方联合芙黄膏外用;疗程均为5 d。患者每日记录疼痛程度(VAS评分);比较治疗前后关节疼痛、压痛、肿胀和活动障碍评分;记录湿热蕴结证积分;检测治疗前后超敏C反应蛋白(hs-CRP)、肿瘤坏死因子-α(TNF-α)、白细胞介素-1β(IL-1β)、白细胞介素-6(IL-6)、丙二醇(MDA)、超氧化物歧化酶(SOD)、8-羟基脱氧鸟苷(8-OHdG)、基质金属蛋白酶-3(MMP-3)、基质金属蛋白酶-7(MMP-7)、基质金属蛋白酶-9(MMP-9)和金属蛋白酶抑制剂-1(TIMP-1)水平;进行安全性评价。比较两组中医证候疗效。结果 治疗后两组患者VAS评分显著下降(P <0.05),观察组患者在治疗后2~5 d的VAS评分均低于对照组(P <0.05);治疗后观察组患者关节疼痛、压痛、肿胀和活动障碍评分低于对照组(P <0.05);治疗后,两组患者hs-CRP、TNF-α、IL-1β和IL-6水平下降(P <0.05),且观察组低于对照组(P <0.05);治疗后观察组MMP-3、MMP-7、MMP-9水平低于对照组(P <0.05),TIMP-1水平高于对照组(P <0.05);治疗后观察组8-OHdG、MDA低于对照组(P <0.05),SOD高于对照组(P <0.05);治疗后观察组中医证候疗效总有效率高于对照组(P <0.05)。结论 泄化浊瘀方联合芙黄膏外用治疗AGA(湿热蕴结证)患者,具有抗炎、抗氧化和调节MMP作用,能减轻疼痛、肿胀,改善肢体活动范围,疗效优于常规抗炎止痛治疗措施,且使用安全。Objective:To observe the clinical efficacy of Xiehua Zhuoyu Decoction combined with Fuhuang Ointment for external use in the treatment of acute gouty arthritis(AGA)with damp heat accumulation syndrome and its effect on serum inflammatory factors,oxidative stress and matrix metalloprotein.Methods:A total of 100 patients were randomly divided into the control group and observation group,with 50 patients in each group.The control group was given meloxicam tablets combined with diclofenac diethylamine emulsion for external use;the ob⁃servation group was given Xiehua Zhuoyu Decoction combined with Fuhuang Ointment for external use.The treat⁃ment period for both groups were 5 days.The pain level(VAS score),scores of joint pain,tenderness,swelling,and mobility disorders before and after treatment were compared;the integral of dampness heat accumulation syndrome,hypersensitive C-reactive protein(hs-CRP)and tumor necrosis factor-α(TNF-α)before and after treatment,inter⁃leukin-1β(IL-1β),IL-6,MDA,superoxide dismutase(SOD),8-hydroxy deoxyguanosine(8-OHdG),matrix metal⁃loproteinase-3(MMP-3),matrix metalloproteinase-7(MMP-7),matrix metalloproteinase-9(MMP-9)and inhibitor of metalloproteinase-1(TIMP-1)levels,and the safety evaluation,therapeutic effects of traditional Chinese medi⁃cine syndromes were compared between the groups.Results:After treatment,the VAS scores of the two groups gradually decreased(P<0.05),and the VAS scores of the observation group patients were lower than those of the control group on the 2~5 days after treatment(P<0.05);after treatment,the scores of joint pain,tenderness,swell⁃ing,and movement disorders in the observation group were lower than those in the control group(P<0.05);after treatment,hs-CRP,TNFα,IL-1βand IL-6 decreased(P<0.05),and the observation group was lower than the control group(P<0.05);after treatment,the levels of MMP-3,MMP-7,and MMP-9 in the observation group were lower than those in the control group(P<0.05),while the levels of TIMP-1 were higher than those in the c

关 键 词：急性痛风性关节炎 湿热蕴结证 泄化浊瘀方 炎症因子 氧化应激 基质金属蛋白酶 

分 类 号：R589.7[医药卫生—内分泌]