四妙散加减联合外敷痛风膏治疗慢性肾脏病合并急性痛风的临床研究  

Clinical study on treating chronic kidney disease complicated with acute gout by Addition and Subtraction of Simiao Powder combined with External Application of Gout Cream

作　　者：熊斯璐 李宇丹 彭璘 Xiong Silu;Li Yudan;Peng Lin(Jiangxi Hospital of Integrated Traditional Chinese and Western Medicine,Nanchang,Jiangxi 330006,China;Affiliated Hospital of Jiangxi University of TCM,Nanchang,Jiangxi 330006,China)

机构地区：[1]江西省中西医结合医院,江西南昌330006 [2]江西中医药大学附属医院

出　　处：《齐齐哈尔医学院学报》2023年第18期1731-1735,共5页Journal of Qiqihar Medical University

基　　金：江西省卫生计生委中医药科研课题项目(2018A170)。

摘　　要：目的 本研究通过运用四妙散加减联合痛风膏外敷治疗,观察其对慢性肾脏病急性痛风发作患者的疗效。方法 选择2019年1月-2021年12月在本院肾病科门诊及住院部确诊为慢性肾脏病(CKD)急性痛风发作的患者60例作为研究对象,采用随机数表法分为治疗组和对照组两组,每组各30例。在常规治疗的基础上,治疗组选用四妙散加减+外敷方,对照组选用非甾体解热镇痛药;两组均以8周作为1个疗程,在1个疗程的治疗结束以后,观察各组治疗前后的中医征候积分、关节肿痛与活动度、血尿酸(UA)、血肌酐(Scr)、尿素氮(BUN)、C-反应蛋白(CRP)、血沉(ESR)、白细胞计数(WBC)等指标的变化情况。结果 在改善临床疗效方面,治疗组总有效率为86.7%;对照组总有效率为50.0%,与对照组比较,治疗组疗效具有统计学意义(P<0.01)。两组患者在改善中医征候疗效方面,对照组总有效率为56.7%,治疗组总有效率达80.0%,差异具有统计学意义(P<0.05)。在降低各项中医征候积分方面,治疗组亦较对照组差异具有统计学意义(P<0.05);在降低血尿酸、血肌酐、尿素氮、C-反应蛋白、血沉、白细胞计数水平方面,与对照组比较,治疗组治疗后具体统计学意义(P<0.05)。结论 本研究表明四妙散加减联合中药外敷可降低慢性肾脏病急性痛风发作患者的血尿酸、血肌酐、尿素氮、C-反应蛋白、血沉、白细胞计数水平,改善关节肿痛与活动度,减少肾损害,改善肾功能。Objective To observe the effect of Simiao powder addition/subtraction combined with external application of gout cream on acute gout patients with chronic kidney disease.Methods From January 2019 to December 2021,60 patients diagnosed with acute gout attack of chronic kidney disease(CKD)in the nephrology clinic and inpatient department of Jiangxi Hospital of Integrated Traditional Chinese and Western Medicine were selected as the research objects.According to the random number table method,they were divided into the treatment group and the control group,with 30 cases in each group.On the basis of conventional treatment,the treatment group was treated with Simiao powder addition/subtraction plus external application,and the control group was treated with non-steroidal antipyretic and analgesic drugs.After a course of treatment(8 weeks),the TCM symptom score,joint swelling and pain and activity,blood uric acid(UA),serum creatinine(Scr),blood urea nitrogen(BUN),C-reactive protein(CRP),erythrocyte sedimentation rate(ESR),white blood cell count(WBC)and other indicators were observed before and after treatment.Results The total effective rate of the treatment group was 86.7%,and the total effective rate of the control group was 50.0%.There was statistically significant difference in curative effect between the control group and the treatment group(P<0.01).In improving the efficacy of TCM symptoms,the total effective rate was 56.7%in the control group and 80.0%in the treatment group,and the difference between the two groups was statistically significant(P<0.05).Compared with the control group,the treatment group also had significant differences in reducing the scores of TCM syndromes(P<0.05).Compared with the control group,the treatment group had significant reductions in the levels of serum uric acid,serum creatinine,urea nitrogen,C-reactive protein,erythrocyte sedimentation rate,and white blood cell count(P<0.05).Conclusions This study shows that Simiao powder addition/subtraction combined with external application of

关 键 词：慢性肾脏病 急性痛风 四妙散 痛风膏外敷 

分 类 号：R259[医药卫生—中西医结合]