中西医不同治疗策略对痛风性关节炎的疗效及安全性分析  

Analysis of the efficacy and safety of different treatment modalities of Chinese and Western medicine on gouty arthritis

作　　者：魏凯 杜星辰[3] 章渊源 钱奕 姜婷 汪荣盛[2] 杨晓凌[2] 朱琦 关凤媛[4] 鲁盈 苏晓[6] 姜洪泽[7] 李鸿斌 方勇飞 赵恒立[10] 彭江云 高明利[12] 苏励 何方[14] 陶庆文 胡春蓉[16] 李鹏[17] 李泽光 朱跃兰[19] 古英[20] 姜泉[21] 张明[22] 张剑勇[23] 薛愉[3] 何东仪[12] WEI Kai;DU Xingchen;ZHANG Yuanyuan;QIAN Yi;JIANG Ting;WANG Rongsheng;YANG Xiaoling;ZHU Qi;GUAN Fengyuan;LU Ying;SU Xiao;JIANG Hongze;LI Hongbin;FANG Yongfei;ZHAO Hengli;PENG Jiangyun;GAO Mingli;SU Li;HE Fang;TAO Qingwen;HU Chunrong;LI Peng;LI Zeguang;ZHU Yuelan;GU Ying;JIANG Quan;ZHANG Ming;ZHANG Jianyong;XUE Yu;HE Dongyili(Shanghai Guanghua Hospital of Integrated Traditional Chinese and Western Medicine,Shanghai 200052,China;Shanghai University of Traditional Chinese Medicine,Shanghai 201203,China;Huashan Hospital,Fudan University,Shanghai 200040,China;Yingkou Hospital of Traditional Chinese Medicine,Yingkou 115002,China;Tongde Hospital of Zhejiang Province,Hangzhou 310012,China;Traditional Chinese Medicine Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 200071,China;Affiliated Hospital of Inner Mongolia Medical University,Hohhot 750306,China;Shandong Haiyang Hospital of Traditional Chinese Medicine,Haiyang 265199,China;Chongqing Southwest Hospital,Chongqing 400038,China;Yantai Hospital of Traditional Chinese Medicine,Yantai 264013,China;Yunnan Hospital of Traditional Chinese Medicine,Kunming 650021,China;Liaoning Hospital of Traditional Chinese Medicine,Shenyang 110033,China;Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 200032,China;Community Health Service Center of Xinjing Town Street,Changning District,Shanghai 200336,China;China-Japan Friendship Hospital,Beijing 00029,China;Chongqing Ninth People's Hospital,Chongqing 400799,China;Xinjiang Uygur Autonomous Region Hospital of Traditional Chinese Medicine,Urumqi 830099,China;First Affiliated Hospital,Heilongjiang University of Chinese Medicine,Harbin 150040,China;Dongfang Hospital,Beijing University of Chinese Medicine,Bejing 100078,China;Sichuan Mianyang Hospital of Traditional Chinese Medicine,Mianyang 621053,China;Guang'anmen Hospital,China Academy of Chinese Medical Sciences,Bejing 100053,China;Yueyang Hospital of Integrated Traditional Chinese and Western Medicine,Shanghai U

机构地区：[1]上海市光华中西医结合医院,上海200052 [2]上海中医药大学,上海201203 [3]复旦大学附属华山医院,上海200040 [4]营口市中医院,营口115002 [5]浙江省立同德医院,杭州310012 [6]上海中医药大学附属中医医院,上海200071 [7]内蒙古医科大学附属医院,呼和浩特750306 [8]山东省海阳市中医医院,海阳265199 [9]重庆西南医院,重庆400038 [10]烟台市中医医院,烟台264013 [11]云南省中医医院,昆明650021 [12]辽宁省中医院,沈阳110033 [13]上海中医药大学附属龙华医院,上海200032 [14]上海市长宁区新泾镇街道社区卫生服务中心,上海200336 [15]中日友好医院,北京100029 [16]重庆市第九人民医院,重庆400799 [17]新疆维吾尔自治区中医医院,乌鲁木齐830099 [18]黑龙江中医药大学附属第一医院,哈尔滨150040 [19]北京中医药大学东方医院,北京100078 [20]四川省绵阳市中医医院,绵阳621053 [21]中国中医科学院广安门医院,北京100053 [22]上海中医药大学附属岳阳中西医结合医院,上海200083 [23]深圳市中医院,深圳518005

出　　处：《中华中医药杂志》2023年第12期6133-6138,共6页China Journal of Traditional Chinese Medicine and Pharmacy

基　　金：国家中医药管理局区域中医(专科)诊疗中心建设项目-风湿病科(2018-2022);国家中医药管理局国家中医药循证医学研究建设项目基本中医药循证能力建设(2019-2021);上海市卫健委华东片区中西医结合关节病专科联盟项目(No.2021.12-2023.12);上海申康医院发展中心重大疾病多中心临床研究项目(No.SHDC2020CR1013B)。

摘　　要：目的:本研究旨在分析中西医不同治疗策略对治疗痛风性关节炎的有效性及安全性。方法:收集了全国10个省市、21家医院的3287例痛风性关节炎患者的临床信息,将患者分为中药组(127例)、中西医结合组(155例)、西药组(405例)。并对患者的中医症状评价、血尿酸指标、疼痛缓解度以及综合评价指标进行统计学分析,以评估中西医不同治疗策略下痛风性关节炎患者的疗效和安全性。结果:治疗后,西药组较其他两组尿酸达标率更高(P<0.05)。以中医证候学评分为标准,中药组和中西医结合组较西药组更优(P<0.05)。治疗后疼痛缓解率中药组和中西医结合组也优于西药组(P<0.05)。综合评价体系下,中西医结合治疗优于中药及西药治疗,但差异无统计学意义。在安全性方面,3组患者治疗后的肝、肾功能指标均值均在正常范围内,没有临床意义。结论:相对于西药治疗,中药和中西医结合治疗策略对于痛风性关节炎的疗效更佳,有良好的安全性。Objective:To analyze the efficacy and safety of different treatment strategies of Chinese and Western medicine in the treatment of gouty arthritis.Methods:The clinical information of 3287 patients with gouty arthritis from 10 provinces and 21 hospitals in China were collected and divided into Chinese medicine group(127 cases),combined Chinese and Western medicine group(155 cases),and Western medicine group(405 cases).The patients'traditional Chinese medicine(TCM)symptom evaluation,blood uric acid index,pain relief and comprehensive evaluation index were also statistically analyzed to assess the efficacy and safety of patients with gouty arthritis under different treatment strategies of Chinese and Western medicine.Results:Among the three groups of patients after treatment,the uric acid compliance rate was higher in the Western medicine group compared with the other two groups(P<0.05).The Chinese medicine group and the combined Chinese and Western medicine group were better than the Western medicine group in terms of TCM evidence-based score(P<0.05).The posttreatment pain relief rate was also btter in the Chinese medicine group and the combined Chinese and Western medicine group than in the Western medicine group(P<0.05).Under the comprehensive evaluation system,the combined Chinese and Western medicine treatment was superior to the Chinese and Western medicine treatment,but there was no statistical difference.In terms of safety,the liver and kidney function values of patients in the three groups were within the normal range after treatment,with no clinical significance.Conclusion:Compared with Western medicine treatment,the combined treatment strategy of Chinese and Western medicine is more effective for gouty arthritis and has a good safety profile.

关 键 词：中西医 中药 痛风性关节炎 疗效 安全性 

分 类 号：R589.7[医药卫生—内分泌]