三仁汤加减联合艾瑞昔布治疗急性痛风性关节炎临床观察  

Clinical Observation of Modified Sanren Decoction Combined with Iricoxib in the Treatment of Acute Gouty Arthritis

作　　者：张永刚 李慧艳[1] 张绍君 严亚萍 王平 侯亚卓 杨宗娜 王一帆 李俊巧[1] Zhang Yonggang;Li Huiyan;Zhang Shaojun;Yan Yaping;Wang Ping;Hou Yazhuo;Yang Zongna;Wang Yifan;Li Junqiao(Baoding No.1 Central Hospital,Hebei,Baoding 071000,China)

机构地区：[1]河北省保定市第一中心医院,河北保定071000

出　　处：《中国中医急症》2024年第3期476-480,共5页Journal of Emergency in Traditional Chinese Medicine

基　　金：河北省医学科学研究课题计划(20220283);保定市科技计划项目(2341ZF106)。

摘　　要：目的观察三仁汤加减联合艾瑞昔布治疗急性痛风性关节炎(湿热痹阻证)临床疗效及对实验室指标的影响。方法将80例患者分为对照组与观察组各40例。对照组患者在常规治疗基础上给予艾瑞昔布片治疗,观察组在对照组治疗基础上联合三仁汤加减方治疗,均连续治疗7 d。观察两组患者治疗前后主要症状体征积分、湿热体质积分、血尿酸(UA)、血沉(ESR)、C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)、白细胞介素6(IL-6)、白细胞介素-1β(IL-1β)水平变化,比较两组治疗后临床疗效、湿热体质改善疗效,并评价两组治疗安全性情况。结果两组治疗后关节急性红肿、关节压痛、关节疼痛及关节活动障碍度评分均降低(P<0.05),且观察组治疗后以上症状体征积分均低于对照组(P<0.05);两组治疗后身重困倦、口苦口干、心烦懈怠、大便黏滞或燥结、小便短赤积分均降低(P<0.05),且观察组均低于对照组(P<0.05);两组治疗后UA、ESR、CRP、TNF-α、IL-6、IL-1β水平均降低(P<0.05),且观察组均低于对照组(P<0.05);观察组总有效率为92.50%,明显高于对照组的75.00%(P<0.05);观察组湿热体质改善总有效率90.00%,明显高于对照组72.50%(P<0.05);两组治疗期间均未出现明显与用药相关的不良反应。结论三仁汤加减联合艾瑞昔布治疗急性痛风性关节炎(湿热痹阻证)疗效显著,能够有效缓解患者临床症状,改善湿热体质,调节理化检查指标水平,且毒副作用小,可为痛风性关节炎急性发作的中西医治疗提供新的思路。Objective:To explore the clinical efficacy of Modified Sanren Decoction combined with irecoxib in the treatment of acute gouty arthritis with syndrome of heat-dampness blockage and its impact on laboratory indi⁃cators.Methods:A total of 80 patients were randomly divided into a control group and an observation group,with 40 cases each.The control group was treated with iricoxib tablets on the basis of routine treatment,while the obser⁃vation group was treated with Modified Sanren Decoction on the basis of the control group.All were continuously treated for 7 days.The main symptoms and signs of two groups before and after treatment,dampness and heat con⁃stitution score,laboratory indicators(UA,ESR,CRP),and serum inflammation indicators TNF-α,IL-6,IL1βchanges were observed;the clinical efficacy and improvement of heat-dampness constitution between the two groups after treatment were compared,and the safety of the two groups treatments was evaluated.Results:After treatment,the scores of acute joint redness and swelling,joint tenderness,joint pain,and joint mobility disorders in both groups were all decreased(P<0.05),and the scores of the above symptoms and signs in the observation group were lower than those in the control group(P<0.05);the scores of heavy body drowsiness,bitter and dry mouth,irritated and lax,sticky or dry stools,short and red urine in both groups were all decreased(P<0.05),and the observation group was lower than the control group(P<0.05).The levels of UA,ESR,CRP,TNF-α,IL-6,IL-1βin both groups were all decreased(P<0.05),and the observation group was lower than the control group(P<0.05).The total effective rate of 92.50%in the observation group was significantly higher than 75.00%in the control group(P<0.05);the total effective rate of improving heat-dampness constitution in the observation group was 90.00%,which was significantly higher than 72.50%in the control group(P<0.05).There were no significant adverse reactions related to medication during the treatment period in both groups.Concl

关 键 词：急性痛风性关节炎 湿热痹阻证 三仁汤加减方 湿热体质 理化检查指标 炎症指标 

分 类 号：R589.7[医药卫生—内分泌]