化浊散结除痹方及其联合别嘌醇治疗慢性痛风性关节炎疗效观察  

Effect of Huazhuo Sanjie Chubi Decoction and Huazhuo Sanjie Chubi Decoction Combined with Allopurinol in Treatment of Chronic Gouty Arthritis

作　　者：郭洁梅 张英杰 肖艳[2] 陈鹏 苏友新 GUO Jiemei;ZHANG Yingjie;XIAO Yan;CHEN Peng;SU Youxin(College of Traditional Chinese Medicine,Fujian University of Traditional Chinese Medicine,Fuzhou,Fujian 350122,China;College of Rehabilitation Medicine,Fujian University of Traditional Chinese Medicine,Fuzhou,Fujian 350122,China;Key Laboratory of Orthopedics&Traumatology of Traditional Chinese Medicine and Rehabilition,Ministry of Education,Fujian University of Traditional Chinese Medicine,Fuzhou,Fujian 350122,China)

机构地区：[1]福建中医药大学中医学院,福建福州350122 [2]福建中医药大学康复医学院,福建福州350122 [3]中医骨伤及运动康复教育部重点实验室,福建福州350122

出　　处：《福建中医药》2024年第3期4-7,12,共5页Fujian Journal of Traditional Chinese Medicine

基　　金：国家重点研发计划“中医药现代化”重点专项(2022YFC 3501200);福建省教育厅、福建省工信厅2023年技术创新重点攻关及产业化项目(2023XQ013)。

摘　　要：目的 观察化浊散结除痹方、别嘌醇及其二者联合治疗慢性痛风性关节炎(CGA)的疗效。方法选择2021年7月—2023年3月在福建中医药大学附属第三人民医院、福建中医药大学国医堂就诊的169例男性CGA患者,按随机数字表法分为西药组56例、中药组56例和联合组57例。西药组给予别嘌醇口服,中药组给予化浊散结除痹方口服,联合组同时口服别嘌醇加化浊散结除痹方,3组疗程均为8周。治疗期间西药组脱落6例、中药组脱落4例、联合组脱落7例,最终完成研究152例,西药组、中药组和联合组各50、52、50例。观察3组治疗前,治疗4、8周后血尿酸(UA)、肌酐(Cr)、血沉(ESR)水平;治疗前后中医证候评分及关节肿胀、关节疼痛、关节屈伸不利等单项症状评分;治疗期间痛风发作次数,并比较疗效及不良反应发生情况。结果 与治疗前比较,治疗4、8周后3组UA、Cr、ESR均降低(P<0.05),中药组与联合组中医证候评分,关节肿胀、关节疼痛、关节屈伸不利等中医证候单项评分降低(P<0.05)。治疗4周后,与西药组比较,中药组UA水平升高,ESR水平降低(P<0.05);治疗8周后,与西药组比较,中药组、联合组中医证候评分、关节肿胀、关节疼痛、关节屈伸不利等中医证候单项症状评分、治疗期间痛风发作次数减少(P<0.05)。结论 化浊散结除痹方及其联合别嘌醇治疗可显著降低CGA患者血UA、Cr、ESR水平,改善中医证候,减少治疗期间痛风发作次数。化浊散结除痹方及其联合别嘌醇治疗在改善患者关节肿胀、关节疼痛、关节屈伸不利等中医证候表现以及减少治疗期间痛风发作次数方面,效果优于单纯应用别嘌醇,值得推广应用。Objective:To compare and observe the curative effect of Huazhuo Sanjie Chubi Decoction(HSCD),allopurinol and their combination in the treatment of chronic gouty arthritis(CGA).Methods:A total of 169 male patients with CGA who were admitted to the Third People's Hospital Affiliated to Fujian University of Traditional Chinese Medicine and the Guoyitang of Fujian University of Traditional Chinese Medicine from July 2021 to March 2023 were selected and divided into the western medicine group(56 cases),traditional Chinese medicine(TCM)group(56 cases)and combined treatment group(57 cases)according to random number table method.The western medicine group took allopurinol orally,the TCM group was given oral treatment of HSCD,and the combined treatment group was treated with the above two. The course of treatment was 8 weeks. During treatment, 6 cases fell off in the western medicine group, 4 cases fell off in the TCM group and 7 cases fell off in the combined treatment group. Finally, 152 cas‐es were completed in the study, 50 cases in the western medicine group, 52 cases in the TCM group and 50 cases in the combined treatment group. The levels of serum uric acid (UA), creatinine (Cr) and erythrocyte sedimentation rate (ESR) before treatment and 4 weeks and 8 weeks after treatment;the total score of TCM syndromes, and the single TCM syndrome scores (including joint swelling, joint pain, adverse flexion and extension) before and after treatment in the 3 groups were counted. The number of gout attacks in the 3 groups during treatment was observed, and the efficacy and adverse reactions were compared. Results: Compared with those before treatment, UA, Cr, and ESR in 3 groups decreased after 4 weeks and 8 weeks of treatment, the difference was statis‐tically significant (P<0.05);the total score of TCM syndromes and the single TCM syndrome scores decreased between the TCM group and the combined group (P<0.05). After 4 weeks of treatment, The UA in TCM group was higher while the ESR was lower than that in western medicine

关 键 词：慢性痛风性关节炎 化浊散结除痹方 脾虚湿浊 痰瘀互结证 

分 类 号：R259[医药卫生—中西医结合]