解毒散瘀膏联合西药治疗急性痛风性关节炎(湿热蕴结证)的疗效观察  

Evaluation of the Efficacy of Jiedu Sanyu Ointment Combined with Western Medications in Treating Acute Gouty Arthritis(Syndrome of Accumulated Dampness-heat)

作　　者：刘文平 李善志 周永东 Liu Wenping;Li Shanzhi;Zhou Yongdong(Shapingba District Traditional Chinese Medicine Hospital,Chongqing 400000,China)

机构地区：[1]重庆市沙坪坝区中医院,重庆400000

出　　处：《中国中医急症》2024年第10期1784-1787,共4页Journal of Emergency in Traditional Chinese Medicine

基　　金：重庆市沙坪坝区科卫联合项目(2023SQKWLH057)。

摘　　要：目的 观察外敷解毒散瘀膏联合口服秋水仙碱及依托考昔治疗急性痛风性关节炎(湿热蕴结证)的临床疗效。方法 选取86例患者随机分为观察组与对照组各43例。对照组予以口服秋水仙碱片和依托考昔片治疗,观察组在对照组基础上加用外敷解毒散瘀膏治疗,连续治疗6 d。比较两组治疗前后临床症状和体征(TSS)评分、中医证候评分、实验室指标[白细胞计数(WBC)、血尿酸水平(BUA)、血清C反应蛋白(CRP)及血沉(ESR)]、不良反应发生率与复发率,并于治疗结束后进行疗效评定。结果 治疗后两组TTS评分和中医证候评分均较治疗前明显下降(P <0.05),且观察组下降程度更明显(P <0.05);治疗后两组WBC、BUA、CRP及ESR水平较治疗前明显降低(P <0.05),且观察组WBC、CRP及ESR较对照组更低(P <0.05),但两组间BUA水平无明显差异(P> 0.05)。观察组的总有效率为94.87%,高于对照组的85.00%(P <0.05)。研究期间两组不良反应总发生率差异无统计学意义(P> 0.05)。随访3个月,两组复发率差异无统计学意义(P> 0.05)。结论 外敷解毒散瘀膏联合口服秋水仙碱及依托考昔治疗急性痛风性关节炎的疗效确切,能有效改善患者的症状及体征,降低炎症反应,复发率低且安全性高,且联合用药比单纯口服西药在改善症状、体征、降低炎症因子水平及中医证候方面更具优势。Objective:To observe the clinical efficacy of Jiedu Sanyu ointment combined with oral colchicine and etoricoxib in treating acute gouty arthritis(syndrome of accumulated dampness-heat).Methods:A total of 86 patients were randomly divided into an observation group and a control group,each with 43 patients.The control group received oral colchicine tablets and etoricoxib tablets,while the observation group was added with topical ap-plication of Jiedu Sanyu ointment on the basis of the control group.The treatment lasted for 6 consecutive days.Clinical symptoms and signs(TSS)scores,traditional Chinese medicine(TCM)syndrome scores,laboratory indica-tors[white blood cell count(WBC),blood uric acid level(BUA),serum C-reactive protein(CRP),erythrocyte sedi-mentation rate(ESR)],incidence of adverse reactions,and recurrence rates were compared before and after treat-ment.An efficacy assessment was conducted at the end of the treatment period.Results:After treatment,TSS scores and TCM syndrome scores decreased significantly in both groups compared with before treatment(P<0.05),with a more significant reduction in the observation group(P<0.05).WBC,BUA,CRP,and ESR levels decreased significantly in both groups after treatment compared with before treatment(P<0.05);the WBC,CRP,and ESR lev-els were lower in the observation group than those in the control group(P<0.05),but there was no significant dif-ference in BUA levels between the two groups(P>0.05).The overall effective rate of the observation group was 94.87%,which was better than the 85.00%in the control group(P<0.05).There was no significant difference in the total incidence of adverse reactions between the two groups during the study period(P>0.05).During the 3-month follow-up,there was no significant difference in recurrence rates between the two groups(P>0.05).Conclu-sion:The combination of topical application of Jiedu Sanyu ointment with oral colchicine and etoricoxib for treat-ing acute gouty arthritis shows definite efficacy,effectively improving symptoms and signs,

关 键 词：急性痛风性关节炎 湿热蕴结证 解毒散瘀膏 秋水仙碱 依托考昔 

分 类 号：R589.7[医药卫生—内分泌]