伤柏膏外敷联合关节镜清理术治疗湿热蕴结型急性痛风性关节炎临床研究  

Clinical Study on External Application of Shangbai Ointment Combined with Ar⁃throscopic Debridement for Acute Gouty Arthritis of Damp-Heat Accumulation Type

作　　者：方磊[1] 刘晓虹 田晓翔 蒋欢 吴长军 欧亚新 罗德发 王亚元 朱玉胜 张爱华 杨永红 罗昌军 邱恺[1] 黄应炜 佘梓宏 FANG Lei;LIU Xiaohong;TIAN Xiaoxiang;JIANG Huan;WU Changjun;OU Yaxin;LUO Defa;WANG Yayuan;ZHU Yusheng;ZHANG Aihua;YANG Yonghong;LUO Changjun;QIU Kai;HUANG Yingwei;SHE Zihong(Traditional Chinese Medicine Hospital of Tianhe District,Guangzhou Guandong 510665,China;Liu Xiaohong Guangzhou Grassroots Famous Medical Studio,Guangzhou Guandong 510665,China;Traditional Chinese Medicine Hospital of Dafang County,Dafang Guizhou 551700,China;People's Hospital of Dafang County,Dafang Guizhou 551700,China)

机构地区：[1]广州市天河区中医医院,广东广州510665 [2]刘晓虹广州市基层名医工作室,广东广州510665 [3]大方县中医医院,贵州大方551700 [4]大方县人民医院,贵州大方551700

出　　处：《新中医》2024年第13期121-125,共5页New Chinese Medicine

基　　金：广东省中医药局科研项目(20231268);贵州省科技厅临床科研项目(黔科合成果-LC[2024]108)。

摘　　要：目的:观察伤柏膏外敷联合关节镜清理术治疗湿热蕴结型急性痛风性关节炎的疗效。方法:选取100例湿热蕴结型急性痛风性关节炎患者,按随机数字表法分为试验组及对照治各50例。2组术前、术后均接受苯溴马隆降尿酸治疗,关节清理术治疗,术后均予预防感染、指导康复功能锻炼等常规处理。试验组术后在常规处理基础上使用外敷伤柏膏,对照组在常规处理基础上给予秋水仙碱片治疗。比较2组临床疗效,比较2组治疗前后疼痛视觉模拟评分法(VAS)评分、膝关节Lysholm评分、膝关节液白细胞介素-1β(IL-1β)水平、中医证候积分的变化。结果:治疗后,关节液IL-1β水平均较治疗前下降(P<0.05),ESR、CRP组内比较,差异无统计学意义(P>0.05);治疗后,试验组关节液IL-1β水平低于对照组(P<0.05),ESR、CRP组间比较,差异无统计学意义(P>0.05)。治疗后,2组VAS评分、中医证候积分均较治疗前下降(P<0.05),Lysholm评分均较治疗前上升(P<0.05);试验组VAS评分、中医证候积分均低于对照组(P<0.05),Lysholm评分高于对照组(P<0.05)。治疗后,试验组临床疗效优于对照组,差异有统计学意义(P<0.05)。结论:伤柏膏外敷联合关节镜清理术治疗湿热蕴结型急性GA可有效缓解临床症状,降低关节炎症程度,减轻关节肿痛度,改善关节功能。Objective:To observe the curative effect of external application of Shangbai Ointment combined with arthroscopic debridement on acute gouty arthritis of damp-heat accumulation type.Methods:A total of 100 cases of patients with acute gouty arthritis of damp-heat accumulation type wereselected and divided into the trial group and the control group according to the random number tablemethod,with 50 cases in each group.Both groups received uric acid lowering treatment withbenzbromarone and arthroscopic debridement before and after surgery,and routine treatments such asinfection prevention and guidance for rehabilitation and functional exercise after surgery.The trial groupreceived external application of Shangbai Ointment on the basis of routine treatment after surgery,and thecontrol group received treatment with Colchicine Tablets on the basis of routine treatment.The clinicaleffects were compared between the two groups.The changes in Visual Analogue Scale(VAS)scores ofpain,knee joint Lysholm score,levels of interleukin-1β(IL-1β)in knee joint fluid,and traditional Chinesemedicine(TCM)syndrome scores were compared before and after treatment between the two groups.Results:After treatment,IL-1βlevels in knee joint fluid were reduced when compared with those beforetreatment(P<0.05),and the levels of ESR and CRP showed no significant difference in the two groupsrespectively(P>0.05).After treatment,IL-1βlevel in knee joint fluid in the trial group was lower than thatin the control group(P<0.05),and the levels of ESR and CRP showed no significant difference between thetwo groups(P>0.05).After treatment,the VAS scores and TCM syndrome scores in the two groups weredecreased when compared with those before treatment(P<0.05),and the Lysholm scores were increasedwhen compared with those before treatment(P<0.05).The VAS score and TCM syndrome score in the trialgroup were lower than those in the control group(P<0.05),and the Lysholm score was higher than that inthe control group(P<0.05).After treatment,the clinical effect in

关 键 词：急性痛风性关节炎 湿热蕴结型 伤柏膏 关节镜清理术 

分 类 号：R589.7[医药卫生—内分泌]