桂枝芍药知母汤加味辨治风寒湿痹型急性痛风性关节炎45例
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摘要
目的:观察桂枝芍药知母汤加味辨治风寒湿痹型急性痛风性关节炎的临床疗效。方法:将90例急性痛风性关节炎患者随机分为观察组和对照组,每组各45例。对照组患者给予塞来昔布联合秋水仙碱治疗,观察组在对照组的基础上加用桂枝芍药知母汤加味治疗。比较两组患者的临床疗效、疼痛缓解时间、复发次数及不良反应发生率,比较两组患者治疗前后中医证候积分变化情况,检测两组患者治疗前后炎症相关指标[白细胞计数(white blood cell,WBC)、C反应蛋白(C reactive protein,CRP)、白细胞介素-6(interleukin-6,IL-6)、白细胞介素-8(interleukin-8,IL-8)]及血沉(erythrocyte sedimentation rate,ESR)、血尿素氮(blood urea nitrogen,BUN)水平变化情况。结果:观察组有效率为95.56%,对照组有效率为82.22%,两组患者临床疗效比较,差异具有统计学意义(P<0.05)。观察组患者疼痛缓解时间及随访6个月复发次数均低于对照组,差异具有统计学意义(P<0.05)。两组患者治疗后中医证候积分均低于本组治疗前,且观察组低于对照组,差异具有统计学意义(P<0.05)。两组患者治疗后WBC、CRP、IL-6、IL-8、ESR、BUA水平均低于同组治疗前,且观察组低于对照组,差异具有统计学意义(P<0.05)。观察组患者治疗期间不良反应发生率低于对照组,差异具有统计学意义(P<0.05)。结论:桂枝芍药知母汤加味辨治风寒湿痹型急性痛风性关节炎疗效显著,可明显改善患者的临床症状及炎症状态。
Objective:To observe the clinical curative effect of Supplemented Cinnamon Twig and Peony Decoction plus Rhizoma Anemarrhenae on acute gouty arthritis with wind-cold-dampness arthralgia syndrome.Methods:Ninety patients with acute gouty arthritis were randomly divided into the observation group and the control group,with 45 cases in each group.The control group was treated with celecoxib combined with colchicines,while the observation group was treated with Cinnamon Twig and Peony Decoction plus Rhizoma Anemarrhenae on the basis of the control group.The clinical efficacy,pain relief time,recurrence times during follow-up and the incidence of adverse reactions during treatment were compared between the two groups.The changes of TCM syndromes score before and after the treatment were compared between the two groups.Inflammation-related indexes including white blood cell(WBC),C reactive protein(CRP),interleukin-6(IL-6),interleukin-8(IL-8),the levels of erythrocyte sedimentation rate(ESR) and blood urea nitrogen(BUN) before and after the treatment were measured.Results:The effective rate was 95.56% in the observation group and 82.22% in the control group.There was a significant difference between the two groups(P<0.05).The pain relief time and the recurrence times of 6 months follow-up in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).After the treatment,the scores of TCM syndromes in both groups were lower than those before the treatment,and the observation group was lower than the control group,the difference was statistically significant(P<0.05).The levels of WBC,CRP,IL-6,IL-8,ESR and BUA in the two groups after the treatment were lower than those before the treatment in the same group,and those in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).The incidence of adverse reactions in the observation group was lower than that in the control group,and there was a significant difference between the two groups(P<0.05).Conclusion:Supplemented Cinnamon Twig and Peony Decoction plus Rhizoma Anemarrhenae has a remarkable efficacy on acute gouty arthritis with wind-cold-dampness arthralgia syndrome,can significantly improve the clinical symptoms and inflammatory state of patients.
Objective:To observe the clinical curative effect of Supplemented Cinnamon Twig and Peony Decoction plus Rhizoma Anemarrhenae on acute gouty arthritis with wind-cold-dampness arthralgia syndrome.Methods:Ninety patients with acute gouty arthritis were randomly divided into the observation group and the control group,with 45 cases in each group.The control group was treated with celecoxib combined with colchicines,while the observation group was treated with Cinnamon Twig and Peony Decoction plus Rhizoma Anemarrhenae on the basis of the control group.The clinical efficacy,pain relief time,recurrence times during follow-up and the incidence of adverse reactions during treatment were compared between the two groups.The changes of TCM syndromes score before and after the treatment were compared between the two groups.Inflammation-related indexes including white blood cell(WBC),C reactive protein(CRP),interleukin-6(IL-6),interleukin-8(IL-8),the levels of erythrocyte sedimentation rate(ESR) and blood urea nitrogen(BUN) before and after the treatment were measured.Results:The effective rate was 95.56% in the observation group and 82.22% in the control group.There was a significant difference between the two groups(P<0.05).The pain relief time and the recurrence times of 6 months follow-up in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).After the treatment,the scores of TCM syndromes in both groups were lower than those before the treatment,and the observation group was lower than the control group,the difference was statistically significant(P<0.05).The levels of WBC,CRP,IL-6,IL-8,ESR and BUA in the two groups after the treatment were lower than those before the treatment in the same group,and those in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).The incidence of adverse reactions in the observation group was lower than that in the control group,and there was a significant difference between the two groups(P<0.05).Conclusion:Supplemented Cinnamon Twig and Peony Decoction plus Rhizoma Anemarrhenae has a remarkable efficacy on acute gouty arthritis with wind-cold-dampness arthralgia syndrome,can significantly improve the clinical symptoms and inflammatory state of patients.
引文
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[11] 王春荣,王鹏,夏建华.中西医结合治疗急性痛风性关节炎临床观察[J].中国中医急症,2018,27(7):1256-1258.
[12] 杜永怡,庞学丰,王思超,等.中医治疗痛风性关节炎急性发作研究近况[J].亚太传统医药,2018,14(2):124-126.
[2] 谭凯玥,曹文富.中医及中西医结合治疗急性痛风性关节炎研究现状[J].实用中医药杂志,2018,34(4):503-505.
[3] 李建洪,杨博,段姮妃,等.中医药治疗痛风的研究概况[J].风湿病与关节炎,2017,6(10):72-76.
[4] 中华医学会风湿病学分会.骨关节炎诊断及治疗指南[J].中华风湿病学杂志,2010,14(6):416-419.
[5] 吴启富,范永中,叶志中.常见风湿病中西医结合诊疗指南(草案) 骨关节炎中西医结合诊疗指南[J].中药药理与临床,2013,29(6):150-155.
[6] 国家中医药管理局.中医病证诊断疗效标准(2012版)[S].北京:中国医药科技出版社,2012:57.
[7] LIU W,SIGDEL K R,WANG Y,et al.High Level Serum Procalcitonin Associated Gouty Arthritis Susceptibility:From a Southern Chinese Han Population[J].PLoS One,2015,10(7):e0132855.
[8] 袁艳平,李长贵.急性痛风性关节炎的规范化治疗[J].医学综述,2014,20(21):3902-3905.
[9] 于一云,薛愉,朱小霞,等.急性痛风性关节炎的药物治疗及选择[J].上海医药,2015,36(11):14-18.
[10] 高丽君,于红娟,王庆华,等.痛风急性期中医外治新进展[J].中医临床研究,2017,9(30):92-95.
[11] 王春荣,王鹏,夏建华.中西医结合治疗急性痛风性关节炎临床观察[J].中国中医急症,2018,27(7):1256-1258.
[12] 杜永怡,庞学丰,王思超,等.中医治疗痛风性关节炎急性发作研究近况[J].亚太传统医药,2018,14(2):124-126.