萆薢祛风饮联合洛索洛芬钠治疗湿热蕴结型急性痛风性关节炎的临床研究
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摘要
【目的】观察萆薢祛风饮联合洛索洛芬钠治疗湿热蕴结型急性痛风性关节炎的临床疗效。【方法】将70例湿热蕴结型急性痛风性关节炎患者随机分为观察组和对照组,每组各35例。2组患者均给予急性痛风性关节炎的常规基础治疗,在此基础上,对照组给予洛索洛芬钠片+苯溴马隆胶囊治疗,观察组给予洛索洛芬钠片+萆薢祛风饮治疗,连续治疗1周。观察2组患者治疗前后关节疼痛和肿胀的视觉模拟法(VAS)评分、血尿酸(SUA)和C-反应蛋白(CRP)水平的变化情况,评价2组的疗效和安全性。【结果】(1)治疗1周后,观察组总有效率为91.43%,对照组为85.71%,观察组的疗效略优于对照组(P<0.05)。(2)治疗后,2组患者的关节疼痛和肿胀VAS评分均较治疗前明显下降(P<0.05),但治疗后组间比较,差异无统计学意义(P>0.05)。(3)治疗后,2组患者SUA和CRP水平均较治疗前明显下降(P<0.05),且观察组的下降作用均明显优于对照组(P<0.05)。(4)治疗过程中,对照组有3例出现上腹部不适,2例出现恶心纳差,观察组有2例出现腹泻症状;观察组的不良反应发生率为5.71%,明显低于对照组的14.29%(P<0.05)。【结论】萆薢祛风饮联合洛索洛芬钠治疗湿热蕴结型急性痛风性关节炎,疗效满意,有较好的降SUA和抗炎作用,且安全性高。
Objective To observe the clinical effect of Bixie Qufeng Yin plus Loxoprofen Sodium for the treatment of acute gouty arthritis(AGA)of damp-heat accumulation type.Methods Seventy patients with AGA of damp-heat accumulation type were randomly divided into observation group and control group,35 cases in each group.The two groups were given routine treatment for AGA,and additionally the control group was treated with Loxoprofen Sodium Tablets+Benzbromarone Capsules and the observation group was treated with Loxoprofen Sodium Tablets+Bixie Qufeng Yin.The treatment of the two groups lasted one week.Before and after treatment,the visual analogue scale(VAS)scores of joint pain and swelling,and serum uric acid(SUA)and C-reactive protein(CRP)levels in the two groups were observed.After treatment,the clinical efficacy and safety of the two groups were compared.Results(1)After treatment for one week,the total effective rate in the observation group was 91.43%,and that in the control group was 85.71%,the effect of the observation group being superior to that of the control group(P<0.05).(2)VAS scores of joint pain and swelling in the two groups were obviously decreased(P<0.05 compared with those before treatment),but the difference between the two groups was insignificant(P>0.05).(3)SUA and CRP levels in the two groups were obviously decreased after treatment(P<0.05 compared with those before treatment),and the decrease in the observation group was superior to that in the control group(P<0.05).(4)During the treatment,the control group had 3 cases of upper abdominal discomfort and 2 cases of nausea and poor appetite,the incidence of adverse reaction being 14.29%;the observation group had 2 cases of diarrhea,the incidence of adverse reaction being 5.71%.The observation group had lower adverse reaction incidence than the control group(P<0.05).Conclusion Bixie Qufeng Yin plus Loxoprofen Sodium is safe and effective for the treatment of acute gouty arthritis of damp-heat accumulation type,showing certain effect on decreasing SUA and counteracting inflammation.
Objective To observe the clinical effect of Bixie Qufeng Yin plus Loxoprofen Sodium for the treatment of acute gouty arthritis(AGA)of damp-heat accumulation type.Methods Seventy patients with AGA of damp-heat accumulation type were randomly divided into observation group and control group,35 cases in each group.The two groups were given routine treatment for AGA,and additionally the control group was treated with Loxoprofen Sodium Tablets+Benzbromarone Capsules and the observation group was treated with Loxoprofen Sodium Tablets+Bixie Qufeng Yin.The treatment of the two groups lasted one week.Before and after treatment,the visual analogue scale(VAS)scores of joint pain and swelling,and serum uric acid(SUA)and C-reactive protein(CRP)levels in the two groups were observed.After treatment,the clinical efficacy and safety of the two groups were compared.Results(1)After treatment for one week,the total effective rate in the observation group was 91.43%,and that in the control group was 85.71%,the effect of the observation group being superior to that of the control group(P<0.05).(2)VAS scores of joint pain and swelling in the two groups were obviously decreased(P<0.05 compared with those before treatment),but the difference between the two groups was insignificant(P>0.05).(3)SUA and CRP levels in the two groups were obviously decreased after treatment(P<0.05 compared with those before treatment),and the decrease in the observation group was superior to that in the control group(P<0.05).(4)During the treatment,the control group had 3 cases of upper abdominal discomfort and 2 cases of nausea and poor appetite,the incidence of adverse reaction being 14.29%;the observation group had 2 cases of diarrhea,the incidence of adverse reaction being 5.71%.The observation group had lower adverse reaction incidence than the control group(P<0.05).Conclusion Bixie Qufeng Yin plus Loxoprofen Sodium is safe and effective for the treatment of acute gouty arthritis of damp-heat accumulation type,showing certain effect on decreasing SUA and counteracting inflammation.
引文
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[16]邢振龙,丘青中,李剑.萆薢祛风饮联合肿痛消膏治疗急性痛风性关节炎的临床研究[J].中国中医急症,2018,27(1):69.
[2]李迎春,徐建华.急性痛风性关节炎的发病机制及研究进展[J].安徽医学,2013,34(1):96.
[3]Lu X,Li X,Zhao Y,et al.Contemporary epidemiology of gout and hyperuricemia in community elderly in Beijing[J].Int JRheum Dis,2014,17(4):40.
[4]Kuo C F,Grainge M J,Zhang W,et al.Global epidemiology of gout:prevalence,incidence and risk factors[J].Nat Rev Rheumatol,2015,11(11):49.
[5]Zhang W,Doherty M,Pascual E,et al.EULAR evidence based recommendations for gout.Part1:Diagnosis.Report of a task force of the standing committee for international clinical studies including therapeutics[J].Ann Rheum Dis,2006,65(10):1301.
[6]Zhu Y,Pandya B J,Choi H K.Prevalence of gout and hyperuricemia in the US general population[J].Arthritis Rheum,2011,63(10):3136.
[7]Kuo C F,Grainge M J,Mallen C,et al.Rising burden of gout in the UK but continuing suboptimal management:a nationwide population study[J].Ann Rheum Dis,2015,74(4):661.
[8]Gonzalez-Rozas M,Prieto D P,Franco H S,et al.Chronic tophaceous gout[J].Semergen,2013,39(6):29.
[9]杨雪,刘磊,朱小霞,等.2015年美国风湿病学会/欧洲抗风湿病联盟痛风分类标准评述[J].中华风湿学杂志,2016,20(2):141.
[10]国家中医药管理局.中医病证诊断疗效标准[M].南京:南京大学出版社,1994:60.
[11]郑筱萸.中药新药临床研究指导原则[M].北京:中国医药科技出版社,2002:2015.
[12]王磊.清热解毒除湿通痹法治疗原发性急性痛风性关节炎的临床观察[D].北京:北京中医药大学,2014.
[13]中华医学会.临床诊疗指南·风湿病分册[M].北京:人民卫生出版社,2005:120.
[14]Sivera F,Andres M,Carmona L,et al.Multinational evidencebased recommendations for the diagnosis and management of gout:integrating systematic literature review and expert opinion of a broad panel of rheumatologists in the 3e initiative[J].Ann Rheum Dis,2014,73(2):328.
[15]Khanna P P,Gladue H S,Singh M K,et al.Treatment of acute gout:a systematic review[J].Semin Arthritis Rheum,2014,44(1):31.
[16]邢振龙,丘青中,李剑.萆薢祛风饮联合肿痛消膏治疗急性痛风性关节炎的临床研究[J].中国中医急症,2018,27(1):69.