复方四黄膏治疗急性痛风性关节炎临床观察
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摘要
目的观察复方四黄膏(由黄连、大黄、黄芩、黄柏、冰片及凡士林制成)治疗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,随机分为对照组、观察组各45例。对照组予口服秋水仙碱片,观察组在对照组的基础上予外敷复方四黄膏,疗程均为7 d。对比2组患者治疗后的临床疗效,治疗前后的中医证候积分、疼痛视觉模拟(VAS)评分和红细胞沉降率(ESR)、C-反应蛋白(CRP)、血尿酸(BUA)指标的变化情况,以及评估2组的安全性。结果治疗后,观察组总有效率达95. 56%,对照组总有效率达91. 11%,观察组临床疗效明显优于对照组(P <0. 05)。治疗后2组患者的中医证候积分以及VAS评分均较治疗前降低(P <0. 05);其中观察组降低幅度明显优于对照组(P <0. 05)。治疗后2组患者的ESR、CRP、BUA均较治疗前降低(P <0. 05);其中2组患者BUA指标降低幅度无明显差异(P> 0. 05),而观察组的ESR和CRP两项指标降低幅度明显优于对照组(P <0. 05)。治疗前后2组患者的血常规、尿常规以及肝肾功能指标比较均无异常变化(P> 0. 05),但治疗过程中2组患者出现的不良反应比较,差异有统计学意义(P <0. 05),说明观察组安全性高于对照组。结论复方四黄膏治疗急性痛风性关节炎疗效可观,且安全性高,不仅可消肿止痛、缓解症状,还可降低炎症指标。
Objective To observe the clinical efficacy of compound Sihuang ointment( made of coptis,rhubarb,scutellaria,phellodendron,borneol and vaseline) in treating acute gouty arthritis. Methods 90 patients with acute gouty arthritis were selected and randomly divided into control group and observation group,with 45 cases in each group. The control group was received colchicine tablets orally,while observation group was received compound Sihuang ointment externally based on the treatment of control group. The treatment course was 7 days. Comparison was made on post-treatment clinical efficacy,traditional Chinese medicinesyndrome before and after treatment,and the changes of visual analogy score( VAS),erythrocyte sedimentation rate( ESR),C-reactive protein( CRP) and blood uric acid( BUA).Safety of both groups was also evaluated. Result After treatment,total effective rate of observation group was 95. 56%,while the one of control group was 91. 11%,which showed that the clinical efficacy of observation group was better than control group( P < 0. 05). After treatment,TCM syndrome and VAS of both groups were lower than the ones before treatment( P < 0. 05). Thereinto,the ones of observation group were lower( P < 0. 05). After treatment,ESR,CRP and BUA of both groups were lower than the ones before treatment. Thereinto,BUA reduction of both groups had no much difference,but ESR and CRP reduction of observation group were lower than the ones of control group( P < 0. 05). There were no abnormal changes in blood routine,urine routine and liver and kidney function indexes between both groups before and after treatment( P > 0. 05). There were significant differences in the adverse reactions between both groups during the treatment( P < 0. 05). Safety of observation group is higher than control group. Conclusion Compound Sihuang ointment has good efficacy and high safety in treating acute gouty arthritis. It not only relieves swelling and pain,but also reduces inflammation index.
Objective To observe the clinical efficacy of compound Sihuang ointment( made of coptis,rhubarb,scutellaria,phellodendron,borneol and vaseline) in treating acute gouty arthritis. Methods 90 patients with acute gouty arthritis were selected and randomly divided into control group and observation group,with 45 cases in each group. The control group was received colchicine tablets orally,while observation group was received compound Sihuang ointment externally based on the treatment of control group. The treatment course was 7 days. Comparison was made on post-treatment clinical efficacy,traditional Chinese medicinesyndrome before and after treatment,and the changes of visual analogy score( VAS),erythrocyte sedimentation rate( ESR),C-reactive protein( CRP) and blood uric acid( BUA).Safety of both groups was also evaluated. Result After treatment,total effective rate of observation group was 95. 56%,while the one of control group was 91. 11%,which showed that the clinical efficacy of observation group was better than control group( P < 0. 05). After treatment,TCM syndrome and VAS of both groups were lower than the ones before treatment( P < 0. 05). Thereinto,the ones of observation group were lower( P < 0. 05). After treatment,ESR,CRP and BUA of both groups were lower than the ones before treatment. Thereinto,BUA reduction of both groups had no much difference,but ESR and CRP reduction of observation group were lower than the ones of control group( P < 0. 05). There were no abnormal changes in blood routine,urine routine and liver and kidney function indexes between both groups before and after treatment( P > 0. 05). There were significant differences in the adverse reactions between both groups during the treatment( P < 0. 05). Safety of observation group is higher than control group. Conclusion Compound Sihuang ointment has good efficacy and high safety in treating acute gouty arthritis. It not only relieves swelling and pain,but also reduces inflammation index.
引文
[1]王仁崇,蒋电明,黄伟,等.痛风性关节炎的研究进展[J].中华风湿病学杂志,2011,15(9):647-650.
[2]中华医学会风湿病学分会.原发性痛风诊断和治疗指南[J].中华风湿病学杂志,2011,15(6):410-413.
[3]李建洪,谢招虎,杨博,等.中医外治法治疗痛风的研究进展[J].辽宁中医杂志,2018,45(7):1560-1562.
[4]张敏,张恒耀.痛风清利方治疗高尿酸血症临床观察[J].光明中医,2017,32(15):2198-2200.
[5]葛均波,徐永健.内科学[M]. 8版.北京:人民卫生出版社,2013:856-859.
[6]美国风湿病学会.急性痛风关节炎分类标准[J].中华风湿病学杂志,1998,2(2):120.
[7]国家中医药管理局.中医病证诊断疗效标准[S].南京:南京大学出版社,1994:32.
[8]王昱,邓雪蓉,张卓莉. 2017年英国风湿病学会痛风管理指南[J].中华风湿病学杂志,2018,22(2):142-144.
[9]祁志敏,王华,王春煦,等.清热利湿逐瘀方配合健康宣教治疗痛风性关节炎临床观察及其机制探讨[J].光明中医,2017,32(11):1529-1531.
[10]郑筱萸.中药新药临床研究指导原则[S].北京:中国医药科技出版社,2002:26.
[11]国家中医药管理局医政司. 22个专业95个病种中医诊疗方案[S].北京:中国中医药出版社,2010:269-270.
[12]申利红,李雅.秋水仙碱的研究与应用进展[J].中国农学通报,2009,25(21):185-187.
[13]李嘉诚,吴岚,蔡同凯,等.黄柏化学成分及其药理作用研究进展[J].药学实践杂志,2018,36(5):389-391,398.
[14]孙晓萍,欧立娟,宓穗卿,等.冰片抗炎镇痛作用的实验研究[J].中药新药与临床药理,2007,18(5):353-355.
[2]中华医学会风湿病学分会.原发性痛风诊断和治疗指南[J].中华风湿病学杂志,2011,15(6):410-413.
[3]李建洪,谢招虎,杨博,等.中医外治法治疗痛风的研究进展[J].辽宁中医杂志,2018,45(7):1560-1562.
[4]张敏,张恒耀.痛风清利方治疗高尿酸血症临床观察[J].光明中医,2017,32(15):2198-2200.
[5]葛均波,徐永健.内科学[M]. 8版.北京:人民卫生出版社,2013:856-859.
[6]美国风湿病学会.急性痛风关节炎分类标准[J].中华风湿病学杂志,1998,2(2):120.
[7]国家中医药管理局.中医病证诊断疗效标准[S].南京:南京大学出版社,1994:32.
[8]王昱,邓雪蓉,张卓莉. 2017年英国风湿病学会痛风管理指南[J].中华风湿病学杂志,2018,22(2):142-144.
[9]祁志敏,王华,王春煦,等.清热利湿逐瘀方配合健康宣教治疗痛风性关节炎临床观察及其机制探讨[J].光明中医,2017,32(11):1529-1531.
[10]郑筱萸.中药新药临床研究指导原则[S].北京:中国医药科技出版社,2002:26.
[11]国家中医药管理局医政司. 22个专业95个病种中医诊疗方案[S].北京:中国中医药出版社,2010:269-270.
[12]申利红,李雅.秋水仙碱的研究与应用进展[J].中国农学通报,2009,25(21):185-187.
[13]李嘉诚,吴岚,蔡同凯,等.黄柏化学成分及其药理作用研究进展[J].药学实践杂志,2018,36(5):389-391,398.
[14]孙晓萍,欧立娟,宓穗卿,等.冰片抗炎镇痛作用的实验研究[J].中药新药与临床药理,2007,18(5):353-355.