摘要
目的:研究自拟金车化浊汤对急性期浊毒内蕴型痛风的临床疗效及其对相关炎性因子IL-1β、TNF-α水平的影响。方法:将70例浊毒内蕴型痛风患者随机分为对照组与治疗组各35例,对照组应用秋水仙碱片治疗,治疗组应用自拟金车化浊汤治疗,疗程均为14 d。14 d后观察2组患者的临床疗效,并检测治疗前后各组患者血中IL-1β、TNF-α水平。结果:治疗组和对照组总有效率分别为91.43%和94.29%,金车化浊汤治疗急性痛风性关节炎浊毒内蕴型有明确疗效,经统计2组间疗效差异无显著性(P>0.05);治疗后,2组患者炎性因子IL-1β、TNF-α水平均较治疗前有明显下降,差异有非常显著性(P<0.01),治疗后2组间IL-1β、TNF-α水平比较差异无显著性(P>0.05)。结论:自拟金车化浊汤能显著降低血中炎性因子IL-1β、TNF-α水平,治疗急性痛风性关节炎(浊毒内蕴型)临床疗效显著,副作用低,长期治病依从性好。
Objective: To study the clinical effect of Jin Che Hua Zhuo Decoction on gout of turbid toxin accumulation in the acute stage and its influence on the levels of IL-1β and TNF-α. Methods: 70 patients with turbid toxin accumulation gout were randomly divided into the control group and the treatment group(35 cases). The control group was treated with Colchicine Tablets,and the treatment group with the self-made Jin Che Hua Zhuo Decoction. The treatment course was 14 d. Then,the clinical efficacy of the 2 groups was observed,and the levels of IL-1β and TNF-α in each group were detected before and after treatment. Results: the total effective rates of the treatment group and the control group were 91. 43% and 94. 29% respectively. The treatment of acute gouty arthritis with Jin Che Hua Zhuo Decoction had a definite effect,and the difference between the 2 groups was not significant(P > 0. 05); after treatment,the levels of inflammatory factors IL-1β and TNF-α in the 2 groups were significantly lower than those before treatment(P< 0. 01). There was no significant difference in the level of IL-1β and TNF-α among the 2 groups after treatment(P > 0. 05). Conclusion: Jin Che Hua Zhuo Decoction can significantly reduce the level of IL-1β and TNF-α in blood,and it is effective in the treatment of acute gouty arthritis(turbid toxin accumulation),with low side effects and good compliance for long-term treatment.
引文
[1]中华医学会风湿病学分会.原发性痛风诊治指南(草案)[S].中华风湿病学杂志,2004,8(3):178-181
[2]中华人民共和国卫生部.中药新药临床研究指导原则(第2辑)[S].北京:卫生部,1995.179-183
[3]朱军,余俊文.高尿酸血症和痛风的流行病学及其危险因素的研究进展[J].现代生物医学进展,2008,8(1):191-194
[4]陈登青,徐恩.高尿酸血症与脑血管病[J].国外医学脑血管疾病分册,2005,13(2):144-146
[5]党万太,周京国,谢文光,等.痛风不同中医证型患者外周血单个核细胞NLRP3基因转录剪接体的研究[J].中华中医药杂志,2014,5(29):1 378-1 384
[6]姚祖培,陈建新.朱良春治疗痛风的经验[J].中医杂志,1989,30(3):16
[7]许桂芳,彭勇,陈勇.痛风患者血清中IL-37、IL-1β及IL-18水平检测及其相关性研究[J].温州医科大学学报,2014,44(5):370-373
[8]黄继勇,张艳.痛风患者外周血中炎症因子IL-18、IL-1β、TNF-α的变化[J].中华全科医学,2017,15(9):1 487-1 489
[9]陈玉婷,茅建春.健脾化湿解毒方治疗缓解期痛风的临床疗效及其对相关炎性因子的影响[J].上海中医药大学学报,2014,28(1):38-41
[10]邱侠,张剑勇,于丽,等.痛风泰颗粒剂对痛风患者外周血IL-1β、IL-8的影响[J].河南中医,2009,29(5):460-462
[11]周洁茹,陈海燕,薛俊丽,等.高尿酸血症和痛风患者外周血IL–10的水平检测[J].同济大学学报(医学版),2009,30(1):101-103
[12]刘圳奋,马红霞,李秀宁,等.痛风性关节炎与高尿酸血症炎性细胞因子水平比较[J].西部中医药,2014,27(8):157-158
[13]金泽,张振营,姜珊珊,等.针药并用对大鼠急性痛风性关节炎滑膜IL-1、IL-8的影响[J].上海针灸杂志,2012,31(12):923-924
[14]张建勇,刘题章.痛风泰颗粒对兔滑膜细胞IL-1β和NF-α影响的研究[J].中国中医风湿病学杂志,2009,12(3):119-120
[15]韩宏妮,姬艳波,陈立忠,等.痛风合剂治疗高尿酸血症及急性痛风性关节炎的实验研究[J].中国中医骨伤科杂志,2010,18(1):9-11