桂枝汤治疗风湿郁热型急性痛风性关节炎35例
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摘要
目的:观察桂枝汤联合秋水仙碱治疗风湿郁热型急性痛风性关节炎的临床疗效及对细胞炎症因子和免疫功能的影响。方法:将70例患者随机分为2组。对照组35例,予口服秋水仙碱片;观察组35例,在对照组治疗基础上加服桂枝汤。2组均连续治疗7天,比较2组治疗前后平均症状积分、血尿酸、临床疗效、细胞炎性因子(IL-1β、IL-6、IL-8、TNF-α)水平、免疫功能(白细胞计数、红细胞沉降率及C反应蛋白)水平的变化情况及临床疗效和不良反应发生率。结果:总有效率观察组为94.29%,对照组为74.29%,2组比较差异有统计学意义(P<0.05)。平均症状积分,血尿酸水平,血清IL-1β、IL-6、IL-8、TNF-α水平,白细胞计数,红细胞沉降率(ESR)及C反应蛋白(CRP)水平,治疗前2组组间比较,差异无统计学意义(P>0.05);治疗前后2组组内比较,差异均有统计学意义(P<0.05);治疗后2组组间比较,差异也有统计学意义(P<0.05)。不良反应发生率观察组为42.86%,对照组为31.43%,2组比较差异无统计学意义(P>0.05)。结论:桂枝汤联合秋水仙碱治疗急性痛风性关节炎疗效显著,可明显抑制炎症因子的释放和免疫反应水平,改善急性痛风性关节炎患者的临床症状,且安全性较高。
Objective: To observe clinical effects of GuiZhi Tang combined with colchicin in the treatment for acute gouty arthritis of wind-dampness stagnant heat pattern, and its influences on cellular inflammatory factors and immunologic function. Methods: Seventy patients were randomly divided into two groups. 35 cases in the control group took colchicin tablets orally; 35 cases in the observation group took GuiZhi Tang on the foundation of the therapy the control group accepted. Both groups were treated for seven consecutive days, adverse reaction incidences, clinical effects, mean symptom scales, blood uric acid(BUA), the levels of cell inflammatory factors(IL-1β, IL-6, IL-8 and TNF-α) and immunologic functions(WBC, ESR and CRP) of both groups were compared between before and after treating. Results: Total effective rate of the observation group was 94.29%, higher than74.29% of the control group, and the difference showed statistical meaning(P <0.05). The difference had no statistical meaning in the comparisons of mean symptom scales, the levels of BUA, the levels of IL-1β, IL-6, IL-8and TNF-α, the levels of WBC, ESR and CRP before treating between both groups(P >0.05); the difference presented statistical meaning in the comparison between before and after treating within two groups(P<0.05); the difference had statistical meaning in the comparison after treating between both groups(P<0.05). The incidence of adverse reaction in the observation group was 42.86%, higher than 31.43% of the control group, and the difference had no statistical meaning(P>0.05). Conclusion: GuiZhi Tang combined with colchicin could gain notable effects in the treatment for acute gouty arthritis of wind-dampness stagnant heat pattern, it could obviously inhibit the release of inflammatory factors and immune reaction, and improve clinical symptoms of the patients with high safety.
Objective: To observe clinical effects of GuiZhi Tang combined with colchicin in the treatment for acute gouty arthritis of wind-dampness stagnant heat pattern, and its influences on cellular inflammatory factors and immunologic function. Methods: Seventy patients were randomly divided into two groups. 35 cases in the control group took colchicin tablets orally; 35 cases in the observation group took GuiZhi Tang on the foundation of the therapy the control group accepted. Both groups were treated for seven consecutive days, adverse reaction incidences, clinical effects, mean symptom scales, blood uric acid(BUA), the levels of cell inflammatory factors(IL-1β, IL-6, IL-8 and TNF-α) and immunologic functions(WBC, ESR and CRP) of both groups were compared between before and after treating. Results: Total effective rate of the observation group was 94.29%, higher than74.29% of the control group, and the difference showed statistical meaning(P <0.05). The difference had no statistical meaning in the comparisons of mean symptom scales, the levels of BUA, the levels of IL-1β, IL-6, IL-8and TNF-α, the levels of WBC, ESR and CRP before treating between both groups(P >0.05); the difference presented statistical meaning in the comparison between before and after treating within two groups(P<0.05); the difference had statistical meaning in the comparison after treating between both groups(P<0.05). The incidence of adverse reaction in the observation group was 42.86%, higher than 31.43% of the control group, and the difference had no statistical meaning(P>0.05). Conclusion: GuiZhi Tang combined with colchicin could gain notable effects in the treatment for acute gouty arthritis of wind-dampness stagnant heat pattern, it could obviously inhibit the release of inflammatory factors and immune reaction, and improve clinical symptoms of the patients with high safety.
引文
[1]周丽丽.吲哚美辛加如意金黄散外敷治疗急性痛风性关节炎的疗效观察[J].重庆医学,2015,44(7):969-970.
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[4]张仙珍,严小倩,陈钦,等.急性痛风性关节炎患者并发急性肾损伤的相关因素分析[J].中华急诊医学杂志,2014,23(9):1030-1033.
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[10]张汝卫.健脾祛湿清热凉血方配合消瘀止痛药膏治疗急性痛风性关节炎48例临床观察[J].中医杂志,2013,54(24):2121-2123.
[11]蓝柳贵,谢雯雯,范冠杰,等.运用“动-定序贯八法”理论治疗急性痛风性关节炎[J].中国中医基础医学杂志,2013,19(11):1317-1318.
[12]蓝柳贵,王丘平,罗露露,等.范冠杰治疗急性痛风性关节炎经验[J].广州中医药大学学报,2013,30(3):421-423.
[13]王刚,陈晓,丁培东.利湿通络方治疗急性痛风性关节炎及高尿酸血症46例[J].中国实验方剂学杂志,2014,20(1):181-184.
[14]汪元,刘健,黄传兵,等.中药内服外敷治疗湿热瘀阻型痛风性关节炎急性发作30例临床观察[J].中医杂志,2014,55(15):1299-1302.
[15]朱金凤,吴萍.酸脂清胶囊对实验大鼠急性痛风性关节炎模型IL-1β、TNF-α的影响[J].时珍国医国药,2014,25(9):2131-2133.
[2]陈昉,姚红,童娟,等.白子菜提取物对急性痛风性关节炎大鼠模型的抗炎免疫作用[J].广州中医药大学学报,2015,32(2):275-281.
[3]顾祖莲,黄惠珠,施琬,等.中药药对虎杖-桂枝对急性痛风性关节炎的影响[J].中药新药与临床药理,2015,26(3):315-319.
[4]张仙珍,严小倩,陈钦,等.急性痛风性关节炎患者并发急性肾损伤的相关因素分析[J].中华急诊医学杂志,2014,23(9):1030-1033.
[5]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,2002:191.
[6]国家中医药管理局.中医病证诊断疗效标准[M].北京:中国医药科技出版社,2015:173.
[7]武东,赵金霞,孙琳,等.痛风炎症机制的研究进展[J].中华风湿病学杂志,2014,18(2):128-130.
[8]郑德勇,刘峻承.红藤虎杖汤治疗急性痛风性关节炎43例[J].中医杂志,2013,54(3):250-251.
[9]余霄龙,李杨,李恩泽,等.穿虎痛风合剂治疗急性痛风性关节炎的临床研究[J].中华内分泌代谢杂志,2014,30(1):49-51.
[10]张汝卫.健脾祛湿清热凉血方配合消瘀止痛药膏治疗急性痛风性关节炎48例临床观察[J].中医杂志,2013,54(24):2121-2123.
[11]蓝柳贵,谢雯雯,范冠杰,等.运用“动-定序贯八法”理论治疗急性痛风性关节炎[J].中国中医基础医学杂志,2013,19(11):1317-1318.
[12]蓝柳贵,王丘平,罗露露,等.范冠杰治疗急性痛风性关节炎经验[J].广州中医药大学学报,2013,30(3):421-423.
[13]王刚,陈晓,丁培东.利湿通络方治疗急性痛风性关节炎及高尿酸血症46例[J].中国实验方剂学杂志,2014,20(1):181-184.
[14]汪元,刘健,黄传兵,等.中药内服外敷治疗湿热瘀阻型痛风性关节炎急性发作30例临床观察[J].中医杂志,2014,55(15):1299-1302.
[15]朱金凤,吴萍.酸脂清胶囊对实验大鼠急性痛风性关节炎模型IL-1β、TNF-α的影响[J].时珍国医国药,2014,25(9):2131-2133.