清热利湿、活血通络法治疗急性期痛风74例临床观察

Clinical observation of method of clearing heat and promoting diuresis, promoting blood circulation to remove meridian obstruction on acute gout

关键词:  痛风  萆薢汤  清热利湿  活血通络  随机对照试验

Key words:  gout  Bixie decoction  clearing heat and promoting diuresis  promoting blood circulation to remove meridian  randomized controlled trial

摘要:

[目的] 通过临床与常规西药治疗比较，观察清热利湿、活血通络法治疗急性期痛风的临床疗效与安全性。[方法] 将明确诊断的74例患者随机分为治疗组37例和对照组37例。治疗组给予萆薢汤化裁中药汤剂口服，对照组口服双氯芬酸钠缓释片及秋水仙碱，入组期间两组患者均采用低嘌呤饮食。1周后进行中医证候疗效评价，观察治疗前后受试者关节疼痛评分、肿胀评分、全身症状评分、血尿酸、血沉及不良反应发生情况。[结果] 与对照组比较，治疗组中医证侯疗效评分差异无统计学意义（P>0.05）。两组治疗后关节疼痛评分、肿胀评分、全身症状评分、血尿酸、血沉较治疗前均明显改善，差异有统计学意义（P<0.05）。治疗后治疗组全身症状评分、血尿酸及血沉改善情况均优于对照组，差异有统计学意义（P<0.05）。研究期间，治疗组未见不良反应发生，对照组不良反应4例，停药或经对症处理后即恢复正常。[结论] 清热利湿、活血通络法治疗急性期痛风疗效显著，在改善全身症状，降低血尿酸及血沉方面优于常规西药治疗，且具有良好的安全性，值得临床推广应用。

Abstract:

[Objective] Through clinical compared with conventional Western medicine treatment, to observe the clinical effect and security of method of clearing heat and promoting diuresis, promoting blood circulation to remove meridian obstruction of acute gout.[Methods] Diagnosis of 74 patients were randomly divided into treatment group (37 cases) and control group (37 cases). Patients in treatment group were treated by traditional Chinese medicine of oral Bixie decoction, wlile the control group was treated with diclofenac sodium sustained release tablets and colchicine. Two groups of patients were sustained low purine diet. Evaluated syndrome of traditional Chinese medicine efficacy after one week. Patients before and after treatment was observed joint pain score, swelling score, systemic symptom score, blood uric acid, blood sedimentation and adverse reactions.[Results] Compared with the control group, the traditionnal Chinese medicine (TCM) syndrome efficacy score had no significant difference in the treatment group(P>0.05). After treatment joint pain score, swelling score, systemic symptom score, blood uric acid, blood sedimentation of two groups were obviously improved, and the difference was statistically significant(P<0.05). Treatment group after treatment of systemic symptom score, blood uric acid and blood sedimentation were superior to control group, and the difference was statistically significant (P<0.05). In the treatment, there was no adverse reaction in the treatment group, while there were 4 cases in the control group, and patients returned to be normal after stopping the medicine or expectant treatment.[Conclusion] Method of clearing heat and promoting diuresis, promoting blood circulation to remove meridian obstruction had a good effect and treatment of acute gout. Compared with the conventional treatment of western medicine,traditional Chinese medicine had better effect to improve the system symptoms and decrease the level of blood uric acid and blood sedimentation with good effect and safety.