化浊解毒方联合西药治疗浊毒内蕴型急性痛风性关节炎的临床疗效分析

Clinical analysis of Huazhuo Jiedu Recipe combined with Western medicine in the treatment of acute gouty arthritis turbidity toxin intrinsic type

关键词:  化浊解毒方  急性痛风性关节炎  血尿酸  中医证候积分  骨破坏

Key words:  Huazhuo Jiedu Recipe  acute gouty arthritis  blood uric acid  traditional Chinese medicine syndrome score  bone destruction

摘要:

[目的] 探讨化浊解毒方联合西药治疗浊毒内蕴型急性痛风性关节炎（AGA）的临床疗效。[方法] 选取2020年12月—2022年12月唐山市中医医院浊毒内蕴型AGA患者118例，根据随机数字表法分观察组和对照组，各59例。对照组予常规西药治疗，观察组在对照组基础上加用化浊解毒方治疗。两组均治疗1周，对比疗效、中医证候积分、血尿酸水平、炎症水平[白细胞介素-1β（IL-1β）、半胱氨酸酶-1（Caspase-1）、NOD样受体热蛋白结构域3（NLRP3）]、骨破坏指标[缺氧诱导因子-1α（HIF-1α）、抵抗素（RETN）、瘦素（LEP）]和不良反应情况。[结果] 观察组总有效率98.31%高于对照组86.44%（P<0.05）；治疗后中医证候积分及血尿酸水平均降低，且观察组低于对照组（P<0.05）；治疗后血清IL-1β、Caspase-1、NLRP3、HIF-1α、RETN、LEP水平降低，且观察组低于对照组（P<0.05）；观察组不良反应发生率与对照组对比，差异无统计学意义（P>0.05）。[结论] 化浊解毒方联合西药治疗浊毒内蕴型AGA效果显著，能有效改善症状，减轻炎症及骨破坏，且安全性高。

Abstract:

[Objective] To explore the clinical effect of Huazhuo Jiedu Recipe combined with Western medicine on acute gouty arthritis(AGA) with turbidity toxin intrinsic type. [Methods] A total of 118 AGA patients with turbidity toxin intrinsic type in Tangshan Traditional Chinese Medicine Hospital from December 2020 to December 2022 were selected and they were divided into observation group and control group according to random number table method, with 59 cases respectively. The control group was treated with conventional Western medicine, and the observation group was treated with Huazhuo Jiedu Recipe on the basis of the control group. Both groups were treated for 2 weeks. The curative effect, traditional Chinese medicine syndrome score, blood uric acid level, inflammation [interleukin-1β(IL-1β), cysteinase-1(Caspase-1), Nod-like receptor heat protein domain 3(NLRP3)], bone destruction index [hypoxia-inducible factor-1α(HIF-1α), resistin(RETN), leptin(LEP)], adverse reactions were compared. [Results] The total effective rate of the observation group of 98.31% was higher than that of 86.44% in the control group(P<0.05). After treatment, TCM syndrome score and blood uric acid level were significantly decreased, and observation group was significantly lower than control group(P<0.05). After treatment, serum levels of IL-1β, Caspase-1, NLRP3, HIF-1α, RETN and LEP were significantly decreased, and observation group was significantly lower than control group(P<0.05). There was no significant difference in the incidence of adverse reactions between the observation group and the control group(P>0.05). [Conclusion] Huazhuo Jiedu Recipe combined with Western medicine in the treatment of AGA turbidity toxin intrinsic type has remarkable effect, and it can effectively improve symptoms, reduce inflammation and bone damage, and it has high safety.