摘要
目的:观察桂枝芍药知母汤联合非布司他、塞来昔布治疗痛风性关节炎(GA)急性期的效果,为临床治疗提供参考。方法:选取GA患者110例,根据随机原则分为对照组(西药)和观察组(桂枝芍药知母汤+西药),每组55例。记录两组治疗前及治疗3、7 d后血尿酸(UA)、血沉(ESR)、白细胞介素-1β(IL-1β)、Diekkopf-1(DKK-1)、白细胞介素-18(IL-18)、嘌呤能受体(P2X7R)水平及中医证候积分的变化,统计两组疗效和不良反应。结果:治疗7 d后,观察组总有效率为90.91%(50/55),明显高于对照组的76.36%(42/55),差异有统计学意义(P<0.05)。治疗3、7 d后,两组皮色皮温、全身症状及关节相关积分较治疗前下降,观察组低于对照组,且两组治疗7 d后低于治疗3 d后(P<0.05)。治疗3、7 d后,两组UA、IL-1β、DKK-1、IL-18、P2X7R、ESR较治疗前下降,观察组低于对照组,且两组治疗7 d后上述因子低于治疗3 d后(P<0.05)。观察组不良反应发生率为9.09%(胸闷1例、胃肠道症状4例),与对照组的20.00%(胸闷2例、胃肠道症状8例和皮疹1例)比较,差异无统计学意义(P>0.05)。结论:桂枝芍药知母汤联合西药治疗GA急性期可减轻症状,提高疗效,可能与调节相关因子的表达水平有关。
Objective:To observe the effect of Guizhi Shaoyao Zhimu decoction combined with colchicine and celecoxib in treating acute stage of gouty arthritis,and to provide reference for clinical treatment.Methods:110 patients with gout arthritis in the acute stage were randomly divided into a conventional group(treated with western medicine)and a decoction group(treated with western medicine+Guizhi Shaoyao Zhimu decoction),with 55 patients in each group.Recorded the changes in the levels of blood uric acid(UA),sedimentation(ESR),interleukin-1β(IL-1β),interleukin-18(IL-18),Diekkopf-1(DKK-1),purinergic receptor(P2X7R)and TCM syndrome score before and after 3 d and 7 d,efficacy and adverse effects included in group 2 were calculated,and TCM syndrome score were calculated.Results:After 7 days of treatment,the total effective rate of the observation group was 90.91%(50/55),which was significantly higher than that of the control group 76.36%(42/55),with statistical significance(P<0.05).After 3 and 7 days of treatment,skin color skin temperature,systemic symptoms and joint related scores in both groups were lower than before treatment,the observation group was lower than the control group,and the two groups were lower than after 7 days of treatment(P<0.05).After 3 and 7 days of treatment,UA,IL-1β,DKK-1,IL-18,P2X7R and ESR in both groups were lower than before treatment,the observation group was lower than the control group,and the above factors were lower after 7 days of treatment than after 3 days of treatment(P<0.05).The incidence of adverse reactions in the observation group was 9.09%(1 case of chest tightness and 4 cases of gastrointestinal symptoms),compared with 20.00%(2 cases of chest tightness,8 cases of gastrointestinal symptoms and 1 case of rash)in the control group,there was no statistical significance(P>0.05).Conclusion:Guizhi Shaoyao Zhimu decoction combined with western medicine in the treatment of acute gouty arthritis can reduce symptoms and improve the curative effect,which may be related to regulating the expression levels of related factors.
作者
戴政文
钟传棋
杨志新
DAI Zhengwen;ZHONG Chuanqi;YANG Zhixin(Hubei Provincial Hospital of Traditional Chinese Medicine,Wuhan 430061,China)
出处
《陕西中医》
CAS
2024年第1期67-70,共4页
Shaanxi Journal of Traditional Chinese Medicine
基金
湖北省中医药中西医结合科研项目[鄂卫生计生通(2017)20号]。
关键词
痛风性关节炎急性期
桂枝芍药知母汤
非布司他
塞来昔布
血尿酸
血沉
Acute states of gouty arthritis
Guizhi Shaoyao Zhimu decoction
Colchicine
Celecoxib
Blood uric acid
Sedimentation
