清热利湿方联合洛索洛芬钠片治疗急性痛风性关节炎的疗效观察及对细胞因子的影响

目的 观察清热利湿方联合西药洛索洛芬钠片治疗急性痛风性关节炎湿热瘀阻证的疗效及对患者细胞因子的影响.方法 将92例急性痛风性关节炎湿热瘀阻证患者随机分为治疗组46例、对照组46例.对照组采用洛索洛芬钠片治疗,治疗组在对照组西药治疗基础上联合清热利湿方加减治疗.观察中医证候积分,中医证候疗效,采用视觉模拟评分法(VAS)记录疼痛评分,红细胞沉降率(ESR)、C反应蛋白(CRP)、血白细胞(WBC)、血尿酸(UA)、白介素-1β(IL-1β)、白介素-18(IL-18)、白细胞介素-37(IL-37),记录不良反应.结果 2组治疗前后中医证候积分较治疗前均降低(P<0.05),治疗组较对照组降低明显,治疗前后差值比较,差异有统计学意义(P<0.05).治疗组46例中,临床痊愈12例,显效25例,有效6例,无效3例,总有效率为93.48％;对照组46例中,临床痊愈9例,显效23例,有效8例,无效6例,总有效率为86.96％.经秩和检验,Z=-1.247,P>0.05,说明2组疗效相当.2组治疗后ESR,CRP,WBC,UA,IL-1β,IL-18,VAS评分均较治疗前降低(P<0.05),治疗组较对照组降低明显,治疗前后差值比较,差异均有统计学意义(P<0.05).治疗组不良反应总发生率2.17％,对照组为6.52％.结论 清热利湿方治疗急性痛风性关节炎湿热瘀阻证可有效减轻炎症反应,改善症状,同时具备良好的安全性.

Therapeutic observation of Qingre Lishi Formula combined with loxoprofen sodium tablets in the treatment of acute gouty arthritis and its effects on cytokines

Objective To observe the efficacy of Qingre Lishi Formula combined with loxoprofen sodium tablets in the treatment of acute gouty arthritis with dampness-heat stasis syndrome and its effects on cytokines. Methods Ninety-two patients with acute gouty arthritis with dampness-heat stasis syndrome were randomly assigned to the treatment group(n=46) and the control group(n=46). The control group was treated with loxoprofen sodium tablets, and the treatment group was treated with modified Qingre Lishi Formula in addition to Western medicine in the control group. The scores of TCM syndromes, clinical effects, pain scores, erythrocyte sedimentation rate(ESR), C-reactive protein(CRP), leukocyte(WBC), uric acid(UA), interleukin-1 β(IL-1 β), interleukin-18(IL-18) and interleukin-37(IL-37) were observed, and the adverse reactions were recorded by visual analogue score(VAS). Results The TCM syndrome scores of the two groups were significantly lower after treatment than before treatment(P< 0.05). The TCM syndrome scores were significantly lower in the treatment group than in the control group(P< 0.05). There were significant differences between the two groups before and after treatment(P< 0.05). Among the 46 cases in the treatment group, 12 cases were clinically cured, 25 cases were markedly effective, 6 cases were effective and 3 cases were ineffective with the overall effective rate of 93.48%. Among the 46 cases in the control group, 9 cases were clinically cured, 23 cases were markedly effective, 8 cases were effective and 6 cases were ineffective with the overall effective rate of 86.96%. The rank sum test showed that there was no significant difference in the curative effect between the two groups(P>0.05). The scores of ESR, CRP, WBC, UA, IL-1 β, IL-18 and VAS were significantly lower in the two groups after treatment than before treatment, and the scores were significantly lower in the treatment group than in the control group, and there were significant differences between the two groups before and after treatment. The total incidence of adverse reactions was 2.17% in the treatment group and 6.52% in the control group. Conclusions Qingre Lishi Formula can effectively reduce inflammatory reactions, improve symptoms and has good safety in the treatment of acute gouty arthritis with dampness-heat and blood stasis syndrome.