中西医结合治疗痛风性关节炎疗效及不良反应的研究

发布时间：2019-04-03 14:11

【摘要】：目的痛风有着很久的历史,被称为“国王的疾病”和“不能行走的疾病”,是一系列的临床条件下对血清尿酸过量的一个泛称。痛风性关节炎通常是痛风的首发临床表现,一般表现为急性发作,有时候也可表现出或者发展成慢性关节炎。本研究旨在探讨中西医结合治疗痛风性关节炎的临床疗效,同时对其造成的不良反应进行分析,为中西医结合治疗痛风性关节炎的有效性及安全性提供依据。方法选择2012年06月~2015年06月新乡市第一人民医院风湿免疫科160例资料齐全的痛风性关节炎患者作为研究对象,根据随机分组原则将160例患者分成中西医结合治疗组和西医治疗组,每组各80例。西医治疗组在痛风性关节炎发作期给予西药对症治疗,中西医结合治疗组在西医治疗组的基础之上给予中药外敷及中药口服治疗,2周后对两组患者临床疗效、治疗前后血液尿酸水平以及治疗后不良反应发生率之间进行分析对比,同时采用SF-36生存质量调查表对患者治疗后1年的生存质量进行评价。结果中西医结合治疗组治疗后痊愈患者53例,好转患者24例,无效患者3例,痊愈率为66.25%(53/80),有效率为96.25%(77/80);西医治疗组治疗后痊愈患者33例,好转患者31例,无效患者16例,痊愈率为41.25%(33/80),有效率为80.00%(64/80);中西医结合治疗组在痊愈率和有效率方面均要优于西医治疗组,两组之间相比差异具有显著性,P0.05。两组患者血尿酸水平在治疗前无显著性差异,治疗后中西医结合治疗组血尿酸水平要明显低于西医治疗组,两组之间相比差异具有显著性,P0.05。中西医结合治疗组治疗后发生胃肠道反应3例,肾绞痛1例,急性关节炎发作1例,白细胞减少0例,肝功能异常0例,不良反应发生率为6.25%(5/80);西医治疗组治疗后发生胃肠道反应6例,肾绞痛3例,急性关节炎发作2例,白细胞减少2例,肝功能异常1例,不良反应发生率为17.50%(14/80);中西医结合治疗组在不良反应发生率方面要优于西医治疗组,两组之间相比差异具有显著性,P0.05。两组患者治疗前在心理健康总测表和生理健康总测表相比,差异无显著性意义,具有统计学意义上的可比性;中西医结合治疗组患者治疗后在生理功能、生理职能、躯体疼痛、总体健康以及社会功能方面均要优于西医治疗组,两组之间相比差异具有显著性,P0.05;而在活力、情感职能和精神健康三个方面,两组相比差异无显著性,P0.05。结论1.中西医结合治疗痛风性关节炎较西医单独治疗的临床效果更佳,降低患者血尿酸浓度更快;2.中西医结合治疗痛风性关节炎较西医单独治疗的不良反应发生率更低,安全性更高;3.中西医结合治疗痛风性关节炎对患者的生存质量改善较为明显,值得临床上进行推广应用。
[Abstract]:Objective gout has a long history, known as "King's disease" and "unable to walk disease", is a series of clinical conditions of serum uric acid excess is a generic term. Gout arthritis is usually the first clinical manifestation of gout, usually characterized by acute attacks and sometimes chronic arthritis. The purpose of this study is to explore the clinical efficacy of integrated traditional Chinese and western medicine in the treatment of gouty arthritis, and to analyze the adverse reactions caused by it, so as to provide evidence for the effectiveness and safety of integrated traditional Chinese and western medicine in the treatment of gouty arthritis. Methods from June 2012 to June 2015, 160 patients with gouty arthritis were selected from the Department of Rheumatology and Immunology, first people's Hospital of Xinxiang City. According to the principle of random grouping, 160 patients were divided into two groups: treatment group (80 cases) and western medicine treatment group (80 cases). The western medicine treatment group was given the symptomatic treatment of western medicine in the attack period of gouty arthritis. On the basis of the western medicine treatment group, the western medicine treatment group was treated with external application of traditional Chinese medicine and oral Chinese medicine. Two weeks later, the two groups of patients were treated clinically. The levels of serum uric acid and the incidence of adverse reactions were analyzed and compared before and after treatment. The quality of life (QOL) of the patients was evaluated by SF-36 quality of Life questionnaire (QOL) 1 year after treatment. Results in the treatment group, 53 cases were cured, 24 cases were improved and 3 cases were ineffective. The cure rate was 66.25% (53 / 80) and the effective rate was 96.25% (77 / 80). In the western medicine treatment group, 33 cases were cured, 31 cases were improved, and 16 cases were ineffective. The cure rate was 41.25% (33 / 80), and the effective rate was 80.00% (64 / 80). The cure rate and effective rate of the integrated Chinese and western medicine treatment group were better than those of the western medicine treatment group, and there was significant difference between the two groups (P 0.05). There was no significant difference in the serum uric acid level between the two groups before treatment. After treatment, the serum uric acid level in the integrated Chinese and western medicine treatment group was significantly lower than that in the western medicine treatment group, and there was a significant difference between the two groups (P 0.05). There were 3 cases of gastrointestinal reaction, 1 case of renal colic, 1 case of acute arthritis, 0 cases of leukopenia and 0 cases of abnormal liver function. The incidence of adverse reactions was 6.25% (5 / 80). In the western medicine treatment group, gastrointestinal reaction occurred in 6 cases, renal colic in 3 cases, acute arthritis in 2 cases, leukopenia in 2 cases, liver function abnormality in 1 case. The incidence of adverse reactions was 17.50% (14 / 80). The incidence of adverse reactions in the integrated Chinese and western medicine treatment group was better than that in the western medicine treatment group, and there was a significant difference between the two groups (P 0.05). There was no significant difference between the two groups in mental health and physiological health before treatment, and there was statistical comparability between the two groups. After treatment, the patients in the treatment group were better than the western medicine group in physiological function, body pain, general health and social function, and there was significant difference between the two groups (P0.05). In the three aspects of vitality, emotional function and mental health, there was no significant difference between the two groups (P 0.05). Conclusion 1. The clinical effect of combined traditional Chinese and western medicine on gouty arthritis is better than that of western medicine alone, and the decrease of serum uric acid concentration is faster than that of western medicine alone. 2. Treatment of gouty arthritis by combination of traditional Chinese and western medicine has a lower incidence of adverse reactions and higher safety than that of western medicine alone; 3. The treatment of gouty arthritis with combination of traditional Chinese and western medicine can improve the quality of life of patients obviously, and it is worth popularizing and applying in clinic.
【学位授予单位】：新乡医学院
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R589.7

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