痛风宁口服液联合香连金黄散治疗急性痛风性关节炎的临床观察

发布时间：2018-01-19 23:57

本文关键词： 急性痛风性关节炎痛风宁口服液香连金黄散临床观察作用机理　出处：《成都中医药大学》2016年硕士论文　论文类型：学位论文

【摘要】：目的：通过观察痛风宁口服液联合香连金黄散治疗急性痛风性关节炎的临床疗效及安全性,探讨其作用机制,为临床治疗该病提供一种安全可靠的方法。方法：随机抽取2014年9月至2015年9月成都中医药大学骨科门诊符合病例纳入标准的60例急性痛风性关节炎的患者,分两组,各30例。治疗组(中药组)予痛风宁口服液联合香连金黄散,对照组(西药组)予秋水仙碱及扶他林软膏,疗程一周,分析治疗前后的临床症状体征积分情况、血尿酸(BUA)、炎性指标(血WBC计数、ESR、CRP)、安全性指标(BUN、Cr、ALT、AST)、不良反应、随访复发率等动态变化,探讨痛风宁口服液联合香连金黄散治疗急性痛风性关节炎的临床疗效及安全性。结果：1、治疗前两组患者的基线资料经统计学分析,无显著差异,具有可比性(P0.05)。2、两组药物总体疗效相当,总有效率治疗组为86.7%,控显率60%,对照组为83.3%,控显率43.3%；总有效率组间比较无显著差异(P0.05),中药组和西药组均可以有效治疗急性痛风性关节炎,但中药组的控显率优于西药组。3、两组药物在降低血尿酸上有显著性差异(P0.05)；中药组可显著降低血尿酸(P(0.05);西药组无明显降低血尿酸的作用(P0.05)。4、炎性指标比较,治疗后两组的血WBC计数、CRP、ESR均较治疗前明显降低(P0.05),其中血WBC计数进行组间比较时,无明显差异(P0.05)。CRP、 ESR进行组间比较有显著差异(PO.05),中药组明显优与西药组。5、安全性指标的比较,治疗组治疗前后肝肾功(ALT、AST、Cr、BUN)无明显差异(P0.05)；对照组治疗前后肝肾功有显著差异(P0.05)；组间比较肝肾功有明显差异(P0.05)。6、治疗组不良反应发生率6.07%,而对照组不良反应发生率为33.4%。两组对比具有显著差异性(PO.05),中药组明显优于西药组。7、随访复发率比较,前2月组间比较无明显差异(P0.05)；3月后两组对比有显著差异(P0.05),中药组改善临床症状的远期疗效优于西药组。结论：痛风宁口服液联合香连金黄散在治疗急性痛风性关节炎方面与秋水仙碱及扶他林软膏无显著差异性,疗效几乎相近,可明显降低血尿酸及炎性指标(血WBC计数、CRP、ESR),无明显的肝肾损伤,不良反应较少,安全性较高,随访复发率低,远期疗效乐观,是一个安全有效的治疗急性痛风性关节炎的方案,表明中医中药在治疗痛风性关节炎方面具有明显优势,值得中医人进一步挖掘。
[Abstract]:Objective: to observe the clinical efficacy and safety of Tongfungning Oral liquid combined with Xianglian Jinhuang Powder in the treatment of acute gouty arthritis and to explore its mechanism. To provide a safe and reliable method for the treatment of the disease. From September 2014 to September 2015, 60 patients with acute gouty arthritis were randomly selected from orthopedic outpatient department of Chengdu University of traditional Chinese Medicine. Treatment group (TCM group) was treated with Tongfeng Ning oral liquid combined with Xianglian Jinhuang powder, and control group (western medicine group) with colchicine and Futalin ointment for one week. The clinical symptoms and signs before and after treatment were analyzed, such as blood uric acid BUAA, inflammatory index (blood WBC count and CRP, safety index). To explore the clinical efficacy and safety of Tongfungning Oral liquid combined with Xianglian Jinhuang Powder in the treatment of acute gouty arthritis. There was no significant difference in baseline data between the two groups before treatment. There was no significant difference between the two groups. The overall curative effect of the two groups was similar, and the total effective rate was 86.7% in the treatment group. The control rate was 60%, the control group was 83.3%, and the control rate was 43.3%. There was no significant difference in the total effective rate between the two groups. Both the Chinese medicine group and the western medicine group could effectively treat acute gouty arthritis, but the effective rate of the traditional Chinese medicine group was better than that of the western medicine group (.3%). There was significant difference in reducing uric acid between the two groups (P 0.05). In the Chinese medicine group, the serum uric acid content was decreased significantly. There was no significant decrease of serum uric acid in the western medicine group (P 0.05). Compared with the inflammatory indexes, the blood WBC count of the two groups was significantly lower than that of the control group (P 0.05). There was no significant difference in blood WBC count between groups. There was no significant difference between ESR group and western medicine group. There was significant difference between ESR group and western medicine group. Compared with the safety indexes, there was no significant difference in liver and kidney function before and after treatment in the treatment group (P 0.05). In the control group, there was significant difference in liver and kidney function before and after treatment. There was a significant difference in liver and kidney function between the two groups. The incidence of adverse reactions in the treatment group was 6.07%. The incidence of adverse reactions in the control group was 33.4. There was a significant difference between the two groups. The traditional Chinese medicine group was superior to the western medicine group .7.The recurrence rate of the two groups was higher than that of the western medicine group. There was no significant difference between groups before February. After March, there was a significant difference between the two groups (P 0.05). Conclusion: there is no significant difference in the treatment of acute gouty arthritis between Tongfunning oral liquid and Xianglianjin powder in the treatment of acute gouty arthritis with colchicine and Futalin ointment. The therapeutic effect was almost similar, which could significantly reduce serum uric acid and inflammatory indexes (blood WBC count and CRP ESR, no obvious liver and kidney injury, less adverse reactions, higher safety, low recurrence rate of follow-up. The long-term curative effect is optimistic, it is a safe and effective scheme to treat acute gouty arthritis, which indicates that Chinese traditional medicine has obvious advantages in treating gouty arthritis, which is worthy of further excavating.
【学位授予单位】：成都中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R259

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