加减木防己汤联合香连金黄散治疗急性痛风性关节炎湿热蕴结证的临床研究

发布时间：2018-01-29 19:15

本文关键词： 急性痛风性关节炎加减木防己汤香连金黄散临床研究　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：本课题采用中药制剂加减木防己汤内服联合香连金黄散外敷治疗湿热蕴结证急性痛风性关节炎的方法,旨在评价其近期临床疗效、安全性,从而彰显中医治疗优势,力求为广大急性痛风性关节炎患者提供一种方便、安全、实用的中医治疗方法,并推进其临床的进一步应用。方法：择符合受试条件的急性痛风性关节炎湿热蕴结证的患者60例,采用随机数字表法按1：1分为中医治疗组(治疗组)30例和西医治疗组(对照组)30例,治疗组应用内服加减木防己汤联合外敷香连金黄散的中医综合治疗方案治疗,对照组给予口服双氯芬酸钠双释放肠溶胶囊和碳酸氢钠片,两组疗程均为7天。记录各组治疗前、治疗3天后、治疗7天后各项中医症状体征积分、中医证候积分、镇痛起效时间、血沉、C-反应蛋白、血尿酸指标的变化以及不良事件。采用SPSS21.0统计软件对所得数据进行统计分析,然后对各组的临床治疗效果进行深入探讨,评价其临床疗效及安全性。结果：两组患者治疗七天后的总有效率、临床痊愈率、愈显率相当(P0.05)。两组的治疗方案均可改善患者中医证候积分,且治疗组的治疗方案在改善患者中医证候积分方面优于对照组(P0.05)。两组的治疗方案均可改善关节疼痛、关节压痛、关节肿胀、关节屈伸不利、关节发热、关节表面皮色、发热、头身困重、口干、汗出、心烦、小便短黄、大便黏滞不爽、舌质、舌苔等方面(P0.05)。治疗组在改善关节疼痛、关节肿胀、头身困重、口干、汗出、心烦、大便黏滞不爽、舌质、舌苔、脉象等方面优于对照组(P0.05)。两组的治疗方案在改善关节压痛、关节屈伸不利、关节发热、关节表面皮色、发热、小便短黄等方面疗效相当(P0.05)。治疗组患者的关节肿胀、头身困重、口干、汗出、大便黏滞不爽、舌质、舌苔表现的消失率优于对照组(P0.05),而关节疼痛、关节压痛、关节屈伸不利、关节发热、关节表面皮色、发热、心烦、小便短黄、脉象表现的消失率两组疗效相当(P0.05)。两组患者镇痛起效时间方面比较无明显差异(P0.05)。两组治疗方案均可降低患者C-反应蛋白、血尿酸、血沉水平(P0.05),两组的治疗方案在降低患者C-反应蛋白、血尿酸、血沉水平方面无明显差异(P0.05)。本治疗方案具有较好的安全性。结论：中药制剂加减木防己汤内服联合香连金黄散外敷可以有效地治疗急性痛风性关节炎湿热蕴结证患者,改善患者临床症状体征,并能降低血沉、C-反应蛋白、血尿酸的浓度,且安全性良好,值得临床推广及应用。
[Abstract]:Objective: to evaluate the clinical efficacy and safety of traditional Chinese medicine preparation plus Xianmu Fangji decoction combined with external application of Xianglian Jinhuang Powder in the treatment of acute gouty arthritis with dampness and heat accumulation syndrome. In order to highlight the advantages of traditional Chinese medicine treatment, and strive to provide a convenient, safe and practical Chinese medicine treatment for the vast number of patients with acute gouty arthritis. Methods: 60 cases of acute gouty arthritis with damp-heat accumulation syndrome were selected. According to 1: 1, randomly divided into Chinese medicine treatment group (treatment group, 30 cases) and western medicine treatment group (control group, 30 cases). The treatment group was treated with internal administration of Xianmu Fangji decoction combined with external application of Xianglianjin Huangsan. The control group was given oral diclofenac sodium double release enteric capsule and sodium bicarbonate tablet. The course of treatment in both groups was 7 days. The scores of symptoms and signs of TCM, symptoms and signs of TCM, onset time of analgesia, erythrocyte sedimentation rate and C-reactive protein were recorded before treatment, 3 days after treatment and 7 days after treatment. The changes of serum uric acid index and adverse events were analyzed by SPSS21.0 software, and then the clinical effect of each group was discussed. Results: the total effective rate, clinical recovery rate and effective rate of the two groups were similar to that of P0.050.The two treatment schemes could improve the score of TCM syndromes of the patients. And the treatment group in the improvement of TCM syndrome score is better than the control group P0.05. both groups of treatment can improve joint pain, joint tenderness, joint swelling, joint flexion and extension unfavorable. Joint fever, joint surface color, fever, head and body weight, dry mouth, sweat, upset, short yellow urine, stool sticky discomfort, tongue, tongue coating and other aspects of P0.05. the treatment group in the improvement of joint pain. Joint swelling, head weight, dry mouth, sweating, upset, sticky stool, tongue, tongue coating, pulse and so on are better than the control group P0.050.The two groups of treatment in improving joint tenderness. Joint flexion and extension, joint fever, joint surface skin color, fever, short yellow urine and other aspects of the curative effect is quite P0.05. the treatment group patients with joint swelling, head and body weight, dry mouth, sweating, stool viscosity is not cool. The disappearance rate of tongue quality and tongue coating was better than that of control group (P 0.05), but joint pain, joint tenderness, joint flexion and extension disadvantage, joint fever, skin color of joint surface, fever, upset, short yellow urination. There was no significant difference in the onset time of analgesia between the two groups. Serum uric acid, ESR level, P0.05N, two groups of treatment in the reduction of patients with C-reactive protein, blood uric acid. There was no significant difference in ESR level (P0.05). Conclusion: internal administration of traditional Chinese medicine preparation plus Xianmu Fangji decoction combined with external application of Xianglian Jinhuang Powder can effectively treat acute gouty arthritis patients with damp-heat accumulation syndrome. To improve the clinical symptoms and signs of patients, and can reduce the concentration of erythrocyte sedimentation rate (ESR) C-reactive protein and serum uric acid, and the safety is good, it is worthy of clinical promotion and application.
【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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