蚕矢汤加减治疗痛风性关节炎湿热蕴结证临床观察

发布时间：2018-07-15 08:57

【摘要】：目的:观察蚕矢汤加减及其联合秋水仙碱治疗痛风性关节炎湿热蕴结证的疗效及安全性。方法:将258例患者随机分为中药组、西药组和中西药组,每组各86例。中药组口服蚕矢汤加减,西药组口服秋水仙碱,中西药组同时口服蚕矢汤加减联合秋水仙碱,疗程均为14 d。观察治疗前后各组临床症状,血清尿酸(SUA),血沉(ESR),C-反应蛋白(CRP)和白细胞介素-6(IL-6)的变化;比较各组总有效率、不良反应发生率及随访3个月患者的复发率。结果:治疗过程中药组剔除3例,西药组剔除2例,中西药剔除5例。中西药组总有效率93.8%,优于中药组的81.9%和西药组的83.3%(P0.05),中药组与西药组比较无明显差异;中西药组各临床症状和实验室检查指标改善较中药组和西药组更为明显(P0.05),中药组与西药组比较无统计学意义;不良反应发生率中药组(3.6%)中西药组(60.5%)西药组(82.1%)(P0.05);复发率中西药组(7.4%)中药组(20.5%)西药组(26.1%)(P0.05)。结论:蚕矢汤加减治疗痛风性关节炎湿热蕴结证的疗效与西药秋水仙碱无明显差异,说明其具有有效性,且不良反应的发生率和复发率较秋水仙碱低;蚕矢汤加减联合秋水仙碱治疗痛风性关节炎湿热蕴结证具有协同增效的作用,疗效优于单用蚕矢汤加减或秋水仙碱,且可降低秋水仙碱的不良反应、复发率低。
[Abstract]:Objective: to observe the efficacy and safety of silkworm Yam decoction and colchicine in treating damp-heat accumulation syndrome of gouty arthritis. Methods: 258 patients were randomly divided into Chinese medicine group, western medicine group and western medicine group with 86 cases in each group. The Chinese medicine group was treated with silkworm decoction, the western medicine group with colchicine, the traditional Chinese medicine group with the combination of silkworm decoction and colchicine. The course of treatment was 14 days. The clinical symptoms, serum uric acid (SUA), erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) and interleukin-6 (IL-6) were observed before and after treatment, the total effective rate, the incidence of adverse reactions and the recurrence rate of the patients were compared. Results: in the course of treatment, 3 cases were eliminated in Chinese medicine group, 2 cases in western medicine group and 5 cases in Chinese and western medicine group. The total effective rate of the Chinese and western medicine group was 93.8%, which was better than that of the traditional Chinese medicine group (81.9%) and the western medicine group (83.3%) (P0.05). There was no significant difference between the Chinese medicine group and the western medicine group. The improvement of clinical symptoms and laboratory examination indexes in the Chinese and western medicine group was more obvious than that in the traditional Chinese medicine group and the western medicine group (P0.05), but there was no significant difference between the traditional Chinese medicine group and the western medicine group. The incidence of adverse reactions was 3.6% in TCM group, 60.5% in TCM group, 82.1% in western medicine group (P0.05), and the recurrence rate in TCM group (7.4%), traditional Chinese medicine group (20.5%) and western medicine group (26.1%) (P0.05). Conclusion: there is no significant difference between YYD and western medicine colchicine in the treatment of damp-heat accumulation syndrome of gouty arthritis, which indicates that it is effective, and the incidence and recurrence rate of adverse reactions is lower than that of colchicine. The combination of silkworm yam decoction and colchicine in the treatment of damp-heat accumulation syndrome of gouty arthritis has synergistic effect, which is superior to that of silkworm Yayi decoction alone or colchicine, and can reduce the adverse reaction of colchicine, and the recurrence rate is low.
【作者单位】：河南省中医院;
【基金】：河南省科学技术厅科技发展计划项目(14B360018)
【分类号】：R259

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