土萆宁痛汤治疗湿热蕴结型急性痛风性关节炎的临床研究

发布时间：2018-07-18 20:52

【摘要】：目的:观察土萆宁痛汤对湿热蕴结型急性痛风性关节炎的临床疗效及安全性,以便临床推广应用。方法:严格遵循试验设计,选取96例急性痛风性关节炎患者,且中医辨证为湿热蕴结型,采用随机数字表法将患者分为土萆宁痛汤组(治疗组)48例和依托考昔组(对照组)48例。对照组给予基础治疗并口服依托考昔片120mg,每日1次;治疗组予基础治疗并口服土萆宁痛汤,每日1剂,早晚各服一次。两组疗程均为7天,治疗期间观察记录两组患者症状体征改善情况及实验室指标变化情况,评估临床总体疗效及安全性。采用SPSS22.0对所有数据进行统计分析。结果:(1)综合疗效评价:治疗组47例,其中治愈14例、显效26例,有效5例,无效2例,总有效率达95.7%,对照组46例,其中治愈2例、显效29例,有效11例,无效4例,总有效率达91.3%,治疗组疗效更为显著(P0.01)。(2)症状体征改善情况对比:两组治疗方案均能有效改善患者的关节疼痛积分、关节压痛积分、关节红肿积分、关节受限积分及症状体征积分(P0.01),在改善患者关节红肿、关节受限及症状体征积分方面,治疗组疗效更佳(P0.05)。(3)实验室指标变化情况对比:两组治疗方案均能降低患者ESR、CRP水平(P0.01),且两组疗效相当(P0.05)。治疗组能有效降低患者BUA水平(P0.01),但对照组无降低BUA作用(P0.05)。(4)缓解时间对比:在关节疼痛缓解时间上比较,两组差异无统计学意义(P0.05),在关节红肿缓解时间上比较,治疗组显著短于对照组(P0.01)。(5)安全性评价:治疗组不良反应发生率为2.13%,对照组不良反应发生率为15.22%,显著高于治疗组(P0.05)。结论:土萆宁痛汤治疗急性痛风性关节炎具有良好疗效,其抗炎镇痛作用与依托考昔相当,在改善关节红肿症状方面优于依托考昔,并具有降低血尿酸的作用,不良反应少,疗效确切,值得临床上推广。
[Abstract]:Objective: to observe the clinical efficacy and safety of Tubibinitong decoction in treating acute gouty arthritis with damp-heat accumulation. Methods: according to the experimental design, 96 cases of acute gouty arthritis were selected, and the TCM syndrome differentiation was dampness and heat accumulation type. The patients were randomly divided into Tubibiningtong decoction group (48 cases) and etacoxib group (control group) 48 cases. The control group was given basic treatment and oral etacoxib 120 mg once a day, while the treatment group was given basic treatment and oral Tubibiotong decoction, 1 dose daily, once in the morning and evening. The two groups were treated for 7 days. The improvement of symptoms and signs and the changes of laboratory indexes were observed and recorded during the treatment period to evaluate the overall clinical efficacy and safety. All the data were analyzed by SPSS 2. 0. Results: (1) Comprehensive evaluation of curative effect: in the treatment group, 14 cases were cured, 26 cases were effective, 5 cases were effective, 2 cases were ineffective, and the total effective rate was 95.7%. In the control group, 46 cases were cured, 29 cases were markedly effective, 11 cases were effective, 4 cases were ineffective. The total effective rate was 91.3%. The curative effect of the treatment group was more significant (P0.01). (2) than that of the control group (P0.01). (2). The two treatment schemes could effectively improve the joint pain score, the joint tenderness score and the joint redness score. The joint limited score and symptom and sign score (P0.01) were used to improve the patients' joint redness, joint limitation and symptom and sign score. The therapeutic effect of the treatment group was better (P0.05). (3) compared with the laboratory index: the two groups of treatment can reduce the level of ESR-CRP (P0.01), and the two groups have the same curative effect (P0.05). Treatment group can effectively reduce the Bua level (P0.01), but the control group did not reduce Bua effect (P0.05). (4) remission time comparison: in the joint pain relief time comparison, the two groups have no statistical significance (P0.05), in the joint redness relief time comparison, The safety evaluation of the treatment group was significantly shorter than that of the control group (P0.01). (5): the incidence of adverse reactions was 2.13 in the treatment group and 15.22 in the control group, which was significantly higher than that in the treatment group (P0.05). Conclusion: Tubibiningtong decoction has good curative effect on acute gouty arthritis, its anti-inflammatory and analgesic effect is equal to that of etacoxib, it is superior to etacoxime in improving the symptoms of joint redness and swelling, and it has the effect of reducing blood uric acid, and has fewer adverse reactions. The curative effect is definite, worth popularizing clinically.
【学位授予单位】：广州中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R259

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