国际中医中药杂志
國際中醫中藥雜誌
국제중의중약잡지
INTERNATIONAL JOURNAL OF TRIDITIONAL CHINESE MEDICINE
2014年
7期
600-603
,共4页
痛风性关节炎%四妙汤加味%中药外敷%疗效分析
痛風性關節炎%四妙湯加味%中藥外敷%療效分析
통풍성관절염%사묘탕가미%중약외부%료효분석
Gouty arthritis%Modified Simiao decoction%External application of Chinese medicines%Therapeutic effect evaluation
目的：探讨四妙汤加减配合中药外敷治疗痛风性关节炎的临床疗效。方法收集2010年1月至2013年8月本院就诊痛风性关节炎患者76例，按病例尾号随机分为两组各38例，两组患者治疗期间均进食低热量饮食，并加大日饮水量（＞2000 ml），戒烟酒，禁食高嘌呤食物。对照组急性期口服秋水仙碱片、吲哚美辛肠溶片，缓解期口服双氯芬酸钠缓释片。治疗组在对照组治疗基础上加用四妙汤加味并配合外敷自拟消肿止痛散治疗。治疗7d后观察并记录患者治疗前后的中医症状积分、关节炎症状积分、症状缓解时间，红细胞沉降率（ESR）、C反应蛋白（CRP）、血尿酸（UA）、白细胞介素-1?（IL-1?）、白细胞介素-18（IL-18）。结果两组治疗后CRP、ESR[治疗组分别为（22.06±10.31）mg/L、（25.18±17.80）mm/h，对照组分别为（14.11±7.32） mg/L、（24.16±22.09） mm/h]均较同组治疗前降低[治疗组分别为（82.16±21.37）mg/L、（72.13±32.36）mm/h，对照组分别为（52.46±22.26）mg/L、（62.72±33.31）mm/h， P＜0.01]，治疗组ESR低于对照组（P＜0.05）。两组治疗后IL-1?、IL-18[治疗组为（55.26±16.31）pg/ml、（187.32±50.38）pg/ml，对照组为（57.25±18.21）pg/ml、（178.49±52.60）pg/ml]均较同组治疗前[治疗组分别为（106.11±41.02）pg/ml、（398.15±132.52）pg/ml，对照组分别为（109.23±40.12）pg/ml、（397.16±141.21）pg/ml]明显降低（P＜0.01）。治疗后治疗组完全缓解时间为（4.02±2.08）d，对照组为（4.95±2.68）d，两组完全缓解时间比较，差异有统计学意义（P＜0.05）。结论四妙汤加减配合中药外敷可减少中医症状积分、关节炎症状积分，缩短症状缓解时间；降低ESR、CRP、UA水平，增强机体免疫力。
目的：探討四妙湯加減配閤中藥外敷治療痛風性關節炎的臨床療效。方法收集2010年1月至2013年8月本院就診痛風性關節炎患者76例，按病例尾號隨機分為兩組各38例，兩組患者治療期間均進食低熱量飲食，併加大日飲水量（＞2000 ml），戒煙酒，禁食高嘌呤食物。對照組急性期口服鞦水仙堿片、吲哚美辛腸溶片，緩解期口服雙氯芬痠鈉緩釋片。治療組在對照組治療基礎上加用四妙湯加味併配閤外敷自擬消腫止痛散治療。治療7d後觀察併記錄患者治療前後的中醫癥狀積分、關節炎癥狀積分、癥狀緩解時間，紅細胞沉降率（ESR）、C反應蛋白（CRP）、血尿痠（UA）、白細胞介素-1?（IL-1?）、白細胞介素-18（IL-18）。結果兩組治療後CRP、ESR[治療組分彆為（22.06±10.31）mg/L、（25.18±17.80）mm/h，對照組分彆為（14.11±7.32） mg/L、（24.16±22.09） mm/h]均較同組治療前降低[治療組分彆為（82.16±21.37）mg/L、（72.13±32.36）mm/h，對照組分彆為（52.46±22.26）mg/L、（62.72±33.31）mm/h， P＜0.01]，治療組ESR低于對照組（P＜0.05）。兩組治療後IL-1?、IL-18[治療組為（55.26±16.31）pg/ml、（187.32±50.38）pg/ml，對照組為（57.25±18.21）pg/ml、（178.49±52.60）pg/ml]均較同組治療前[治療組分彆為（106.11±41.02）pg/ml、（398.15±132.52）pg/ml，對照組分彆為（109.23±40.12）pg/ml、（397.16±141.21）pg/ml]明顯降低（P＜0.01）。治療後治療組完全緩解時間為（4.02±2.08）d，對照組為（4.95±2.68）d，兩組完全緩解時間比較，差異有統計學意義（P＜0.05）。結論四妙湯加減配閤中藥外敷可減少中醫癥狀積分、關節炎癥狀積分，縮短癥狀緩解時間；降低ESR、CRP、UA水平，增彊機體免疫力。
목적：탐토사묘탕가감배합중약외부치료통풍성관절염적림상료효。방법수집2010년1월지2013년8월본원취진통풍성관절염환자76례，안병례미호수궤분위량조각38례，량조환자치료기간균진식저열량음식，병가대일음수량（＞2000 ml），계연주，금식고표령식물。대조조급성기구복추수선감편、신타미신장용편，완해기구복쌍록분산납완석편。치료조재대조조치료기출상가용사묘탕가미병배합외부자의소종지통산치료。치료7d후관찰병기록환자치료전후적중의증상적분、관절염증상적분、증상완해시간，홍세포침강솔（ESR）、C반응단백（CRP）、혈뇨산（UA）、백세포개소-1?（IL-1?）、백세포개소-18（IL-18）。결과량조치료후CRP、ESR[치료조분별위（22.06±10.31）mg/L、（25.18±17.80）mm/h，대조조분별위（14.11±7.32） mg/L、（24.16±22.09） mm/h]균교동조치료전강저[치료조분별위（82.16±21.37）mg/L、（72.13±32.36）mm/h，대조조분별위（52.46±22.26）mg/L、（62.72±33.31）mm/h， P＜0.01]，치료조ESR저우대조조（P＜0.05）。량조치료후IL-1?、IL-18[치료조위（55.26±16.31）pg/ml、（187.32±50.38）pg/ml，대조조위（57.25±18.21）pg/ml、（178.49±52.60）pg/ml]균교동조치료전[치료조분별위（106.11±41.02）pg/ml、（398.15±132.52）pg/ml，대조조분별위（109.23±40.12）pg/ml、（397.16±141.21）pg/ml]명현강저（P＜0.01）。치료후치료조완전완해시간위（4.02±2.08）d，대조조위（4.95±2.68）d，량조완전완해시간비교，차이유통계학의의（P＜0.05）。결론사묘탕가감배합중약외부가감소중의증상적분、관절염증상적분，축단증상완해시간；강저ESR、CRP、UA수평，증강궤체면역력。
Objective To evaluate the effects of treating gouty arthritis with modified Simiao decoction and external application of traditional Chinese medicine. Methods 76 patients with gouty arthritis of our hospital from January 2010 to August 2013 were recruited and randomly divided into a treatment group and a control group, 38 patients in each group. Patients in both groups were given low caloric diet, large amount of water(>2 000 ml), and forbidden to smoking, alcohol, sea food, animal splanchna and bean products. The control group was treated with oral intake of colchicines and indometacin in acute stage and oral intake of diclofenc in stable stage, while the treatment group was further added modified Simiao decoction and external application of traditional Chinese medicine on the basis of the control group. TCM symptom score, arthritis symptom score, symptomatic relief time, ESR, CRP, UA, IL-1?and IL-18 were observed after 7 days treatment. Results CRP, ESR decreased after the treatment[The treatment group respectively(22.06±10.31)mg/L, (25.18±17.80)mm/h,the control group respectively(14.11±7.32)mg/L, (24.16±22.09)mm/h]in both groups compared with the values before the treatment[The treatment group respectively(82.16±21.37)mg/L, (72.13± 32.36)mm/h,the control group respectively(52.46±22.26)mg/L, (62.72±33.31)mm/h, P<0.01],while the decrease after of ESR in the treatment group was much obvious than the control group(P<0.05). IL-1?, IL-18 decreased after the treatment[The treatment group respectively(55.26±16.31)pg/ml, (187.32±50.38)pg/ml;the control group respectively(57.25±18.21)pg/ml, (178.49±52.60)pg/ml] in both groups compared with the values before the treatment[The treatment group respectively(106.11±41.02)pg/ml, (398.15±132.52)pg/ml.The control group respectively(109.23±40.12)pg/ml, (397.16±141.21)pg/ml, P<0.01]. The symptomatic relief time was(4.02±2.08)d and(4.95±2.68)d in the treatment group and the control group respectively, showing statistical difference between the two groups(P<0.05). Conclusion Modified Simiao decoction combined with external application of Chinese medicines reduced TCM symptom score and arthritis symptom score, increase symptomatic relief time, decrease ESR, CRP and UA level, and enhance body immunity.
