CAJ | 학술논문

目的：探讨除痹汤内服联合饮食疗法辨治痛风性关节炎的临床效果及对患者关节疼痛、肿胀的影响。方法将92例痛风性关节炎患者随机分为对照组和治疗组各46例。2组均给予多喝水、以低嘌呤饮食为主，多食用蔬菜水果等基础饮食干预。对照组在此基础上给予双氯芬酸钠缓释片口服治疗；治疗组在对照组的基础上给予除痹汤口服治疗，1剂／d，7 d为1个疗程，治疗2个疗程。观察治疗前后2组患者关节疼痛、肿胀、活动受限等主要症状的改善情况及治疗前后血尿酸（ UA）、血沉（ ESR）、C反应蛋白（ CRP）的变化情况，统计治疗效果。结果对照组有效率为72％，治疗组有效率为91％，治疗组的有效率明显高于对照组（P＜0．05）；治疗后2组关节疼痛、肿胀、活动受限等主要症状均有所改善，关节疼痛VAS评分、肿胀、活动受限证候评分均较治疗前下降（P均＜0．05），且治疗组改善程度明显优于对照组（P均＜0．05）；2组治疗后UA、ESR、CRP均较治疗前明显下降（P均＜0．05），且治疗组下降幅度更为明显（P均＜0．05）。结论除痹汤内服联合饮食疗法能明显改善患者的临床症状，缓解患者的痛感，提高关节运动能力，降低患者UA、ESR、CRP水平，凸显出中医论治的优势与特色，值得临床深入研究。
목적：탐토제비탕내복연합음식요법변치통풍성관절염적림상효과급대환자관절동통、종창적영향。방법장92례통풍성관절염환자수궤분위대조조화치료조각46례。2조균급여다갈수、이저표령음식위주，다식용소채수과등기출음식간예。대조조재차기출상급여쌍록분산납완석편구복치료；치료조재대조조적기출상급여제비탕구복치료，1제／d，7 d위1개료정，치료2개료정。관찰치료전후2조환자관절동통、종창、활동수한등주요증상적개선정황급치료전후혈뇨산（ UA）、혈침（ ESR）、C반응단백（ CRP）적변화정황，통계치료효과。결과대조조유효솔위72％，치료조유효솔위91％，치료조적유효솔명현고우대조조（P＜0．05）；치료후2조관절동통、종창、활동수한등주요증상균유소개선，관절동통VAS평분、종창、활동수한증후평분균교치료전하강（P균＜0．05），차치료조개선정도명현우우대조조（P균＜0．05）；2조치료후UA、ESR、CRP균교치료전명현하강（P균＜0．05），차치료조하강폭도경위명현（P균＜0．05）。결론제비탕내복연합음식요법능명현개선환자적림상증상，완해환자적통감，제고관절운동능력，강저환자UA、ESR、CRP수평，철현출중의론치적우세여특색，치득림상심입연구。
Objective It is to investigate the clinical efficacy of self-made Chubi decoction combined with dietotherapy on gouty arthritis, and to explore the effect on joint pain and swelling in the patients.Methods 92 gouty arthritis patients were randomly divided into a control group of 46 cases and a treatment group of 46 cases.All the patients in the two groups were given dietotherapy, such as drinking more water, mainly giving low purine diet, and eating more fruits and vegetables; The control group were treated with diclofanac sodium sustained release tablets, while patients in the treatment group were primarily treated with Chubi decoction for oral treatment on the basis of dietotherapy, 1agent/day, 7 days for treatment, 2 courses for treatment.Before and after treatment, the improvement of clinical symptoms, mainly including joint pain, swelling and activity limitation, and the changes of serum UA, ESR and CRP were observed, and the effective rate of the two groups were calculat-ed.Results The efficiency for patients in the control group was 72%, while for patients in the treatment group was 91%.The clinical efficacy of the treatment group was significantly higher than that of the control group(P<0.05).The main clinical symptoms of the patients in both groups, such as joint pain, swelling and activity limitation,were improved clearly, and the VAS and symptom scores went down clearly, the improvements in the treatment group were more significantly(P<0.05).The levels of UA, ESR and CRP after treatment went down clearly compared with that before treatment, and the changes in the treatment group were more significant (P<0.05).Conclusion Self-made Chubi decoction and dietotherapy can obviously im-prove clinical symptoms, relieve pain of the patients, improve the athletic? ability of joint, low down the levels of UA, ESR and CRP in the treatment of gouty arthritis, which shows the advantages and characteristics of TCM and is worthy of further re-search and development.