白虎加桂枝汤治疗急性痛风性关节炎患者的疗效观察
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摘要
【目的】观察白虎加桂枝汤治疗风湿郁热型急性痛风性关节炎患者的临床疗效。【方法】将69例风湿郁热型急性痛风性关节炎患者随机分为治疗组34例和对照组35例。治疗组给予白虎加桂枝汤治疗,对照组给予秋水仙碱片治疗,治疗5 d后,观察2组患者治疗前后血沉(ESR)水平和疼痛程度视觉模拟评分(VAS)的变化情况,并评价2组患者的疗效及安全性。【结果】(1)治疗组病例全部完成观察,无脱落退出情况;对照组2例患者因口服秋水仙碱后出现腹泻、腹痛而停药并退出临床观察。(2)治疗5 d后,治疗组总有效率为85.3%,对照组为87.9%,2组疗效相当,差异无统计学意义(P>0.05)。(3)治疗后,2组患者的ESR水平及疼痛程度VAS评分均较治疗前明显下降(P0.05)。(4)治疗过程中,2组患者的肝肾功能均无明显异常改变。【结论】白虎加桂枝汤能有效降低风湿郁热型急性痛风性关节炎患者血沉水平,对抑制急性痛风性关节炎的炎症反应有较好疗效。
Objective To investigate the clinical efficacy of Baihu Plus Guizhi Decoction(White Tiger Decoction with Ramulus Cinnamomi) for the treatment of acute gouty arthritis with wind-damp stagnant heat pattern.Methods Sixty-nine acute gouty arthritis patients with wind-damp stagnant heat pattern were randomly divided into observation group(n = 34)and control group(n = 35). The observation group was treated with Baihu Plus Guizhi Decoction, and the control group was treated with Colchicine Tablets orally for 5 days. Before and after treatment,erythrocyte sedimentation rate(ESR)and pain Visual Analogue Scale(VAS)scores in the two groups were examined. And after treatment, the clinical efficacy and safety were compared between the two groups.Results(1)All of patients in the observation group completed the trial;there were 2 cases in the control group dropped out the trial for the appearance of adverse reaction of diarrhea and abdominal pain caused by oral use of Colchicine Tablets.(2)After treatment for 5 days,the total effective rate was 85.3% in the observation group and 87.9% in the control group,the difference between the two groups being not statistically significant(P>0.05).(3)After treatment,ESR and pain VAS scores of the two groups were decreased(P<0.05 compared with those before treatment), but the differences of ESR and pain VAS scores between the two groups after treatment were insignificant(P>0.05).(4)During the treatment,no abnormalities were found in the hepatic and renal function of the two groups. Conclusion Baihu Plus Guizhi Decoction is effective on decreasing ESR and inhibiting the inflammatory reaction of acute gouty arthritis patients with wind-damp stagnant heat pattern.
Objective To investigate the clinical efficacy of Baihu Plus Guizhi Decoction(White Tiger Decoction with Ramulus Cinnamomi) for the treatment of acute gouty arthritis with wind-damp stagnant heat pattern.Methods Sixty-nine acute gouty arthritis patients with wind-damp stagnant heat pattern were randomly divided into observation group(n = 34)and control group(n = 35). The observation group was treated with Baihu Plus Guizhi Decoction, and the control group was treated with Colchicine Tablets orally for 5 days. Before and after treatment,erythrocyte sedimentation rate(ESR)and pain Visual Analogue Scale(VAS)scores in the two groups were examined. And after treatment, the clinical efficacy and safety were compared between the two groups.Results(1)All of patients in the observation group completed the trial;there were 2 cases in the control group dropped out the trial for the appearance of adverse reaction of diarrhea and abdominal pain caused by oral use of Colchicine Tablets.(2)After treatment for 5 days,the total effective rate was 85.3% in the observation group and 87.9% in the control group,the difference between the two groups being not statistically significant(P>0.05).(3)After treatment,ESR and pain VAS scores of the two groups were decreased(P<0.05 compared with those before treatment), but the differences of ESR and pain VAS scores between the two groups after treatment were insignificant(P>0.05).(4)During the treatment,no abnormalities were found in the hepatic and renal function of the two groups. Conclusion Baihu Plus Guizhi Decoction is effective on decreasing ESR and inhibiting the inflammatory reaction of acute gouty arthritis patients with wind-damp stagnant heat pattern.
引文
[1]郭丽珍,廖福金,吕雄.舒痛饮治疗急性痛风性关节炎临床疗效观察[J].广州中医药大学学报,2018,35(6):1002.
[2]刘湘源.表格式临床系列丛书·风湿病分册[M].北京:中国医药科技出版社,2001:202.
[3]郑筱萸.中药新药临床研究指导原则(第2辑)[S].北京:中国医药科技出版社,1995:179-183.
[4]赵俊娟,屈爱春.血流变的影响因素及质量控制[J].山西医药杂志,2007,36(1):54.
[5]李迎春,徐建华.急性痛风性关节炎的发病机制及研究进展[J].安徽医学,2013,34(1):96.
[6] Stafforini D M,Tjoelker L W,McCormick S P,et al. Molecular basic of the interaction between plasma platelet-activating factor acetylhydrolase and low density lipoprotein[J]. J Biol Chem,1999,274(11):7018.
[7] Sugano T,Nasu K,Narahara H,et al. Platelet-activating factor induces an imbalance between matrix metalloproteinase-1 and tissue inhibitor of metalloproteinases-1 expression in human uterine cervical fibroblasts[J]. Biol Reprod,2000,62(3):540.
[8] Carden D L,Granger D N. Pathophysiology of ischaemia-reperfusion injury[J]. J Pathol,2000,190(3):255.
[9] Oshiro T, Kakuta Y, Shimura S, et al. Characterization of platelet-activating factor-induced cytosolic calcium mobilization in human eosinophils[J]. Clin Exp Allergy,2000,30(5):699.
[10] Alihara M, Ishii S, Kume K, et al. Interaction between neurone and microglia mediated by platelet-activating factor[J].Genes Cells,2000,5(5):397.
[11]陈江华,顾向明.痛风急性期患者血瘀相关指标观察[J].中国中医急症,2008,17(2):221.
[12]李玉林.病理学[M].北京:人民卫生出版社,2008:60.
[13]袁艳平,李长贵.痛风性关节炎患者血清白细胞介素-1β肿瘤坏死因子-α环氧化酶-2水平的动态变化研究[J].中华风湿病学杂志,2013,17(12):818.
[14]明继阳,李洋,丁彦,等.知母在白虎汤中解热作用的研究[J].中医药信息,2017,34(3):47.
[15]翁丽丽,陈丽,宿莹,等.知母化学成分和药理作用[J].吉林中医药,2018,38(1):90.
[16]周永学,李敏,唐志书,等.中药石膏及其主要成分解热抗炎作用及机制研究[J].陕西中医学院学报,2012,35(5):74.
[17]余霄龙,李杨,李恩泽,等.穿虎痛风合剂治疗急性痛风性关节炎的临床研究[J].中华内分泌代谢杂志,2014,30(1):49.
[18]何彩莲.不同剂量秋水仙碱治疗痛风急性发作的临床疗效对比[J].北方药学,2017,14(9):41.
[2]刘湘源.表格式临床系列丛书·风湿病分册[M].北京:中国医药科技出版社,2001:202.
[3]郑筱萸.中药新药临床研究指导原则(第2辑)[S].北京:中国医药科技出版社,1995:179-183.
[4]赵俊娟,屈爱春.血流变的影响因素及质量控制[J].山西医药杂志,2007,36(1):54.
[5]李迎春,徐建华.急性痛风性关节炎的发病机制及研究进展[J].安徽医学,2013,34(1):96.
[6] Stafforini D M,Tjoelker L W,McCormick S P,et al. Molecular basic of the interaction between plasma platelet-activating factor acetylhydrolase and low density lipoprotein[J]. J Biol Chem,1999,274(11):7018.
[7] Sugano T,Nasu K,Narahara H,et al. Platelet-activating factor induces an imbalance between matrix metalloproteinase-1 and tissue inhibitor of metalloproteinases-1 expression in human uterine cervical fibroblasts[J]. Biol Reprod,2000,62(3):540.
[8] Carden D L,Granger D N. Pathophysiology of ischaemia-reperfusion injury[J]. J Pathol,2000,190(3):255.
[9] Oshiro T, Kakuta Y, Shimura S, et al. Characterization of platelet-activating factor-induced cytosolic calcium mobilization in human eosinophils[J]. Clin Exp Allergy,2000,30(5):699.
[10] Alihara M, Ishii S, Kume K, et al. Interaction between neurone and microglia mediated by platelet-activating factor[J].Genes Cells,2000,5(5):397.
[11]陈江华,顾向明.痛风急性期患者血瘀相关指标观察[J].中国中医急症,2008,17(2):221.
[12]李玉林.病理学[M].北京:人民卫生出版社,2008:60.
[13]袁艳平,李长贵.痛风性关节炎患者血清白细胞介素-1β肿瘤坏死因子-α环氧化酶-2水平的动态变化研究[J].中华风湿病学杂志,2013,17(12):818.
[14]明继阳,李洋,丁彦,等.知母在白虎汤中解热作用的研究[J].中医药信息,2017,34(3):47.
[15]翁丽丽,陈丽,宿莹,等.知母化学成分和药理作用[J].吉林中医药,2018,38(1):90.
[16]周永学,李敏,唐志书,等.中药石膏及其主要成分解热抗炎作用及机制研究[J].陕西中医学院学报,2012,35(5):74.
[17]余霄龙,李杨,李恩泽,等.穿虎痛风合剂治疗急性痛风性关节炎的临床研究[J].中华内分泌代谢杂志,2014,30(1):49.
[18]何彩莲.不同剂量秋水仙碱治疗痛风急性发作的临床疗效对比[J].北方药学,2017,14(9):41.
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