中药内服结合肿痛消外敷治疗湿热夹瘀型急性痛风性关节炎的疗效(1)
摘要 目的：探究中藥内服结合肿痛消外敷治疗湿热夹瘀型急性痛风性关节炎对红细胞沉降率(ESR)、白细胞介素-1β(IL-1β)及氧化应激水平的影响。方法：选取2017年6月至2019年10月河北省沧州中西医结合医院收治的急性痛风性关节炎患者120例作为研究对象，按照随机数字表法随机分为对照组和观察组，每组60例。对照组给予西医治疗，观察组在此基础上给予中药内服结合肿痛消外敷治疗，2组均连续治疗14 d。统计2组临床疗效;比较2组关节功能及关节疼痛评分、血尿酸(UA)、红细胞沉降率(ESR)水平，检测并比较2组治疗前后炎性反应递质及氧化应激因子水平。结果：观察组治疗有效率(96.67%)高于对照组(78.33%)，差异有统计学意义(P<0.05);治疗后2组关节功能分级评分、关节压痛、关节肿胀、休息时关节疼痛评分均降低，观察组低于对照组，差异有统计学意义(P<0.05);治疗后2组患者的ESR、IL-1β、IL-6、UA均降低，且观察组低于对照组，差异有统计学意义(P<0.05);治疗后2组血清8-羟基脱氧鸟苷(8-OHdG)、脂质过氧化物(LPO)均降低，且观察组低于对照组;2组总抗氧化能力(T-AOC)升高，且观察组高于对照组，差异有统计学意义(P<0.05)。结论：中药内服结合肿痛消外敷可有效缓解急性痛风性关节炎患者疼痛，改善UA、ESR水平及关节功能，可能与降低患者机体炎性反应及调控氧化应激状态有关。
关键词 急性痛风性关节炎;肿痛消;炎性反应;氧化应激;血尿酸;红细胞沉降率
Abstract Objective：To investigate the effects of oral administration of traditional Chinese medicine combined with external application of Zhongtongxiao on acute gouty arthritis of damp-heat and stasis type， and its effects on erythrocyte sedimentation rate (ESR)， Interleukin-1 β (IL-1β) and oxidative stress.Methods：From June 2017 to October 2019， a total of 120 patients with acute gouty arthritis who were admitted to Cangzhou Integrated Traditional Chinese and Western Medicine Hospital of Hebei Province were divided into a control group and an observation group， with 60 cases in each group， by random number table.The control group was treated with Western medicine， and the observation group was given traditional Chinese medicine orally combined with external application of Zhongtongxiao.Both groups were treated continuously for 14 days.The clinical efficacy of the 2 groups was counted; joint function and joint pain scores， serum uric acid (UA)， and ESR levels were compared between the 2 groups， and the levels of inflammatory factors and oxidative stress factors were detected and compared in the 2 groups before and after treatment.Results：The total effective rate in the observation group was higher than that in the control group (96.67% vs 78.33%， P<0.05).After treatment， the joint function grading scores， joint tenderness， joint swelling， and joint pain scores at rest were reduced in the w groups， and the observation group was lower than the control group (P<0.05).After treatment， the ESR， IL-1β， IL-6， and UA of the 2 groups decreased， and the observation group was lower than the control group (P<0.05).After treatment， the serum 8OHdG and LPO in the 2 groups decreased， and the observation group was lower than the control group; the TAOC increased in the 2 groups， and the observation group was higher than the control group (P<0.05).Conclusion：Oral administration of Chinese medicine combined with external application of Zhongtongxiao can effectively relieve pain， improve UA， ESR levels and joint function in patients with acute gouty arthritis， which may be related to reducing the body′s inflammatory response and regulating oxidative stress., 百拇医药(任艳梅 李莉 刘利利)
关键词 急性痛风性关节炎;肿痛消;炎性反应;氧化应激;血尿酸;红细胞沉降率
Abstract Objective：To investigate the effects of oral administration of traditional Chinese medicine combined with external application of Zhongtongxiao on acute gouty arthritis of damp-heat and stasis type， and its effects on erythrocyte sedimentation rate (ESR)， Interleukin-1 β (IL-1β) and oxidative stress.Methods：From June 2017 to October 2019， a total of 120 patients with acute gouty arthritis who were admitted to Cangzhou Integrated Traditional Chinese and Western Medicine Hospital of Hebei Province were divided into a control group and an observation group， with 60 cases in each group， by random number table.The control group was treated with Western medicine， and the observation group was given traditional Chinese medicine orally combined with external application of Zhongtongxiao.Both groups were treated continuously for 14 days.The clinical efficacy of the 2 groups was counted; joint function and joint pain scores， serum uric acid (UA)， and ESR levels were compared between the 2 groups， and the levels of inflammatory factors and oxidative stress factors were detected and compared in the 2 groups before and after treatment.Results：The total effective rate in the observation group was higher than that in the control group (96.67% vs 78.33%， P<0.05).After treatment， the joint function grading scores， joint tenderness， joint swelling， and joint pain scores at rest were reduced in the w groups， and the observation group was lower than the control group (P<0.05).After treatment， the ESR， IL-1β， IL-6， and UA of the 2 groups decreased， and the observation group was lower than the control group (P<0.05).After treatment， the serum 8OHdG and LPO in the 2 groups decreased， and the observation group was lower than the control group; the TAOC increased in the 2 groups， and the observation group was higher than the control group (P<0.05).Conclusion：Oral administration of Chinese medicine combined with external application of Zhongtongxiao can effectively relieve pain， improve UA， ESR levels and joint function in patients with acute gouty arthritis， which may be related to reducing the body′s inflammatory response and regulating oxidative stress., 百拇医药(任艳梅 李莉 刘利利)
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