宣痹汤合白虎桂枝汤内服外洗治疗急性痛风性关节炎57例临床观察

目的:探讨宣痹汤合白虎桂枝汤内服外洗治疗急性痛风性关节炎(AGA)的疗效对血尿酸的影响。方法:将113例患者1∶1比例随机分成对照组56例和观察组57例。对照组采用秋水仙碱片+布洛芬片;观察组在对照组治疗的基础上加用宣痹汤合白虎桂枝汤内服。两组疗程均为14 d。采用视觉模拟评分(VAS)法进行自我疼痛评价,评价治疗前后关节疼痛、压痛、关节肿胀及关节活动障碍情况,记录疼痛缓解时间,检测治疗前后血尿酸(UA),血沉(ESR),C-反应蛋白(CRP)。结果:两组综合临床疗效经Ridit分析结果显示观察组优于对照组(P0.05);观察组在治疗后第2,3,7,10天疼痛VAS评分均低于对照组(P0.01);观察组疼痛缓解时间短于对照组(P0.05);治疗后观察组关节疼痛、压痛、红肿、活动障碍评分均低于对照组(P0.01);治疗后观察组ESR,UA,CRP水平均低于对照组(P0.01)。结论:在西医常规治疗的基础上,宣痹汤合白虎桂枝汤加减内服的使用能减轻AGA疼痛,缩短疼痛时间,减轻炎症反应,能更有效、更快控制AGA的发作。

Clinical Study of Xuanbi Decoction Combined with Baihu Guizhi Decoction in Treatment of 57 Cases with Acute Gouty Arthritis

Objective: To discuss the effect of Xuanbi decoction combined with Baihu Guizhi decoction by oral and washout methods in treating acute gouty arthritis (AGA) and their influence to blood uric acid. Method: One hundred and thirteen patients were randomly divided into control group (56 cases) and observation group (57 cases) at the proportion of 1:1.Patients in control group received colchicine tablets and ibuprofen tablets. Based on the treatment of control group, patients in observation group received additional Xuanbi decoction combined with Baihu Guizhi decoction by oral method. The treatment course was 14 days in both groups. Visual analogue scale(VAS) was used to evaluate arthralgia, tenderness, joints swollen and articular activity obstacle before and after treatment. Remission time was recorded. Blood uric acid (UA), erythrocyte sedimentation rate (ESR), and C-reactive protein (C-RP) were detected. Result: Ridit analysis showed that the comprehensive clinical effect in observation group was superior to that in control group (P<0.05). On the second, third, seventh and tenth day after treatment, VAS scores of pain in observation group were lower than those in control group (P<0.01). Remission time in observation group was shorter than that in control group (P<0.05). Scores of arthralgia, tenderness, joints swollen and articular activity obstacle in observation group were lower than those in control group (P<0.01). Besides, levels of ESR, UA and CRP in observation group were lower than those in observation group (P<0.01). Conclusion: Based on the routine western medicine treatment, Xuanbi decoction combined with Baihu Guizhi decoction by oral taking can relieve pain of AGA and inflammatory reactions, and it can control the seizure of AGA more quickly and effectively.