中药内外兼治急性痛风性关节炎并高尿酸血症临床观察

目的：观察中药内服、外敷法兼治急性痛风性关节炎并高尿酸血症的临床疗效。方法采用数字表法将急性痛风性关节炎患者随机分为观察组和对照组，两组患者均给予生活调整、饮食控制及碱化尿液等基础治疗。观察组在此基础上加用加味四妙散口服及四黄散加味外敷治疗，对照组予口服秋水仙碱及别嘌醇片等西医常规治疗。观察两组治疗前后血尿酸(UA)、血肌酐（Scr）、尿素氮（BUN）、血清C反应蛋白（CRP）、血沉（ESR）变化及关节红肿疼痛改善情况，治疗观察2周。结果观察组总有效率为90.3%，对照组总有效率为74.2%，差异有统计学意义(P＜0.05)；两组治疗前后UA比较，治疗后均较治疗前明显降低(P＜0.05)；治疗后组间比较，观察组较对照组降低(P＜0.05)；Scr和BUN两组治疗前后差异无统计学意义(P＞0.05)；两组治疗前后CRP、ESR比较，治疗后均较治疗前降低(P＜0.05)；治疗后组间比较，观察组较对照组降低(P＜0.05)。结论中药内外兼治急性痛风性关节炎和高尿酸血症安全有效，并在降低UA、ESR、CRP方面有一定优势。

Clinical Observation of Combined Internal and External Traditional Chinese Medicine on Treatment of Acute Gouty Arthritis and High Uric Acid Hematic Disease

Objective To observe the clinical effect of combined internal and external traditional Chinese medicine on treatment of acute gouty arthritis and high uric acid hematic disease. Methods The patients with acute gouty arthritis were randomly divided into the observation group and control group by using digital table method, which were given life adjust-ment, diet control and alkalize urine therapy. The obsevation group was treated with oral modified Siwei powder and exter-nal modified Sihuang powder. The control group was administrated with oral colchicine and allopurinol tablets. The changes of blood uric acid (UA), serum creatinine (Scr), urea nitrogen (BUN), serum c-reactive protein (CRP) and blood sedimentation (ESR), joint swelling pain improvement were observed in the two groups before and after treatment, treatment for 2 weeks. Results The total effective rate of the observation group was for 90.3%, total effective rate of control group was for 74.2%, the difference was statistically significant (P<0.05). The UA in the two groups before and after treatment was compared, which was significantly lower after treatment than before treatment (P<0.05). Comparison between the two groups after treatment, the observation group was lower than the control group (P<0.05). The Scr and BUN in the two groups before and after treat-ment had no obvious difference (P>0.05). The CRP and ESR in the two groups after treatment were significantly lower than that before treatment (P<0.05). Comparison between groups after treatment, the observation group was reduced significantly than the control group (P<0.05). Conclusion The combined internal and external application traditional Chinese medicine is safe and effective in treatment of acute gouty arthritis and high uric acid hematic disease, and shows certain advantages in reduc-ing the UA, ESR and CRP.