中药外敷和直肠滴入治疗慢性肾衰竭伴急性痛风性关节炎临床研究

目的：探讨中药外敷和直肠滴入治疗慢性肾衰竭伴急性痛风性关节炎的临床疗效。方法：将衡阳市第一人民医院82例的慢性肾衰竭伴急性痛风性关节炎患者随机分为研究组42例，采用中药外敷和直肠滴入治疗；对照组40例，采用泼尼松治疗。比较两组治疗后痛风关节的症状和体征，血尿酸、血肌酐、肌酐清除率，不良反应及复发率。结果：研究组与对照组缓解关节红肿疼痛方面疗效相近，差异无显著性。与治疗前相比，治疗后研究组血尿酸、血肌酐显著降低（P＜0.01），肌酐清除率明显升高（P＜0.05）；对照组治疗前后血肌酐、血尿酸、肌酐清除率比较无统计学意义。研究组未发现明显不良反应。随访1个月，中药研究组仅3例复发，明显优于对照组（P＜0.01）。结论：中药外敷和直肠滴入治疗慢性肾衰竭伴痛风性关节炎疗效显著，复发率低，无明显不良反应，值得临床推广。

Clinical Research on External Application and Rectal Instillation with Chinese Medicinein Treatment of Chronic Renal Failure Combined with Acute Gouty Arthritis

This study was aimed to investigate the curative effect on external application and rectal instillation with Chinese medicine in the treatment of chronic renal failure (CRF) with acute gouty arthritis (GA). A total of 82 CRF patients with acute GA from the First People's Hospital of Hengyang City were randomly divided into the study group (n = 42), which was treated with external application and rectal instillation with Chinese medicine, and the control group (n = 40), which was treated with prednisone. The comparison was made on symptoms and body signs of GA, blood uric acid, creatinine, creatinine clearance, adverse reaction, and recurrence rate between two groups. The results showed that there was no significant difference on alleviating of joint swelling and pain between the study group and the control group. Compared with pretreatment, the blood uric acid and creatinine were significantly decreased after treatment in the study group (P < 0.01). The creatinine clearance was obviously increased (P < 0.05). There were no significant differences on blood uric acid, creatinine and creatinine clearance in the control group before and after treatment. There was no adverse reaction in the study group. In the one-month follow-up, there were only three recurrent cases in the study group, which were obviously better than the control group (P < 0.01). It was concluded that external application and rectal instillation with Chinese medicine had a good curative effect on CRF with acute GA in the near future with low recurrence rate and no adverse reaction, which was worthy of popularizing in the clinical practice.