三联疗法对湿热蕴结型急性老年痛风性关节炎的实验研究

目的：通过观察中药内服、外敷、敷贴三联疗法对老年原发性急性痛风性关节炎（湿热蕴结型）患者的实验室指标、安全性，探讨其可能的作用机理，为中医药综合治疗老年痛风性关节炎寻找理论依据。方法：符合纳入标准的60例老年原发性急性痛风性关节炎患者，按组间均衡一致原则，随机分为中药治疗组和西药对照组各30例。两组均在基础治疗之上，治疗组予中药三联疗法，对照组予双氯芬酸钠双释放肠溶胶囊口服。检测实验室指标（WBC、N%、ESR、CRP、UA）及采用ELISA法检测IL-1β、IL-18水平，并就上述数据进行统计学分析。结果：①两组在WBC、N%、CRP，ESR方面，组内比较具有显著性差异（P<0.01或P<0.05），组间比较无显著性差异（P值均>0.05）；在UA方面，组内比较治疗组具有极显著性差异（P<0.01），对照组无明显差异（P>0.05），组间比较具有极显著性差异（P值均<0.01）。②ELISA法检测IL-1β、IL-18表达：两组组内比较具有极显著性差异（P值均<0.01），组间比较无显著性差异（P>0.05）。③安全性监测指标：中药治疗组不良反应发生率10.00%；对照组33.33%。治疗组病例在不良反应及安全性统计方面低于对照组，有明显差异（P<0.05）。

Clinical research of triple therapy for the old gouty arthritis of Damp-heat accumulation type

Objective： Through the observation of Chinese herbs taken orally, external application, dressing of triple therapy on elderly patients with primary acute gouty arthritis （Damp-heat accumulation type） laboratory indicators, safety, to explore its possible functional mechanism, for traditional Chinese medicine in the treatment of elderly patients with gouty arthritis to find the theoretical basis. Methods： 60 elderly patients with primary acute gouty arthritis were randomly divided into Chinese medicine treatment group and the modern medicine control group with 30 patients in each. Two groups were on the basis of treatment, the treatment group used TCM triple therapy of Chinese herbs taken orally, external application, dressing of triple therapy, control group with Diclofenac sodium dual release capsules for oral. Then test the laboratory index （WBC、N%、ESR、CRP、UA）with the integral evaluation method of TCM symptoms, and using ELISA assay for detection of IL-1β, IL-18 level. The data were analyzed statistically. Results： ①Indexes of laboratory examination： Two groups in WBC, N%, CRP, ESR, within group comparisons showed significant difference （P0.01 or P0.05）, were no significant difference between two groups （P0.05）; in the UA group, treatment group with a very significant difference （P0.01）, the control group showed no significant difference （P0.05）, comparison between groups with significant difference （P0.01）. ②ELISA method for the detection of IL-1β, IL-18 expression： The two group comparison within groups, a significant difference （P0.01）, were no significant difference between two groups （P0.05）. ③Safety monitoring indicators： The incidence of adverse reactions in the group with Chinese medicine treatment is 10%, while that in the modern medicine control group is 33.33%. The statistics of the adverse reaction and safety in the treatment groups is lower than that of the control group, which has significant difference （P0.05）.