三联疗法对湿热蕴结型老年痛风性关节炎的临床研究

目的：通过观察中药内服、外敷、敷贴三联疗法对老年原发性痛风性关节炎（湿热蕴结型）患者的临床疗效、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。采用中医症候积分评定法，并就上述数据进行统计学分析。结果：两组在主要症状（关节疼痛、关节红肿、关节皮温、活动障碍）积分方面，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 值均>0.05）；两组在次要症状（口渴多饮、神疲乏力、纳差、五心烦热）积分方面，组内比较治疗组具有极显著性差异（P值均<0.01），对照组无明显差异（P值均>0.05），组间比较具有极显著性差异（P值均<0.01）。从总体疗效来看，中药组的有效率93.33%，西药组则达83.33%，中药组在改善次要症状方面优于西药组。结论：①中药三联疗法可改善患者中医症候，其疗效与双氯芬酸钠双释放肠溶胶囊相当，且有明显降低血尿酸的作用。②不良反应低于对照组，值得临床推广运用。

Clinical research of triple therapy on treating the old gouty arthritis of damp-heat accumulation type

Objective： Through the observation of clinical efficacy and safety of TCM medicine taken orally, extemal application, dressing of triple therapy on elderly patients with primary gouty arthritis （damp-heat accumulation type） to explore its possible functional mechanism to find the theoretical foundation for TCM comprehensive treatment of old gouty arthritis. Methods： 60 elderly patients with primary acute gouty arthritis were randomly divided into TCM medicine treated group and modem medicine control group, 30 for each. The two groups were given basic treatment, the treated group was given TCM medicine triple therapy more, the control group was given dual release diclofenac sodium enteric-coated capsules more. Results： In TCM symptom integral, the two groups in the main symptoms （joint pain, joint swelling, skin temperature, joint movement disorder） of integral, comparison within groups, a significant difference （P〈0.01）, were no significant difference between two groups （/〉0.05）. In a secondary symptoms （thirsty much drink, lassitude, anorexia, five upset hot） of integral, there was significant difference （P〈0.01） between two groups, the control group showed no significant difference （P〉0.05）, comparison between groups with significant difference （/〈0.01）. The total efficiency of the treated group was 93.33%, while the control group was 83.33%, TCM medicine group in improving secondary symptoms was superior to modem medicine group. Conclusion： TCM medicine triple therapy has a good curative effect, worthy of a wide clinical application.