清利泄浊祛痛汤联合西药治疗急性痛风性关节炎湿热蕴结证疗效观察

目的?观察清利泄浊祛痛汤联合西药治疗急性痛风性关节炎（湿热蕴结证）的临床疗效。方法?将70例患者按随机数字表法分为对照组和治疗组各35例。对照组给予秋水仙碱片口服，初始剂量1?mg，随后0.5?mg/h，症状缓解后0.5?mg/次，3?次/d。治疗组在对照组的基础上，给予清利泄浊祛痛汤，每日1剂。2组疗程均为7?d。记录治疗前后关节疼痛评分、关节肿胀评分、中医证候评分；检测治疗前后患者血白细胞(WBC)、红细胞沉降率(ESR)、C反应蛋白(CRP)、血尿酸(BUA)、肿瘤坏死因子-α(TNF-α)、白细胞介素-1(IL-1）水平，并进行安全性评价。结果?治疗后治疗组临床疗效优于对照组(P<0.05)；2组患者关节疼痛评分、关节肿胀评分、中医证候评分及CRP、ESA、TNF-α、IL-1、BUA水平明显降低(P<0.01)，治疗组优于对照组(P<0.05～0.01)。结论?在秋水仙碱治疗的基础上，采用清利泄浊祛痛汤治疗急性痛风性关节炎（湿热蕴结证）可有效缓解其主要临床症状，减轻炎症反应，安全性较好，临床疗效优于单纯的西医治疗。 

Observation on the Efficacy of Qingli Xiezhuo Qutong Decoction Combined with Western Medicine for the Treatment of Acute Gouty Arthritis with Damp-Heat Accumulation Syndrome

OBJECTIVE?To observe the clinical efficacy of Qingli Xiezhuo Qutong Decoction in combination with Western medicine for the treatment of acute gouty arthritis with damp-heat accumulation syndrome. METHODS?70 patients were randomly divided into the control group and the treatment groups with 35 cases each. The control group was given colchicine tablets orally at an initial dose of 1?mg， followed by 0.5 mg per hour and 0.5 mg at a time， for 3 times per day when symptom was relieved， and the treatment group was given Qingli Xiezhuo Qutong Decoction one dose a day. Both groups were treated for 7 days. The joint pain score， joint swelling score， and traditional Chinese medicine (TCM) syndrome score were recorded before and after treatment， and blood leukocyte (WBC)， erythrocyte sedimentation rate (ESR)， C-reactive protein (CRP)， blood uric acid (BUA)， tumor necrosis factor-α (TNF-α)， interleukin-1 (IL-1) levels were tested before and after treatment， and safety evaluation was conducted. RESULTS?The clinical efficacy of the treatment group was better than that of the control group after treatment (P<0.05). Joint pain score， joint swelling score， TCM syndrome score and CRP， ESA， TNF-α， IL-1， BUA levels were significantly reduced in both groups (P<0.01) and the treatment group was better than the control group (P<0.05， P<0.01). CONCLUSION?On the basis of colchicine， Qingli Xiezhuo Qutong Decoction for acute gouty arthritis (damp-heat accumulation syndrome) can effectively relieve the main clinical symptoms reducing the inflammatory response， with better safety and clinical efficacy than that of pure western medicine.