

浏览全部资源
扫码关注微信
1.广州中医药大学 第二临床医学院,广州 510140
2.广东省中医院,广州 510006
3.广东省中医院 珠海医院,广东 珠海 519015
Received:02 March 2020,
Published Online:03 September 2020,
Published:05 December 2020
移动端阅览
夏璇,李文杰,张磊等.芪茯化浊汤对发作间歇期和慢性期痛风的疗效观察[J].中国实验方剂学杂志,2020,26(23):120-124.
XIA Xuan,LI Wen-jie,ZHANG Lei,et al.Clinical Observation of Qifu Huazhuo Decoction in Treating Intermittent and Chronic Gout[J].Chinese Journal of Experimental Traditional Medical Formulae,2020,26(23):120-124.
夏璇,李文杰,张磊等.芪茯化浊汤对发作间歇期和慢性期痛风的疗效观察[J].中国实验方剂学杂志,2020,26(23):120-124. DOI: 10.13422/j.cnki.syfjx.20202221.
XIA Xuan,LI Wen-jie,ZHANG Lei,et al.Clinical Observation of Qifu Huazhuo Decoction in Treating Intermittent and Chronic Gout[J].Chinese Journal of Experimental Traditional Medical Formulae,2020,26(23):120-124. DOI: 10.13422/j.cnki.syfjx.20202221.
目的
2
观察芪茯化浊汤治疗发作间歇期和慢性期痛风的疗效和安全性。
方法
2
160例符合纳入标准的痛风患者被按照治疗方式的不同分为治疗组和对照组,各80例。治疗组口服芪茯化浊汤联合非布司它,对照组口服非布司它联合碳酸氢钠片,疗程为12周。比较各组治疗前后痛风发作的次数,关节疼痛的程度,血尿酸、肌酐、丙氨酸氨基转移酶水平,合并使用止痛药的例数和不良反应,治疗结束后随访12周。
结果
2
治疗组总有效率91.25%(73/80),高于对照组的83.75%(67/80)(
χ
2
=0.16,
P
<
0.05)。治疗组对改善痛风发作的次数、关节疼痛的程度优于对照组(
P
<
0.05)。治疗组对血尿酸的改善优于对照组(
P
<
0.05)。两组患者治疗后血肌酐和丙氨酸氨基转移酶的比较差异无统计学意义。治疗组合并使用止痛药的人数优于对照组(
P
<
0.05)。不良反应方面,治疗组出现发热2例,肝功能异常2例,肾功能异常6例,胃肠道反应3例;对照组发热1例,肝功能异常2例,肾功能异常8例,胃肠道反应5例;两组患者不良反应发生率的比较差异无统计学意义。
结论
2
芪茯化浊汤可有效减少发作间歇期和慢性期痛风急性发作次数和关节疼痛程度,能够有效控制血尿酸水平,减少合并使用止痛药的例数,不良反应少,适合临床推广使用。
Objective
2
To observe the efficacy and safety of Qifu Huazhuo decoction in treating intermittent and chronic gout.
Method
2
A total of 160 eligible patients with intermittent and chronic gout were divided into intervention group and control group according to treatment methods, 80 cases in each group. Qifu Huazhuo decoction combined with febuxostat was given in intervention group by oral administration, while the patients in control took febuxostat combined with sodium bicarbonate tablet. After twelve weeks of treatment in both groups, the onset frequency of gout, the degree of joint pain, the levels of uric acid, creatinine, alanine transaminase in the blood, number of cases to use analgesics and adverse events were recorded compared before and after treatment. Twelve weeks follow-up was also conducted after the treatment.
Result
2
The total effective rate was 91.25% (73/80) in intervention group, higher than 83.75% (67/80) in control group, with a significant difference between two groups (
χ
2
=0.16,
P
<
0.05). Intervention group was superior to control group in improvement of onset frequency of gout, joint pain (
P
<
0.05), and blood uric acid (
P
<
0.05). There was no significant difference between two groups in blood creatinine and alanine transaminase. The number of patients using analgesics was less in intervention group (
P
<
0.05). In terms of adverse reactions, there were two cases of fever, two cases of abnormal liver function, six cases of abnormal kidney function and three cases of gastrointestinal reaction after the treatment in intervention group. While for control group, there were one case of fever, two cases of abnormal liver function, eight cases of abnormal kidney function and five cases of gastrointestinal reaction, without significant differences between two groups.
Conclusion
2
The Qifu Huazhuo decoction can effectively reduce the onset frequency of gout and the degree of joint pain in intermittent and chronic phases, effectively control the level of blood uric acid, and reduce the number of cases using analgesics, with less adverse reactions, so it is suitable for clinical use.
DALBETH N , MERRIMAN T R , STAMP L K . Gout [J]. Lancet , 2016 , 388 ( 10055 ): 2039 - 2052 .
KUO C F , GRAINGE M J , ZHANG W , et al . Global epidemiology of gout: prevalence, incidence and risk factors [J]. Nat Rev Rheumatol , 2015 , 11 ( 11 ): 649 - 662 .
LIU R , HAN C , WU D , et al . Prevalence of hyperuricemia and gout in mainland China from 2000 to 2014:a systematic review and meta-analysis [J]. Biomed Res Int , 2015 , doi: 10.1155/2015/762820 http://dx.doi.org/10.1155/2015/762820 .
ZHU Y , PANDYA B J , CHOI H K . Comorbidities of gout and hyperuricemia in the US general population: NHANES 2007-2008 [J]. Am J Med , 2012 , 125 ( 7 ): 679 - 687 .
KILTZ U , SMOLEN J , BARDIN T , et al . Treat-to-target(T2T) recommendations for gout [J]. Ann Rheum Dis , 2017 , 76 ( 4 ): 632 - 638 .
HAMBURGER M , BARAF H S , ADAMSON T C , et al . 2011 Recommendations for the diagnosis and management of gout and hyperuricemia [J]. Phys Sportsmed , 2011 , 39 ( 4 ): 98 - 123 .
曾小峰 , 陈耀龙 . 2016中国痛风诊疗指南 [J]. 浙江医学 , 2017 , 39 ( 21 ): 1823 - 1832 .
谷慧敏 , 孟庆良 , 左瑞庭 , 等 . 蚕矢汤加减治疗痛风性关节炎湿热蕴结证临床观察 [J]. 中国实验方剂学杂志 , 2017 , 23 ( 24 ): 180 - 184 .
江崛 , 唐润科 . 当归拈痛汤合三妙丸对湿热蕴结型痛风性关节炎的疗效观察 [J]. 中国实验方剂学杂志 , 2015 , 21 ( 21 ): 169 - 172 .
张涵雨 , 李艳 . 国医大师李济仁治疗痹病用药规律分析 [J]. 中医学报 , 2020 , 35 ( 1 ): 99 - 104 .
WALLANCE S L , ROBINSON H , MASI A T , et al . Preliminary criteria for the classification of the acute arthritis of primary gout [J]. Arthritis Rheum , 1977 , 20 ( 3 ): 895 - 900 .
NEOGI T , JANSEN T L , DALBETH N , et al . 2015 Gout classification criteria: an American College of Rheumatology/European League against rheumatism collaborative initiative [J]. Ann Rheum Dis , 2015 , 74 ( 10 ): 1789 - 1798 .
国家中医药管理局 . 22个专业95个病种中医诊疗方案 [M]. 北京 : 中国中医药科技出版社 , 2010 : 270 - 271 .
徐晖 , 黄颖 , 王莹 , 等 . 金乌健骨胶囊联合来氟米特治疗寒湿痹阻型类风湿关节炎38例临床观察 [J]. 中医杂志 , 2020 , 61 ( 7 ): 607 - 612 .
中华人民共和国卫生部 . 中药新药临床研究指导原则 [M]. 北京 : 中国医药科技出版社 , 2002 : 118 - 119 .
吴博 , 马跃平 , 袁久志 , 等 . 土茯苓化学成分的分离与鉴定 [J]. 沈阳药科大学学报 , 2010 , 27 ( 2 ): 116 - 119 .
赵鹏 , 马洪 . 黄芪抗肾脏疾病作用的研究进展 [J]. 贵州医药 , 2014 , 38 ( 5 ): 464 - 465 .
陈光亮 , 武松 , 那莎 , 等 . 萆薢总皂苷对慢性高尿酸血症大鼠尿酸排泄指标的影响 [J]. 中国中西医结合杂志 , 2014 , 34 ( 1 ): 75 - 80 .
WU S , XU H , PENG J , et al . Potent anti-inflammatory effect of dioscin mediated by suppression of TNF- α -induced VCAM-1, ICAM-1 and EL expression via the NF- κ B pathway [J]. Biochimie , 2015 , doi: 10.1016/ j.biochi.2014.12.022 http://dx.doi.org/10.1016/j.biochi.2014.12.022 .
0
Views
16
下载量
1
CSCD
Publicity Resources
Related Articles
Related Author
Related Institution
京公网安备11010802024621