薏苡仁汤加减内外合治对急性痛风性关节炎湿热痹阻证炎症因子的影响

刘宜峰; 曹磊; 杨华; 郑杨杨

doi:10.13422/j.cnki.syfjx.20200132

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薏苡仁汤加减内外合治对急性痛风性关节炎湿热痹阻证炎症因子的影响

临床 | 更新时间：2021-02-09

- 薏苡仁汤加减内外合治对急性痛风性关节炎湿热痹阻证炎症因子的影响
- Effect of Addition and Subtraction Therapy of Yiyiren Tang with External Application Therapy on Inflammatory Factors of Patients with Acute Gouty Arthritis and Damp-heat Obstruction Syndrome
- 中国实验方剂学杂志 2020年26卷第9期页码：75-80
- 作者机构：
  
  海南省中医院，海口　 570203
- 作者简介：
  
  *刘宜峰，博士，副主任中医师，从事中医内科和全科医学临床、教学及科研研究工作，E-mail：gobebs@163.xom
- 基金信息：
  
  海南省卫生计生行业科研项目(16032021A2001)
- DOI：10.13422/j.cnki.syfjx.20200132
  中图分类号： R25; R256; R256.2; R289
- 纸质出版日期：2020-05-05，
  
  网络出版日期：2019-10-21，
  
  收稿日期：2019-09-03，
- 稿件说明：
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刘宜峰, 曹磊, 杨华, 等. 薏苡仁汤加减内外合治对急性痛风性关节炎湿热痹阻证炎症因子的影响[J]. 中国实验方剂学杂志, 2020,26(9):75-80.

Yi-feng LIU, Lei CAO, Hua YANG, et al. Effect of Addition and Subtraction Therapy of Yiyiren Tang with External Application Therapy on Inflammatory Factors of Patients with Acute Gouty Arthritis and Damp-heat Obstruction Syndrome[J]. Chinese Journal of Experimental Traditional Medical Formulae, 2020,26(9):75-80.
刘宜峰, 曹磊, 杨华, 等. 薏苡仁汤加减内外合治对急性痛风性关节炎湿热痹阻证炎症因子的影响[J]. 中国实验方剂学杂志, 2020,26(9):75-80. DOI： 10.13422/j.cnki.syfjx.20200132.

Yi-feng LIU, Lei CAO, Hua YANG, et al. Effect of Addition and Subtraction Therapy of Yiyiren Tang with External Application Therapy on Inflammatory Factors of Patients with Acute Gouty Arthritis and Damp-heat Obstruction Syndrome[J]. Chinese Journal of Experimental Traditional Medical Formulae, 2020,26(9):75-80. DOI： 10.13422/j.cnki.syfjx.20200132.

摘要

目的：

观察薏苡仁汤加减内服和外敷治疗急性痛风性关节炎(AGA)湿热痹阻证的临床疗效及对炎症因子的影响。

方法：

将153例AGA患者随机按数字表法分为对照组77例和观察组76例。对照组采用美洛昔康片，1片/次，1次/d，饭后服用；双氯芬酸钠凝胶，适量外涂患处，适当按摩，3次/d。观察组美洛昔康片使用同对照组，并给予薏苡仁汤加减内服、外敷。两组疗程均为治疗7 d。患者每日记录疼痛视觉模拟评分(VAS)，记录疼痛缓解时间和疼痛消失时间；进行治疗前后湿热痹阻证评分；检测治疗前后尿酸(UA)，C-反应蛋白(CRP)，红细胞沉降率(ESR)，白细胞介素-1

(IL-1

)，IL-6，IL-8，肿瘤坏死因子-

(TNF-

)，血清环氧合酶-2(COX-2)，前列腺素E

(PGE

)，血栓素B

(TXB

)和6-酮-前列腺素F

(6-keto-PGF

)水平；进行安全性评价。

结果：

观察组临床疗效优于对照组(

＝2.205，

0.05)；观察组疼痛缓解时间和疼痛消失时间均短于对照组(

0.01)；观察组在治疗后1，3，5，7 d的VAS评分均低于对照组(

0.01)；治疗后观察组关节疼痛、关节压痛、关节肿胀、活动障碍等主证评分、次证评分和湿热痹阻证总分均低于对照组(

0.01)；治疗后观察组ESR，CRP，UA，IL-1

，IL-6，IL-8，TNF-

，COX-2，PGE

和TXB

水平均低于对照组(

0.01)，6-keto-PGF

水平高于对照组(

0.01)。

结论：

在美洛昔康片治疗的基础上，采用薏苡仁汤加减内服、外敷治疗AGA湿热痹阻证患者可快速缓解和消除疼痛，减轻临床主要症状，抑制炎症反应，有着较好的临床疗效，且使用安全。

Abstract

Objective:

To observe the clinical effect of addition and subtraction therapy of Yiyiren Tang with external application therapy in the patients with acute gouty arthritis (AGA) and damp-heat obstruction syndrome

and to investigate its effect on inflammatory factors.

Method:

One hundred and fifty-three patients were randomly divided into control group (77 cases) and observation group (76 cases) by random number table. Patients in control group got meloxicam tablets after the meal

1 tablet/day

1 time/day

diclofenac sodium gel

3 times/days. On the basis of meloxicam tablets

patients in observation group additionally received addition and subtraction therapy of Yiyiren Tang by oral and topical applications. The course of treatment was 7 days in both groups. Scores of visual analogue score of pain (VAS) were graded everyday

and the relief time and disappearance time of pain were recorded. Before and after treatment

scores of damp-heat obstruction syndrome were recorded. Levels of uric acid (UA)

C-reactive protein (CRP)

erythrocyte sedimentation rate (ESR)

interleukin-1 beta (IL-1

)

interleukin-6 (IL-6)

interleukin-8 (IL-8)

tumor necrosis factor-alpha (TNF-

)

serum cyclooxygenase-2 (COX-2)

prostaglandin E

(PGE

)

thromboxane B

(TXB

) and 6-keto-prostatic factor F1alpha (6-keto-PGF

) were all detected

and the safety was evaluated.

Result:

The clinical efficacy in observation group was better than that in control group (

=2.205

0.05). The relief time and disappearance time of pain were shorter than those in control group (

0.01). At the 1

and 7

day after treatment

scores of VAS were lower than those in control group (

0.01). After treatment

the scores of main symptoms such as joint pain

tenderness

swelling and dyskinesia

scores of the secondary symptoms and the total scores of damp-heat obstruction syndrome were all lower than those in control group (

0.01). After treatment

levels of ESR

CRP

IL-1

IL-6

IL-8

TNF-

COX-2

PGE

and TXB

were all lower than those in control group (

0.01).

Conclusion:

Based on the treatment of meloxicam

addition and subtraction therapy of Yiyiren Tang by oral and topical administration methods can quickly relieve and eliminate pain

alleviate the main clinical symptoms and inhibit inflammation in patients with damp-heat obstruction syndrome

showing good clinical efficacy and safety.

关键词

急性痛风性关节炎湿热痹阻证薏苡仁汤内外合治炎症因子

Keywords

acute gouty arthritisdamp-heat obstruction syndromeYiyiren Tangoral and topical administrationinflammatory factors

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