Objective:To observe the clinical efficacy of addition and subtraction treatment of Pingweisan combined with Guizhi Shaoyao Zhimu Tang for chronic gouty arthritis with spleen deficiency syndrome

and investigate its effect on levels of interleukin-1β (IL-1β)

IL-8

IL-17 and tumor necrosis factor-α (TNF-α). Method:One hundred and forty-eight patients were randomly divided into control group and observation group by random number table

74 cases in each group. Patients in control group got allopurinol tablets after meal

100 mg/time

3 times/day. After the blood uric acid was normal

100-200 mg for maintaining. And in acute episode

nimesulide sustained release tablets were given

0.2 g/time

1 time/day. Patients in observation group got addition and subtraction treatment of Pingweisan combined with Guizhi Shaoyao Zhimu Tang

1 dose/day. The treatment course was 6 months for both groups. Besides

6 months' follow-up and number of acute gout attacks were recorded. Before treatment and at the 2th

4th

6th month after treatment

levels of blood uric acid were detected. Uric acid compliance rate was calculated

and scores of the main symptoms

signs and spleen deficiency phlegm block were graded.In addition

levels of IL-1β

IL-8

IL-17

TNF-α and safety were evaluated. Result:The total effective rate was 91.55% in observation group

higher than 79.71% in control group (χ2=4.105

P<0.05). The number of attacks for acute gout was (1.78±0.89) in observation group

less than (3.67±1.35) in control group (P<0.01) during 48 weeks. Scores of bone destruction and joint stenosis in observation group were lower than those in control group (P<0.05). Level of blood uric acid was lower than that in control group at the 4th and 6th month after treatment (P<0.01). Compliance rate of blood uric acid was 85.92% in observation group

higher than 69.57% in control group (χ2=5.426

P<0.05). Scores of tenderness

flexion and discomfort and spleen deficiency phlegm block and levels of IL-1β

IL-8

IL-17 and TNF-α in observation group were all lower than those in control group (P<0.01)

and the adverse reactions were also less than those in control group. Conclusion:As compared with routine treatment of western medicine

addition and subtraction treatment of Pingweisan combined with Guizhi Shaoyao Zhimu Tang can reduce the number of gout attacks

reduce uric acid levels and improve blood uric acid compliance rate

and relieve clinical symptoms and inflammation in patients with chronic gouty arthritis and spleen deficiency syndrome. The clinical efficacy was better than western medicine treatment program.