桂苓甘露饮加减联合秋水仙碱治疗湿热蕴结型痛风性关节炎的临床观察

左瑞庭; 孟庆良; 马俊福; 谷慧敏

doi:10.13422/j.cnki.syfjx.20201629

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桂苓甘露饮加减联合秋水仙碱治疗湿热蕴结型痛风性关节炎的临床观察

临床 | 更新时间：2023-07-12

- 桂苓甘露饮加减联合秋水仙碱治疗湿热蕴结型痛风性关节炎的临床观察
- Efficacy of Modified Guiling Ganluyin Combined with Colchicine in Treatment of Gouty Arthritis with Damp-heat Accumulation
- 中国实验方剂学杂志 2020年26卷第16期页码：113-118
- 作者机构：
  
  河南省中医院，郑州 450002
- 作者简介：
  
  左瑞庭，硕士，主治医师，从事中医风湿骨病研究，E-mail：zuoruiting123@sohu.com
  谷慧敏，硕士，副主任医师，从事中医风湿骨病研究，Tel：0371-69915492，E-mail：guhuimin6666@163.com
- 基金信息：
  
  河南省中医药研究专项(2018ZY2041)
- DOI：10.13422/j.cnki.syfjx.20201629
  中图分类号： R22;R242;R2-031;R287
- 网络出版日期：2020-06-10，
  
  纸质出版日期：2020-08-20
- 稿件说明：
移动端阅览
左瑞庭,孟庆良,马俊福等.桂苓甘露饮加减联合秋水仙碱治疗湿热蕴结型痛风性关节炎的临床观察[J].中国实验方剂学杂志,2020,26(16):113-118.

ZUO Rui-ting,MENG Qing-liang,MA Jun-fu,et al.Efficacy of Modified Guiling Ganluyin Combined with Colchicine in Treatment of Gouty Arthritis with Damp-heat Accumulation[J].Chinese Journal of Experimental Traditional Medical Formulae,2020,26(16):113-118.
左瑞庭,孟庆良,马俊福等.桂苓甘露饮加减联合秋水仙碱治疗湿热蕴结型痛风性关节炎的临床观察[J].中国实验方剂学杂志,2020,26(16):113-118. DOI： 10.13422/j.cnki.syfjx.20201629.

ZUO Rui-ting,MENG Qing-liang,MA Jun-fu,et al.Efficacy of Modified Guiling Ganluyin Combined with Colchicine in Treatment of Gouty Arthritis with Damp-heat Accumulation[J].Chinese Journal of Experimental Traditional Medical Formulae,2020,26(16):113-118. DOI： 10.13422/j.cnki.syfjx.20201629.

摘要

目的

观察桂苓甘露饮加减联合秋水仙碱治疗湿热蕴结型痛风性关节炎（GA）的临床疗效，并探讨其机制。

方法

将210例GA患者随机分为中药组（70例），西药组（70例）和联合组（70例），分别口服桂苓甘露饮加减、秋水仙碱、桂苓甘露饮加减联合秋水仙碱，疗程均为30 d。观察治疗前后3组临床症状[关节疼痛视觉模拟评分（VAS）、自我感觉的总体评价（PGA）、疼痛数字评价量表（NRS）]，血清和关节液中炎性因子[肿瘤坏死因子-

（TNF-

），白细胞介素-1

（IL-1

），尿酸（UA）]，血液流变学指标[全血高切黏度（HCV），全血低切黏度（LCV），血液还原黏度（RV）]

；比较3组总有效率和不良反应发生率。

结果

研究期间脱落6例。联合组总有效率97.1%（67/69），高于中药组的80.8%（55/68）（

=8.153，

0.05）和西药组的79.1%（53/67）（

=8.735，

0.05）。与中药组和西药组治疗后比较，联合组临床症状VAS和NRS评分明显降低（

0.05），PGA评分明显升高（

0.05）；联合组血清和关节液中炎性因子指标TNF-

，IL-1

和UA 含量明显降低（

0.05）；联合组血液流变学指标HCV，LCV，RV明显降低（

0.05）。与联合组治疗期间不良反应发生率比较，西药组的不良反应升高（

=5.538，

0.05），中药组降低（

=6.273，

0.05）。

结论

桂苓甘露饮加减联合秋水仙碱具有增效减毒的作用，可明显改善湿热蕴结型GA患者的临床症状，不良反应发生率低。

Abstract

Objective

To explore the clinical efficacy of modified Guiling Ganluyin combined with colchicine in treatment of gouty arthritis(GA) damp-heat accumulation.

Method

A total of 210 cases of GA were randomly divided into traditional Chinese medicine(TCM) group(70 cases)

western medicine group (70 cases)

and integrated traditional Chinese and western medicine group(70 cases) according to the digital table method. The patients in TCM group were treated with modified Guiling Ganluyin

the patients in western medicine group were treated with colchicine

and the patients in integrated traditional Chinese and western medicine group received modified Guiling Ganluyin + colchicine

with a treatment course of 30 d in all groups. The clinical symptoms before and after the treatment [joint pain visual analogue scale(VAS)

patient global appraise(PGA)

number rating scale for pain(NRS)]

inflammatory cytokines in serum and joint fluid [tumor necrosis factor-alpha(TNF-

)

interleukin-1

β(

IL-1

)

uric acid(UA)]

hemorheology index [whole blood high cut viscosity(HCV)

whole blood low cut viscosity(LCV)

whole blood reductive viscosity(RV)]

in 3 groups were observed. The total effective rate and the adverse reactions were compared.

Result

Six cases fell off during the study period. The total effective rate in integrated traditional Chinese and western medicine group was 97.1%（67/69）

which higher than 80.8%(55/68) in TCM group (

=8.153

0.05) and 79.1%(53/67) in western medicine group (

=8.735

0.05）. Compared with TCM group and western medicine group

the clinical symptoms VAS and NRS scores in integrated traditional Chinese and western medicine group were significantly lower(

0.05)

while the PGA scores were significantly higher(

0.05). TNF-

IL-1

and UA in serum and articular fluid in integrated traditional Chinese and western medicine group were significantly decreased(

0.05). HCV

LCV and RV were significantly decreased in integrated traditional Chinese and western medicine group(

0.05). Compared with the traditional Chinese and western medicine group

the incidence of adverse reactions was higher in the western medicine group (

=5.538

0.05) and lower in the Chinese medicine group (

=6.273，

0.05).

Conclusion

Modified Guiling Ganluyin combined with colchicine has the effects in enhancing effect and reducing toxicity

and could improve the clinical symptoms of GA patients with damp-heat accumulation

with a low incidence of adverse reactions.

关键词

Keywords

references

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