Objective To observe the effect of fresh aloe external application combined with intra-articular triamcinolone acetonide on the pain degree, blood uric acid (UA), erythrocyte sedimentation rate (ESR), and C-reac-tive protein (CRP) in the treatment of acute gouty arthritis (AGA). Methods A total of 100 patients with AGA, who admitted to Department of Orthopaedics, Xuzhou Center Hospital Affiliated to Nanjing University of Chinese Medi-cine from March 2012 to March 2016 (The treatment were prescribed by Department of Endocrinology and Metabo-lize), were selected and divided into the observation group (n=50) and the control group (n=50) according to the se-quence. The patients in the control group were given fresh aloe external application combined with oral drugs (colchi-cine+brufen), and the observation group were given intra-articular triamcinolone acetonide based on the treatment of the control group for 14 days. Visual Analogue Scale (VAS) was used to evaluate arthralgia, tenderness, joints swollen, and articular activity obstacle before and after treatment. Remission time of the pain in the process of treatment, UA, ESR, and CRP before and after treatment of the two groups were detected and compared. Results After the treat-ment, the clinical effect in observation group (32.43%) was superior to that in the control group (30.77%), but the dif-ference had no statistical significance (P>0.05). On the second, third, seventh, and tenth day after treatment, VAS scores of pain of the observation group were (5.12 ± 1.34), (4.08 ± 0.76), (2.32 ± 0.46), and (1.56 ± 0.32), respectively, which were significantly lower than corresponding (5.43±1.23), (4.23±1.11), (2.76±0.38), and (1.87±0.24) of the con-trol group (P<0.05). In addition, remission time in observation group was (3.23±0.78) d, which was significantly short-er than (4.43±1.02) d in the control group (P<0.05). The scores of arthralgia in the observation group were (0.76±0.11), (0.52 ± 0.08), (0.41 ± 0.09), and (0.56 ± 0.12), respectively, which were significantly lower than corresponding (0.92 ± 0.13), (0.78±0.11), (0.73±0.13), and (0.68±0.11) in the control group (P<0.05). Moreover, the levels of UA, ESR, and CRP in the observation group were (336.54±72.62)μmol/L, (18.43±3.45) mm/h, (9.32±2.12) mg/L, respectively, which were significantly lower than corresponding (375.27 ± 67.57) μmol/L, (24.54 ± 5.43) mm/h, (12.32 ± 2.21) mg/L in the control group (P<0.05). Conclusion On the basic of fresh aloe external application, the treatment of intra-articular tri-amcinolone acetonide can ease the degree of pain, shorten the span, and improve inflammatory reaction in the treat-ment of patients with AGA.%目的 观察新鲜芦荟外敷联合曲安奈德关节腔注射对急性痛风性关节炎(AGA)患者疼痛程度、血尿酸(UA),血沉(ESR),C-反应蛋白(CRP)的影响,并评价其临床疗效.方法 选取2012年3月至2016年3月于南京中医药大学附属徐州中心医院骨科(由内分泌与代谢病科制定内科治疗方案)确诊为AGA的患者100例,按照入选先后顺序将其分为对照组与观察组,每组50例.对照组给予新鲜芦荟外敷+口服药物(秋水仙碱+布洛芬)治疗,观察组在此基础上加用关节腔内注射曲安奈德治疗,连续治疗14 d.治疗前后采用视觉模拟评分(VAS)法进行自我疼痛评价,比较两组患者治疗前后关节恢复情况(疼痛、压痛、关节肿胀及关节活动障碍),治疗过程中的疼痛缓解时间以及治疗前后外周血的UA、ESR、CRP水平.结果 治疗结束后,观察组患者的治疗有效率为32.43%,略高于对照组的30.77%,但差异无统计学意义(P>0.05);治疗第2、3、7、10天,观察组的疼痛VAS评分分别为(5.12±1.34)分、(4.08±0.76)分、(2.32±0.46)分、(1.56±0.32)分,均明显低于对照组的(5.43±1.23)分、(4.23±1.11)分、(2.76±0.38)分、(1.87±0.24)分,且差异均有统计学意义(P<0.05);观察组患者的疼痛缓解时间为(3.23±0.78)d,短于对照组的(4.43±1.02)d,差异有统计学意义(P<0.05);治疗结束后观察组患者的关节疼痛、压痛、红肿、活动障碍评分分别为(0.76±0.11)分、(0.52±0.08)分、(0.41±0.09)分、(0.56±0.12)分,均低于对照组的(0.92±0.13)分、(0.78±0.11)分、(0.73±0.13)分、(0.68±0.11)分,且差异均有统计学意义(P<0.05).此外,治疗结束后观察组患者的UA、ESR、CRP分别为(336.54±72.62)μmol/L、(18.43±3.45)mm/h、(9.32±2.12)mg/L,均低于对照组的(375.27±67.57)μmol/L、(24.54±5.43)mm/h、(12.32±2.21)mg/L,且差异均有统计学意义(P<0.05).结论 在新鲜芦荟外敷的基础上给予关节腔内注射曲安奈德能很好地减轻急性痛风性关节炎的疼痛程度、缩短疼痛时间、减轻炎症反应.
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