加味四妙散内服合金黄膏外敷对急性痛风性关节炎的疗效及镇痛作用

摘要

目的 观察加味四妙散内服合金黄膏外敷治疗急性痛风性关节炎(AGA)的临床效果.方法 将134例AGA患者按随机数字表法均分为两组.对照组给予常规西药治疗;观察组采取加味四妙散内服合金黄膏外敷治疗.记录比较两组治疗前后关节活动功能、压痛、肿胀及疼痛评分,疗程结束后临床疗效,治疗前后C反应蛋白(CRP)、红细胞沉降率(ESR)、白细胞介素-8(IL-8)、血尿酸(BUA)水平以及治疗期间不良反应.结果 两组治疗后关节活动功能、压痛、肿胀及疼痛评分与治疗前比较,均显著降低(P＜0.01),且观察组症状改善程度较对照组相比,均更为显著(P＜0.01);观察组总有效率为94.03％,高于对照组的82.09％ (P＜ 0.05);与治疗前比较,治疗后两组CRP、ESR、IL-8及BUA水平均显著改善(P＜0.01),且观察组改善幅度均更为显著(P＜0.01);观察组不良反应率为2.99％,明显低于对照组的13.43％(P＜ 0.05).结论 AGA应用加味四妙散内服合金黄膏外敷治疗更能有效解除患者症状,镇痛效果更佳,疗效切实,安全可靠,具有较高临床参考价值.%Objective:To investigate the clinical effect of Jiawei Simiao San for oral administration together with external application of Jinhuang cream on acute gouty arthritis (AGA).Methods:134 cases of AGA patients treated in our hospital from March 2014 to March 2016 were selected and divided into two groups with the method of random number table.The control group was given conventional western medicine;the observation group adopted the treatment of Jiawei Simiao San for oral administration together with external application of Jinhuang cream.Then articulatory activity function,tenderness,swelling and pain score of the two groups before and after the treatment and the clinical efficacy after the treating courses and levels of C-reactive protein (CRP),erythrocyte sedimentation rate (ESR),interleukin 8 (IL-8) and blood uric acid (BUA) before and after the treatment and adverse reactions during the treatment of the two groups were recorded and compared.Results:After the treatment,joint activity function,tenderness,swelling and pain scores of the two groups all significantly reduced compared with those before the treatment (P ＜ 0.01),and compared with that of the control group,the improvement degree of the observation group was more significant (P＜ 0.01);the total effective rate of the observation group was 94.03％,compared with 82.09％ of the control group,which was significantly higher (P＜ 0.05);compared with those before the treatment,levels of CRP,ESR,IL-8 and BUA of the two groups after the treatment significantly improved (P ＜0.01),and the observation group improved more significantly (P＜ 0.01);the adverse reaction rate of the observation group was 2.99％,significantly lower than 13.43％ of the control group (P＜ 0.05).Conclusion:The application of Jiawei Simiao San for oral administration together with external application of Jinhuang cream on AGA can more effectively relieve the symptoms and has better analgesic effects with real effect,safety and reliability,which has a high clinical reference value.