加味四妙汤合金黄膏外敷治疗急性痛风性关节炎临床疗效观察

摘要

Objective To observe the clinical effect of modified Simiao decoction and external application of Jinhuanggao in treating acute gouty arthritis (AGA).Methods 82 patients with AGA were randomly divided into treatment group (42 patients) and control group (40 patients). Patients in the control group were treated with oral Loxoprofen sodium tablets ,and patients in the treatment group were treated with modified Simiao decoction and external application of Jinhuanggao. The total efficiency ,main symptom and sign score ,symptomatic relief time , and the level of ESR ,C‐reactive protein(CRP) ,uric acid (UA) were observed after two weeks. Result ① The to‐tal efficiency of the treatment group was significantly better than the control group (90.48% vs 77.50% ) (P<0.05);②After treatment ,the main symptom and sign scores ,such as arthralgia ,swelling and joint mobility ,de‐creased significantly in the two groups (P< 0.05). Compared with control group ,the main symptom and sign scores of treatment group decreased more obviously (P<0.05);③The effect initiating time had no differences be‐tween the two groups (P>0.05);④After treatment ,the level of ESR、CRP、UA in the two groups decreased sig‐nificantly (P<0.05) ,and the level of UA of treatment group were lower than that of control group (P<0.05).Conclusion Modified Simiao decoction and external application of Jinhuanggao could not only relief significantly the clinical symptom of patients with AGA and reduce the symptomatic relief time ,but also promote the excretion of UA and reduce inflammation reaction.%目的：观察加味四妙汤合金黄膏外敷治疗急性痛风性关节炎的临床疗效。方法将82例急性痛风性关节炎患者随机分为对照组40例和治疗组42例。对照组采用洛索洛芬钠片治疗，治疗组采用加味四妙汤合金黄膏外敷治疗，2组疗程均为2周，观察2组总有效率、治疗前后主要症状体征积分、显效时间及红细胞沉降率（ESR）、C‐反应蛋白（CRP）、血尿酸（UA）水平。结果①治疗组总有效率为90.48％，对照组总有效率为77.50％，2组比较差异有统计学意义（ P＜0.05）；②2组治疗后关节疼痛、红肿、活动受限等主要症状体征积分均较治疗前有改善（P＜0.05），治疗组积分优于对照组（P＜0.05）；③治疗组显效时间与对照组比较，差异无统计学意义（P＞0.05）；④2组治疗后 ESR、CRP、UA水平均较治疗前降低（P＜0.05），治疗组 UA 水平优于对照组（P＜0.05）。结论加味四妙汤合金黄膏外敷治疗急性痛风性关节炎，不仅能改善临床症状，缩短显效时间，还能促进 UA 排泄，减轻炎症反应。