2020 年第 8 期 第 15 卷

加味白虎汤联合秋水仙碱治疗急性痛风性关节炎的效果及对患者炎性因子水平的影响

Effect of modified Baihu decoction combined with colchicine on acute gouty arthritis and the effect of inflammatory factors in patients

作者：林慧李志敏陆志夫

英文作者：Lin Hui Li Zhimin Lu Zhifu

单位：海口市中医医院推拿科570000 

英文单位：Department of Manipulation Haikou Traditional Chinese Medicine Hospital Haikou 570000 China

关键词：急性痛风性关节炎；白虎汤；秋水仙碱；炎症指标；安全性 

英文关键词：Acutegoutyarthritis;Baihudecoction;Colchicines;Inflammationindex;Safety

• 摘要：

• 目的 探讨白虎汤加味联合秋水仙碱在急性痛风性关节炎（湿热痹阻型）患者治疗中的应用效果及其对患者炎性因子水平的影响。方法 选取2017年6月至2019年3月就诊于海口市中医医院的急性痛风性关节炎（湿热痹阻型）患者96例，依随机数字表法分为对照组和观察组，各48例。对照组单用秋水仙碱治疗；观察组在对照组基础上联合加味白虎汤治疗。治疗前及治疗2周后检测患者血浆C反应蛋白（CRP）、红细胞沉降率（ESR）、尿酸、转化生长因子β（TGF-β）、γ-干扰素（IFN-γ）及肿瘤坏死因子α（TNF-α）水平，比较临床疗效。结果 治疗后2组关节烧灼感、疼痛、关节肿胀症状积分均明显降低，观察组上述症状积分明显低于对照组［（0.63±0.11）分比（1.18±0.16）分、（0.57±0.13）分比（1.27±0.26）分、（0.61±0.09）分比（1.09±0.21）分］，差异均有统计学意义（均P＜0.05）。治疗后2组CRP、ESR、血尿酸、TGF-β、IFN-γ、TNF-α水平均明显降低，观察组上述指标水平均明显低于对照组［（8.8±1.7）mg/L比（12.0±2.0）mg/L、（11±3）mm/1 h比（17±4）mm/1 h、（360±26）μmol/L比（429±37）μmol/L、（3.5±0.6）ng/L比（5.3±1.3）ng/L、（3.3±0.6）ng/L比（5.4±1.4）ng/L、（29±3）ng/L比（49±6）ng/L］，差异均有统计学意义（均P＜0.05）。观察组总有效率明显高于对照组［95.8%（46/48）比77.1%（37/48）］，差异有统计学意义（P=0.007）。2组不良反应发生率差异无统计学意义（P=0.432）。结论 加味白虎汤联合秋水仙碱治疗急性痛风性关节炎（湿热痹阻型）可有效减轻炎性反应，改善关节功能。

• Objective To investigate the effect of modified Baihu decoction combined with colchicine on acute gouty arthritis(damp-heat stagnation type) and the effect on inflammatory factors. Methods Ninety-six patients with acute gouty arthritis(damp-heat stagnation type) admitted to Haikou Traditional Chinese Medicine Hospital from June 2017 to March 2019 were randomly divided into control group and observation group, with 48 cases in each group. The control group was treated with colchicines and the observation group was treated with modified Baihu decoction combined with colchicines. Plasma levels of C-reactive protein（CRP）, erythrocyte sedimentation rate(ESR), uric acid, transforming growth factor-β（TGF-β）, γ-interferon（IFN-γ） and tumor necrosis factor-α（TNF-α） were detected before and two weeks after treatment. Clinical efficacy was analyzed. Results After treatment, scores of joint burning, pain, joint swelling significantly decreased and the scores in the observation were lower than those in the control group［（0.63±0.11） vs （1.18±0.16）, （0.57±0.13） vs （1.27±0.26）, （0.61±0.09） vs （1.09±0.21）］（all P＜0.05）. Plasma levels of CRP, ESR, uric acid, TGF-β, IFN-γ and TNF-α significantly decreased and the indexes were lower in the observation than those in the control group［（8.8±1.7）mg/L vs （12.0±2.0）mg/L, （11±3）mm/1 h vs （17±4）mm/1 h, （360±26）μmol/L vs （429±37）μmol/L, （3.5±0.6）ng/L vs （5.3±1.3）ng/L, （3.3±0.6）ng/L vs （5.4±1.4）ng/L, （29±3）ng/L vs （49±6）ng/L］（all P＜0.05）. Total effective rate in the observation group was significantly higher than that in the control group［95.8%（46/48） vs 77.1%（37/48）］（P=0.007）. Incidence of adverse reactions showed no statistical difference between groups(P=0.432). Conclusion Modified Baihu decoction combined with colchicines treating acute gouty arthritis(damp-heat stagnation type) can effectively reduce inflammation and improve joint function.