摘要
目的:评价桂枝芍药知母汤(GSZD)联合西药治疗风寒湿痹型痛风性关节炎的临床疗效。方法:选取2018年1月1日—2020年12月31日在上海中医药大学附属上海市中西医结合医院收治的120例风寒湿痹证痛风性关节炎患者,采用随机数字表法随机分为治疗组和对照组,每组各60例。治疗组予秋水仙碱、非布司他联合GSZD治疗,对照组予秋水仙碱、非布司他联合GSZD安慰剂,均治疗6个月。于治疗前、治疗3个月及6个月后评价两组的临床疗效。检测并比较两组的血清尿酸(SUA)、C反应蛋白(CRP)、白细胞介素-6(IL-6)和红细胞沉降率(ESR)水平,并评价两组的中医证候评分。结果:治疗3个月及6个月后,两组的SUA水平较治疗前均显著降低(P<0.05),且治疗组在治疗3个月及6个月后的SUA水平均较同期对照组显著降低(P<0.01)。治疗3个月及6个月后,治疗组的临床总有效率高于对照组,中医证候评分、CRP、IL-6和ESR水平均低于对照组(P<0.05)。结论:GSZD联合西药治疗风寒湿痹型痛风性关节炎具有较好的临床疗效,可有效降低患者的SUA水平,改善中医证候,抑制炎症反应。
Objective To evaluate the clinical efficacy of Guizhi Shaoyao Zhimu decoction(GSZD)combined with conventional Western medicine in treating gouty arthritis of the wind-cold-dampness arthralgia syndrome type.Methods A total of 120 patients with gouty arthritis diagnosed as wind-cold-dampness arthralgia syndrome were enrolled and randomly assigned to the treatment group(n=60)and the control group(n=60).The treatment group received oral colchicine,febuxostat,plus GSZD.The control group received oral colchicine,febuxostat,plus a GSZD placebo.Treatment duration was 6-month for both groups.Clinical efficacy was assessed before treatment,at 3-month,and at 6-month(end of treatment).Serum uric acid(SUA),C-reactive protein(CRP),interleukin-6(IL-6),and erythrocyte sedimentation rate(ESR)levels were measured and compared between the two groups.Traditional Chinese Medicine(TCM)syndrome scores were also evaluated.Results At the 3-month and 6-month follow-ups post-treatment,SUA levels in both groups were significantly lower than baseline(P<0.05).Furthermore,SUA levels in the treatment group were significantly lower than those in the control group at both the 3-month and 6-month follow-ups(P<0.01).At the 3-month and 6-month follow-ups,the total clinical effective rate of treatment group was higher than control group,the TCM syndrome scores,the levels of CRP,IL-6,and ESR in the treatment group were significantly lower than those in the control group(P<0.05).Conclusion The combination of GSZD with conventional Western medicine demonstrates favorable clinical efficacy in treating gouty arthritis of the wind-cold-dampness arthralgia syndrome type.This regimen effectively reduces SUA levels,improves TCM syndrome manifestations,and suppresses inflammatory responses.
作者
张永康
曹烨民
梁志强
彭林峰
王御震
赵诚
赵志国
ZHANG Yong-kang;CAO Ye-min;LIANG Zhi-qiang(Department of Peripheral Vascular II,Shanghai TCM-Integrated Hospital,Shanghai University of Traditional Chinese Medicine,Shanghai 200082,China)
出处
《中国中西医结合外科杂志》
2026年第2期177-181,共5页
Chinese Journal of Surgery of Integrated Traditional and Western Medicine
基金
国家自然科学基金项目(82174382)
重大新药创制科技重大专项(2019ZX09201004-002-091)
上海市科学技术委员会科技创新行动计划(20Z21900200)
上海市虹口区“国医强优”三年行动计划项目(HKGYQYXM-2022-07)
上海市虹口区中医药科研课题(重大项目)(HKQGYQY-ZYY-2022-01)。
关键词
痛风性关节炎
桂枝芍药知母汤
风寒湿痹
尿酸
Gouty arthritis
Guizhi Shaoyao Zhimu decoction
wind-cold-dampness arthralgia
uric acid
