| Objective:To observe the clinical efficacy and safety of agreement prescription of gout in the treatment of acute gouty arthritis of heat-dampness blocking type,and to provide an effective theoretical and practical basis for TCM clinical treatment of this disease.Methods:The outpatients and inpatients were selected in the Department of Endocrinology of Jiangsu Provincial Hospital of TCM from December 1,2016 to February 1,2018.The 90 patients who met the diagnosis criteria for acute gouty arthritis of heat-dampness blocking type,were randomized into treatment group and control group with 45 cases in each according to the order in which they were selected.Under the same premise of non-pharmaceutical basic treatment,the control group was given colchicine(0.5 mg per tablet),with the first dose of 1.0 mg,and 0.5 mg after 1 hour.After 12 hours if the patient has no nausea,vomiting,diarrhea and other adverse symptoms,the oral dose may be 0.5mg each time,2 times a day;if the patient developed the above-mentioned gastrointestinal adverse reactions after administration,the oral dose was changed to 0.25 mg each time,2 times a day for maintenance treatment.At the same time,febuxostat was taken orally,once a day,40 mg each time.The treatment group was given agreement prescription of gout for oral administration on the basis of the control group.Each dose was 200 mL,one dose per day,and two times orally a day.Both courses of treatment were 10 days.After one course of treatment,statistical analysis was performed before and after treatment to compare intragroup and intergroup differences.The indicators of clinical observations such as blood uric acid,ESR,C-reactive protein,VAS scores,the index of joint swelling and pain,TCM symptom scores,and comprehensive efficacy,etc.,as well as the safety indicators such as ALT,AST,Cr,BUN,etc.were evaluated before and after treatment,in order to objectively evaluate the clinical efficacy and safety of gout prescription.Results:1,In this study,97 patients were collected and 7 were lost.Among them,3 were lost in the control group,4 were lost in the treatment group,and ultimately 90 patients were included in the study.2,The indicators of clinical observations:① C-reactive protein,blood uric acid,ESR:In the two groups,the levels of C-reactive protein,blood uric acid and ESR after treatment were significantly lower than those before treatment,and the differences were statistically significant(P<0.05).In intergroup comparison after treatment,the control effect of C-reactive protein,blood uric acid,and ESR and other indicators of the treatment group was better than that of the control group(P<0.05).② VAS scores:In the two groups,VAS scores after treatment were significantly lower than those before treatment(P<0.05);in intergroup comparison after treatment,the decrease of joint VAS scores in the treatment group was greater than that in the control group(P<0.05).③ The index of joint swelling and pain:In intergroup comparison after treatment,the index of joint swelling and pain of the patients in the treatment group was better than that in the control group(P<0.05).④ TCM symptom scores:In the two groups,TCM symptom scores after treatment were significantly lower than those before treatment(P<0.05);in intergroup comparison after treatment,the improvement of TCM syndrome in the treatment group was better than that in the control group(P<0.05).⑤ Clinical efficacy:The treatment group had 45 cases,and the total effective rate was 95.56%.The control group had 45 cases,and the total effective rate was 77.78%.There was a statistically significant difference between the two groups(P<0.05).3,The safety indicators(ALT,AST,Cr,BUN):In the two groups,there was no significant difference in liver and kidney function indicators such as ALT,AST,Cr,BUN before and after the treatment(P>0.05);in intergroup comparison after treatment,there was also no significant difference in liver and kidney function between the two groups(P>0.05).During the treatment period,there were no obvious abnormalities in the routine of blood,urine,excrement,and the electrocardiogram,and the patients did not have the adverse reactions such as panic,nausea,dizziness,diarrhea and so on.Conclusion:agreement prescription of gout combined with low-dose conventional western medicine is more advantageous than simple western medicine in treating acute gouty arthritis of heat-dampness blocking type.The former not only has obvious advantages in improving the clinical symptoms of traditional Chinese medicine and joint-related symptoms in patients with this disease,it also has the significant advantages in reducing inflammatory reactions,decreasing the levels of blood uric acid,and improving clinical efficacy,and no adverse reactions have been increased.Therefore,the agreement prescription of gout has significant curative effect on the treatment of acute gout of heat-dampness blocking type,which not only can inhibit the acute inflammatory reaction of gout,but also can reduce the level of blood uric acid,with fewer adverse reactions,and is safe and reliable.It is worthy of further research and promotion. |
PDF Full Text Request