Clinical Study On The Treatment Of Gout Of Damp Heat Accumulation Type With Simiao Modified Powder And Chronic Disease Management

OBJECTIVE:Combining the theory of traditional Chinese medicine,applying the traditional Chinese medicine prescription Simiaosan modified medication,combined with the emerging disease intervention model "chronic disease management" method in recent years,to treat damp-heat accumulation gouty arthritis,and to observe and evaluate the overall health status of patients,and further discover and explore the effective intervention means of integrated traditional Chinese and Western medicine in the treatment of gouty arthritis in the new period.METHODS:The 68 patients included in this clinical observation were all patients with acute gouty arthritis who were treated in the rheumatology department of the Affiliated Hospital of Shandong University of Traditional Chinese Medicine from March 2016 to September 2019,and after entering the intermittent and chronic phases Treat and follow up for half a year.They were randomly divided into experimental group(34 cases)and control group(34 cases).The control group was treated with diclofenac sodium in the acute phase and febuxostat uric acid lowering therapy after the acute phase;the experimental group was given the Chinese medicine Simiaosan Jiaweifang orally combined with chronic disease management intervention on the basis of the control group.Observation and comparison of changes in pain scores,quantitative signs of symptoms and signs,comprehensive efficacy,blood uric acid,erythrocyte sedimentation rate,C-reactive protein,low-density lipoprotein,and body mass index before and after treatment between the two groups of patients To evaluate the intervention effect of Chinese medicine decoction combined with chronic disease management on local inflammation,uric acid physical condition and aspects of gout patients.RESULTS:Before treatment,the two groups had no difference in age,gender,disease course,VAS score,UA,ESR,CRP,LDL,BMI,and gout patient self-management assessment scale scores,and were comparable.Before and after treatment,the VAS scores,quantitative signs of symptoms and signs,UA,ESR,CRP,LDL,BMI,Gout patients self-management assessment scale scores were statistically different between the two groups before and after treatment;from the 24th hour to the 168th hour The VAS score of the experimental group was lower than that of the control group,and there was a statistical difference;after 7 days of treatment,there was no significant difference in joint tenderness and joint color skin temperature between the two groups.The experimental group was better than the control in terms of joint swelling and joint function after treatment There were statistical differences between the two groups;the comparison between the two groups after 24 weeks of treatment in the two groups,the test group was superior to the control group in the scores of UA,LDL,BMI,gout patients self-management assessment scale,and in the CRP,ESR There is no difference between the two groups;the total effective rate of the test group is 93.75%,the total effective rate of the control group is 89.29%,and the comprehensive effect is better than the control group.Conclusion:Through clinical observation,it was found that the total effective rate of the treatment mode of the experimental group through the combination of Simiao Powder Modified Prescription and Western Medicine combined with chronic disease management was higher than that of the control group(Diclofenac Sodium Dual Release Enteric-coated Capsules,febuxostat western medicine treatment),the experimental group could better improve the symptoms and signs of patients,and was superior to the control group in uric acid,low density lipoprotein,body mass index prescription and disease self-evaluation,which confirmed the use of traditional Chinese medicine.Individualized treatment based on syndrome differentiation and demonstration under the guidance of theoretical systems such as "holistic concept" and "yin-yang balance" can make the overall state and local inflammation of gout patients return to normal more smoothly,and promote the patients’uric acid level to meet the standard.Chronic disease management is an effective way to treat gouty arthritis and can improve patients’quality of life and medical experience.Traditional Chinese medicine combined with chronic disease management is an effective exploration mode of traditional Chinese and Western medicine in the treatment of gouty arthritis,which can be popularized and applied in clinical work.