| 1.Evaluation of the clinical efficacy of Mongolian medicine Xiaozhong Jiuwei San combined with Tongmai Quzhuo Decoction in the treatment of gouty arthritis Objective To observe the clinical efficacy and safety of Mongolian medicine Xiaozhong Jiuwei San combined with Tongmai Quzhuo Decoction in the treatment of gouty arthritis.Methods Choose the outpatients and inpatients from December 2019 to July 2020 in the Department of Traditional Chinese Medicine of the Mongolian Hospital of Traditional Chinese Medicine Affiliated to Inner Mongolia Medical University and the Department of Rheumatology and Immunology of the Mongolian Medicine Hospital of Hohhot City,and select the gouty arthritis that meets the inclusion criteria Ninety patients were taken as the research objects.The patients were randomly divided into treatment group,control group Ⅰand control group Ⅱ according to the time of visit.The treatment group was given Tongmai Quzhuo Decoction Granules orally combined with Mongolian medicine Xiaozhong Jiuwei San for external application;control group I was given Tongmai Quzhuotang granules orally;the control group II was given benzbromarone tablets orally combined with Voltaren latex for external application.Collect the TCM syndrome scores,laboratory indicators(WBC,ESR,CRP,BUA),joint function classification,VAS score,clinical total effective rate,clinical recurrence rate,safety indicators(ALT,AST,Cr,BUN),before and after treatment in three groups of patients,respectively and perform statistical analysis to evaluate its clinical efficacy and adverse reactions.Result Before and after treatment in the three groups,the scores of TCM syndromes,laboratory indicators(WBC,ESR,CRP,BUA),joint function classification,and VAS score were significantly improved,and the difference was statistically significant(P<0.05).There was no significant difference in WBC and joint function classification among the three groups after treatment(P>0.05);but the scores of TCM syndromes,ESR,CRP,BUA,and VAS were all statistically significant(P<0.05).Comparing the three groups in pairs,in terms of TCM syndrome score,the treatment group has the best effect,which is significantly better than the control group I and the control group II(P<0.05),and there is no statistical difference between the two control groups(P>0.05);In terms of ESR,BUA,and VAS scores,the treatment group has the same efficacy as the control group II(P>0.05),and both are better than the control group I,the difference is statistically significant(P<0.05);in terms of CRP,the control group II The effect is the best,which is significantly better than the treatment group and the control group Ⅰ(P<0.05),and the treatment group has a middle effect,which is statistically different from the control group Ⅰ(P<0.05).After treatment,in the treatment group,5 cases were clinically cured,19 cases were markedly effective,3 cases were effective,and 3 cases were ineffective.The total effective rate reached 90%,and the total marked rate reached 80%.In the control group I,2 cases were cured clinically,13 cases were markedly effective,and 8 cases were effective.Cases,7 cases were ineffective,the total effective rate was 76.6%,and the total effective rate was 50%;in the control group II,3 cases were clinically cured,13 cases were markedly effective,12 cases were effective,and 2 cases were ineffective.The total effective rate was 93.3%,and the total marked rate was 93.3%.Up to53.3%.The total clinical effective rate of the three groups of patients was compared,and the difference was not statistically significant(P>0.05),but the total clinical effective rate of the three groups of patients was compared,the difference was statistically significant(P<0.05),the three groups were compared in pairs,the treatment group was clinically The total significant efficiency is better than the control group I(P<0.0167),the treatment group has no statistical difference compared with the control group II(P>0.0167),and there is no statistical difference between the two control groups(P>0.0167).Compared with the total clinical recurrence rate of the three groups of patients,the difference was statistically significant(P<0.05).Comparing the three groups in pairs,the total clinical recurrence rate of the treatment group and the control group Ⅰ was equivalent(P>0.0167),and both were better than the control group Ⅱ,the difference is statistically significant(P<0.0167).During the experiment,there were no adverse reactions in the three groups of patients,and no abnormal changes in liver and kidney function(P>0.05).Conclusion Mongolian medicine Xiaozhong Jiuwei San combined with Tongmai Quzhuo Decoction in the treatment of gouty arthritis can effectively improve the clinical symptoms,signs and laboratory indicators of patients,and the safety of the drug is good,and there is no obvious clinical discomfort or adverse reactions.The total recurrence rate is low,and it is worthy of further promotion and use.2.Effect of Mongolian Medicine Xiaozhong Jiuwei Powder on Inflammatory Cytokines in Rat Model of Gouty ArthritisObjective To explore the effect of the Mongolian medicine Xiaozhong Jiuwei San on the inflammatory cytokines in the rat model of gouty arthritis,and provide experimental evidence for the clinic.Methods 60 male Wister rats were randomly divided into normal group,model group,Yunnan Baiyao spray group,Mongolian medicine Xiaozhong Jiuwei powder group,Voltaren emulsion group,12 rats in each group,using potassium oxazinate and sodium urate The animal model was prepared,and the model was screened and finally used in the experiment of10 rats in each group.After 14 days of medication,the morphological changes of the ankle cartilage and synovium of each group of rats were observed by HE staining method;the rats of each group were detected by biochemical method The content of uric acid(UA)in serum;enzyme-linked immunosorbent assay(ELISA)was used to detect tumor necrosis factor-α(TNF-α),prostaglandin E2(PGE2)and interleukin-1(IL-1)in rat serum),the expression levels of interleukin-6(IL-6)and interleukin-8(IL-8);immunohistochemical methods were used to detect the expression of PGE2 and IL-1 in the soft tissues of the ankle joint of rats.Results Compared with the normal group,the blood UA of the model group increased;the serum levels of TNF-α,PGE2,IL-1,IL-6 and IL-8 increased;the positive expression of PGE2 and IL-1 in the soft tissues of the ankle joint Increased,the difference was statistically significant(P<0.05).Compared with the model group,each treatment group can improve the pathological morphology of the rat’s ankle joint to varying degrees,reduce blood uric acid,reduce serum TNF-α,PGE2,IL-1,IL-6 and IL-8 levels,and inhibit The positive expression of PGE2 and IL-1 in the soft tissues of the ankle joint.Among them,the Mongolian medicine Xiaozhong Jiuweisan group has the best effect on lowering uric acid and lowering serum IL-1content.It can significantly inhibit the positive expression of IL-1 in the soft tissue of the ankle joint.There were statistical differences in each administration group(P<0.05).Conclusion The Mongolian medicine Xiaozhong Jiuwei Powder can reduce the blood UA value and related pathological indicators in rats,reduce the serum levels of TNF-α,PGE2,IL-1,IL-6 and IL-8,and inhibit PGE2 in the soft tissues of the ankle joint,IL-1 positive expression,thereby improving the condition of gouty arthritis. |
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