| Objective: To observe the clinical efficacy and safety of Qingli Zhitong prescription combined with pricking blood therapy in the treatment of acute gouty arthritis,and provide scientific basis for clinical diagnosis and treatment of this disease.Methods: 66 patients with acute gouty arthritis who met the inclusion criteria were randomly divided into observation group and control group according to Doll’s table,with 33 cases in each group.The control group was given basic treatment,colchicine tablets and diclofenac sodium sustained-release capsule;Group B was given basic treatment,Qingli Zhitong prescription and pricking blood therapy.Seven days after treatment,the clinical efficacy of Qingli Zhitong prescription combined with pricking blood therapy in treating acute gouty arthritis was evaluated by evaluating the analgesic effect,scores of main TCM syndromes,blood uric acid,erythrocyte sedimentation rate and C-reactive protein.Results:1.Qingli Zhitong prescription combined with pricking blood therapy has a good effect on patients with damp-heat accumulation syndrome of acute gouty arthritis.After a course of treatment,the analgesic effect,scores of main TCM syndromes,blood uric acid,erythrocyte sedimentation rate and C-reactive protein of the two groups were significantly improved compared with those before treatment.The observation group was significantly better than the control group in reducing the level of blood uric acid(P < 0.05).After one day of treatment,the scores of main TCM syndromes were significantly different between the two groups,and the observation group was better than the control group(P < 0.05).2.Before treatment,the VAS scores of the two groups were compared,P > 0.05,and there was no significant difference.The VAS scores of the two groups at different time points before and after treatment were compared by repeated measurement analysis of variance.The results showed that the treatment time * group F=1.040,P = 0.414 > 0.05,so there was no interaction between the treatment time and the group.Analyzing the main effects of the treatment time and the group,the main effects of the group on VAS scores were not statistically significant,F=0.129,P=0.720,and the difference was not statistically significant.The effect of treatment time on VAS score was statistically significant(F=298.223,P < 0.001).By pairwise comparison,the results showed that there was no statistical difference in VAS scores before treatment,1 hour after treatment and 2hours after treatment(P > 0.05),but there were statistical differences in VAS scores before treatment and 3 hours,6 hours,12 hours,24 hours and 7days after treatment(P < 0.001).3.The main TCM syndrome scores of the two groups at different time points before and after treatment were compared by repeated measurement variance analysis,and the treatment time * group F=6.980,P = 0.005 <0.05,which indicated that there was interaction between the treatment time and the group,and the independent effects of the group and the treatment time were tested.Before treatment,the scores of main TCM syndromes in the two groups were compared,P > 0.05,and there was no significant difference.After one day of treatment,there was a statistically significant difference in TCM syndrome scores between the observation group and the control group(P < 0.05),and the observation group was better than the control group.After 7 days of treatment,there was no significant difference in TCM syndrome scores between the two groups(P > 0.05).In the control group,there was no significant difference between the scores of major TCM syndromes before and after 1 day of treatment(P > 0.05),but there was significant difference between the scores of major TCM syndromes before and after 7 days of treatment(P < 0.05).In the observation group,there was a statistically significant difference between the scores of major TCM syndromes before and after 1 day of treatment(P<0.05),and there was a statistically significant difference between the scores of major TCM syndromes before and after 7 days of treatment(P <0.001).It shows that both groups can improve the scores of major TCM syndromes,but there are differences between the two groups in improving the scores of major TCM syndromes,and the observation group has faster curative effect than the control group.4.There was no significant difference in blood uric acid between the two groups before treatment(P > 0.05),but there was significant difference between the two groups after treatment(P < 0.05).Before and after treatment,there was a significant difference in the observation group(P <0.05),while there was no significant difference in the control group(P >0.05),suggesting that the observation group can effectively reduce the level of uric acid compared with the control group.After treatment,the erythrocyte sedimentation rate and C-reactive protein of the two groups decreased significantly,and there was a statistical difference compared with that before treatment(P < 0.05),but there was no statistical difference between the two groups(P > 0.05).5.Mann-Whitney U test was used to compare the curative effect of TCM syndromes between the two groups before treatment and one day after treatment,Z=2.792,P=0.005,and the difference was statistically significant,which indicated that the observation group was superior to the control group in the rapid relief of main TCM syndromes.After 7 days of treatment,there was a statistically significant difference between the two treatment methods in the curative effects of TCM syndromes and diseases of acute gouty arthritis(P < 0.05),which indicated that both treatment methods had good curative effects.After 7 days of treatment,there was no significant difference between the two groups(P > 0.05),suggesting that there was no significant difference between the two treatment methods.6.No obvious side effects were found in both groups during the treatment,and no obvious abnormalities were found in each safety index.Conclusion: This study shows that Qingli Zhitong prescription combined with pricking blood therapy can improve VAS score,scores of main TCM syndromes,blood uric acid,erythrocyte sedimentation rate and C-reactive protein of patients with acute gouty arthritis,and the curative effect of reducing blood uric acid and rapidly relieving main TCM syndromes is better than that of oral colchicine tablets and diclofenac sodium sustainedrelease capsule.Qingli Zhitong prescription combined with pricking blood therapy is safe,effective,easy to operate and cheap,which can be further promoted and applied in clinic. |
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