| Objective: To discuss the cognition of Traditional Chinese Medicine on the pathogenesis of gout. According to the pathogenesis of acute stage of gout "accumulation of damp and heat", we established the predominate therapy of "purging turbidity and clearing heat" and selected the famous prescription of "Bi Xie Fen Qing Yin" and made it improved. We studied out the "Re Bi Xiao Ganule (RBXG)" on clinical observation. At the same time, we carried out experiments to investigate the effect of the RBXG on acute inflammation and serum uric acid level of mice. It provided reliable theoretical evidence, clinical evidence based proof and experimental data for preventing and treating gout.Methods:1. Theoretical methods: Adopting the methods of philology, logical ratiocination and analogy, etc.2. Experimental methods: Adopting the experimental methods according to the principles random, parallel and control, we observed 60 cases (30 cases for each experimental and control group), the period of treatment was 30 days. The members of experimental group were administered 2 doses of RBXG, 3 times per day , then 1 dose three times per day after the remittion of symptoms.The members of control group were administered 25 mg of Diclofenac 3 times per day,then 25mg 2 times per day after the remittion of symptoms. Before and after the treatment, efficacy, symptom score, onset time, the ease time, serum UA, ESR, CRP and the side effects were evaluated for each group.3. Experimental methods: With the observation of the inhibition of the swelling degree, to understand the effect on anti-inflammation between dose groups of RBXG With the observation of the pain threshold and the number of writhing of the mice through the method of hot plate and writhing, to understand the analgesic effect beteen dose groups of RBXG With the observation of swelling foot of rats induced by sodium urate, to understand RBXG's effect on serum uric acid.Results:1. Theoretical research results: According to the TCM, gout is a disease within the scope of arthromyodynia. According to the pathogenesis of acute stage of gout "accumulation of damp and heat", the therapy should be "purging turbidity and clearing heat". Clearing and dissipating turbidity and demp-heat accompanied by purging toxin and dissolving blood stasis.2. Clinical research results: 60 cases of patients with acute gouty arthritis were randomly divided into experimental group and control group, each 30 cases.Total effective rate and clinical cure rate were 96.7% and 30.0% in experimental group, which were better than 90.0% and 13.3% in control group respectively, but there was no significant difference between the two groups (P>0.05) ; in improving the total symptom scores, experimental group was beter than control group, and there was significant difference between them(P <0.05); experimental group had a faster onset time than control group, especially the rate within 3 days, the experimental group (76.7%) was better than that of control group (36.7%), and there was significant difference (P <0. 01); the time for pain disappearing of the experimental group was also markedly less than that of the control group, there was significantly different between the two groups (P <0.01); the ESR and CRP of the two groups both decreased compared with them before treatment, there was significant difference (P<0.01),but no significant difference between the two groups (P>0.05) ; RBXG could decrease the level of serum uric acid, comparied with control group, there was significant difference(P <0.05);as to side effects, the rate of experimental group (3.3%) was lower than that of control group (30.0%), there was significant difference between them(P <0. 01).3. The experimental research results: 9.2g/kg, 18.3g/kg and 36.6g/kg dose groups of RBXG could inhibit swelling induced by carrageenan, and 18.3g/kg, 36.6g/kg 73.2g/kg dose groups could reduce edema induced by xylene, compared with the saline group, P <0.05; RBXG 36.6g/kg and 73.2g/kg dose groups could extend the pain threshold of mice, 18.3g/kg, 36.6g/kg and 73.2g/kg dose groups could prolong response latency of writhing and reduce the number of writhing of mice, compared with the saline group, P <0.05; 18.3g/kg dose group of RBXG could reduce serum uric acid level 7h after the swelling foot of rats induced by sodium urate, compared with the saline group, P <0.05. The results showed that RBXG had effects of anti-inflammation, analgesic and degrading the level of serum uric acid.Conclusion: RBXG can improve the patients' clinical symptoms of acute gouty arthritis. It is safe and effective. Experimental researches confirm that RBXG had effects of anti-inflammation, analgesic, degrading the level of serum uric acid, etc. It showed that traditional Chinese herbs can treat gout in many taches and ways, which act on many aspects and targets.
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