| Objective1.The study observe the intervention of Qingre Chubi Decotion on the patients with acute gout. To investigate the therapeutic effect and safety of Qingre Chubi Decotion to provide clinical basis of treating acute gout by herbal medicine. It evaluates the changes of the patients with acute gout the symptoms and inflammation index as well as safety index.2.To provide a strong basis for clinical application and investigate the therapeutic effect as well as the mechanisms of anti inflammation, it observe the influences of the degree of joint swelling, functional activities, inflammation index and synovial pathology of acute gout rat model by Qingre Chubi Decotion.Methods1. Clinical observation:80 patients of acute gout were randomly divided into the treatment group and the control group. The treatment group were given Qingre Chubi Decotion and etoricoxib, while the control group were given the equivalent etoricoxib orally, the course of treatment was 5 days. Observe and record the patients the clinical detection index, the symptom of Chinese Medicine and sign before and after the treatment. Statistical analysis was carried out by using the correlation statistical method like the self control study and group control study between the two groups.2. Experimental research:63 SPF rat were randomly divided into blank group, model group, colchicum group, etoricoxib group, Qingre Chubi Decotion high dose group, Qingre Chubi Decotion middle dose group and Qingre Chubi Decotion low dose group. Each groups were given corresponding medicine for seven days. Except the blank group, each group of rats were injected of monosodium urate solution into right lateral posterior of rat ankle in the fifth day, while the blank group were injected of equivalent normal saline. Observe and record the praxiological change and the degree of joint swelling of acute gout rat. To measure the level of IL-1β、TNF-α in serum and synovial, and have the pathological analyzed of joint pathological.Results1.Clinical observation:(1)The VAS score, inflammation index were improved after treatment both in the treatment group and the control group, which the difference was statistically significant (P＜0.05).The effect in the treatment group was better than in the control group, which the difference was statistically significant (P＜0.05)(2) The total effective rate in the relief of the joint symptoms including the joint tenderness, the joint swelling degree, the joint range of motion, the joint skin color and the joint skin temperature was 96.21%in the treatment group,87.22% in the control group. The effect in the treatment group was better than in the control group, which the difference was statistically significant (P<0.05).(3)The total effective rate in the traditional Chinese medicine syndromes was 62.16%in the treatment group,37.12%in the control group. The effect in the treatment group was better than in the control group, which the difference was statistically significant (P＜0.05). The damp-heat symptoms of traditional Chinese medicine symptom score including fever, phlegm, dryness of the mouth and thirst, poor appetite, yellowish or reddish urine and stool constipate in treatment group were improved after treatment, which the difference was statistically significant (P＜0.05)(4)The total cholesterol and triglyceride were deceased, while high density lipoprotein cholesterol increased in the patients of treatment group, which the difference was statistically significant (P＜0.05).Low density lipoprotein cholesterol decreased slightly, which the difference have no statistically significant (P＞0.05)(5)There was no adverse reaction during the treatment period in the treatment group and the control group. The difference was not statistically significant of the patients before and after treatment with blood routine, urine routine, liver function, renal function, blood glucose and other indicators (P＞0.05)2. Experimental research:(1)In general, the Qingre Chubi Decotion high, middle dose group can significantly improve inflammatory condition, functional activities and the swelling joint of acute gout rats, which the difference was statistically signif icant(P＜0.05). It had the same therapeutic effect with the colchicum group and the etoricoxib group, which the difference have no statistically significant (P＞0.05)(2) Compared with the model group, the Qingre Chubi Decotion high, middle, low dose group had the IL-1 β TNF-α of serum and synovial reduced significantly in the acute gout rats, which the difference was statistically significant (P＜0.05).The Qingre Chubi Decotion high, middle dose group had the same therapeutic effect with the colchicum group and the etoricoxib group, which the difference have no statistically significant (P＞0.05)Conclusion1. The Qingre Chubi Decotion can effectively improve the acute gout symptoms, reduce the inflammation index. It also helps to reduce the total cholesterol and triglyceride, elevated high density lipoprotein cholesterol to improve the disorder of lipid metabolism. It improved the traditional Chinese medicine clinical symptoms, with good safety.2. The Qingre Chubi Decotion can improve the inflammatory condition, functional activities and the swelling joint, reduce the IL-1β、TNF-αof serum and synovial, improve synovitis situation. The mechanisms of anti inflammation may be related to the inhibition of IL-1β、TNF-α expression. The Qingre Chubi Decotion may as the inhibitor of IL-1 β、TNF-α be a new method for the assistant treatment of acute gout. |
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