Clinical Study On Sizhu Decoction In The Treatment Of Acute Gouty Arthritis(Damp Heat Accumulation Syndrom)

Objective: 1.To provide clinical evidence for the treatment of acute gouty arthritis(aga)with Sizhu decoction combined with western medicine.2.Preliminary evaluation of the effectiveness and safety of Sizhufang decoction combined with Western medicine in the treatment of aga.Methods: This research used a randomized,controlled study protocol.84 patients of Yunnan Provincial Chinese Medicine Hospital with damp heat accumulation syndrome from rheumatology outpatient AGA were randomly divided into treatment group(42 cases)and control group(42 cases).The two groups were given oral aceclofenac tablets;the treatment group were given Sizhu decoction on the basis of oral aceclofenac tablets.Both groups took 5 days as a course of treatment.The vital signs,visual analog(VAS)scores and TCM symptom scores of the patients were recorded when before treatment,on the third day and after treatment.The curative effect indicators and safety indicators were recorded before and after treatment: Erythrocyte sedimentation rate(ESR),C-reactive protein(CRP),Blood uric acid(UA),routine blood,urine routine,stool routine,defecate occult blood,liver function(ALT,AST),renal function(BUN,Cr),electrocardiogram,statistical analysis of the data obtained.The improvement of symptoms and signs and clinical efficacy were evaluated by TCM syndrome and disease curative effect improvement rate,VAS score,changes in TCM symptom scores and laboratory efficacy index.The safety of Sizhu decoction combined with Western medicine in the treatment of AGA was preliminarily evaluated.Results: On the third day of treatment,the two groups were statistically different(P<0.05)in improving pain scores,comprehensive doctor scores,joint fever,joint pain,joint swelling,joint skin color,thirst,and short urine(P<0.05).The effect of the treatment group was better than the control group(P<0.05),but there was no significant difference between the two groups in the swelling score,the overall score of the patient,the doctor's swelling score,the joint flexion and extension,and the number of onset joints(P>0.05).After treatment,the two groups had statistically significant differences in the improvement of all of VAS scores,TCM symptoms and inflammation indicators(ESR,CRP)(P<0.05),and the treatment group was better than the control group(P<0.05).TCM syndrome curative effect,treatment group total effectiveness 92.68%,control group total effective rate was 75.00%;Disease curative effect,treatment group total effective rate 92.68%,control group total effective rate 77.50%.There were statistically significant differences in TCM syndrome efficacy and disease efficacy of total effective rate between the two groups(P<0.05),and the treatment group was superior to the control group.After treatment,the treatment group uric acid was significantly reduced(p <0.01),and the control group uric acid was not significantly reduce(p>0.05).During the treatment period,there were no abnormalities in urine analysis,stool routine,defecate occult blood,blood routine,liver and kidney function,and electrocardiogram.Conclusion: 1.Sizhu decoction combined with aceclofenac tablets can significantly improve TCM syndromes,disease curative effect and individual TCM symptoms,and can significantly reduce the inflammation index during acute gout attack,and has the effect of reducing uric acid.2.Sizhu decoction combined with aceclofenac tablets for the treatment of AGA is safety,no obvious side effects,and is worthy of popularization and application.