Clinical Study Of Qushi Huoxue Prescription In Treating Chronic Gouty Arthritis Of Phlegm-dampness And Stasis Type

Objective:By observing the clinical efficacy of Qushi Huoxue Decoction in treating chronic gouty arthritis of phlegm-dampness and blood stasis type,and observing its effect on serum inflammatory factors(TNF-a,IL-6,IL-8),the mechanism of Chinese medicine in treating gouty arthritis was discussed.Methods:120 gout patients who met the inclusion criteria in outpatient and inpatient departments of rheumatology department of Guangxi University of Traditional Chinese Medicine were divided into treatment group and control group according to random number table method,60 cases in each group.The control group was given basic treatment of 40 mg QD of febuxostat tablet,1.0 g TID of sodium bicarbonate tablet and 0.5 mg BID of colchicine tablet,and the patients were asked to drink more water and eat low purine diet.The treatment group was given Qushi Huoxue Recipe on this basis.Four weeks is a course of treatment,three courses of treatment were observed.The clinical efficacy,main symptom scores,liver function,renal function,CRP,ESR,UA levels,serum inflammatory factors(TNF-a,IL-6,IL-8)and 24-hour uric acid were observed and compared between the two groups before and after treatment.Excel was used to establish the database,SPSS23.0 statistical software was used for statistical analysis,and corresponding statistical methods were adopted according to the characteristics of data.The data were expressed by mean~-x±s.The comparison before and after treatment in the group was compared with that before and after treatment in the group by one-way ANOVA.The non-parametric test was used when the variance was uneven,and the counting data were tested by_test.Ridit analysis was used to compare the differences in clinical efficacy.P<0.05 was statistically significant.Results:A total of 120 cases were enrolled in the study.Five cases dropped out during the treatment,and 115 cases were included in the statistical analysis.There were 58 cases in the treatment group and 57 cases in the control group.(1)After treatment,the symptoms of the treatment group and the control group were significantly improved compared with those before treatment(P<0.01).(2)The total effective rate was 94.82%in the treatment group and 87.72%in the control group.The curative effect of the treatment group was better than that of the control group(P<0.05).(3)After treatment,the symptoms scores of the treatment group and the control group were compared:the degree of joint swelling in the treatment group was significantly lighter than that in the control group(P<0.01);the symptoms of joint dysfunction in the treatment group were lighter than those in the control group(P<0.05);the skin color scores of the lesions in the treatment group were lower than those in the control group(P<0.05);and the scores of joint pain,fever and the number of involved joints in the treatment There was no statistical difference between the control group(P>0.05).(4)After treatment,CRP,ESR and UA in both groups were lower than before treatment,and the treatment group was lower than the control group(P<0.05).(5)After treatment,the serum inflammatory factors(TNF-a,IL-6,IL-8)in both groups were lower than before treatment(P<0.05),and the treatment group was lower than the control group(P<0.05).(6)Uric acid excretion in the treatment group increased 24 hours after treatment compared with the control group(P<0.05).(7)There was no significant difference in liver and kidney function between the two groups after treatment(P>0.05),and there was no significant difference between the two groups after treatment(P>0.05).(8)There was no significant difference in the incidence of adverse reactions between the treatment group and the control group(P>0.05).Conclusion(s):(1)Qushi Huoxue Decoction combined with febupropath in the treatment of gouty arthritis of phlegm-dampness and blood stasis type can reduce the level of serum inflammatory factors(TNF-a,IL-6,IL-8).(2)Qushi Huoxue Decoction combined with febupropath can effectively reduce the levels of CRP,ESR and CR in patients with gouty arthritis of phlegm-dampness and blood stasis type,and promote the excretion of uric acid.(3)Qushi Huoxue Decoction can effectively improve TCM syndromes and quality of life of patients with gouty arthritis of phlegm-dampness and blood stasis type.