Clinical Observation Of Guijing Danggui Niantong Decoction Combined With Western Medicine In The Treatment Of Gouty Arthritis In Remission Stage

ObjectiveThrough the method of randomized control,we observed the clinical efficacy and safety of Guijing Danggui Niantong Decoction combined with western medicine in the treatment of dampness-heat accumulation and Spleen-Kidney Deficiency Syndrome in the remission stage of gout,so as to provide ideas and methods for clinical treatment of this disease.MethodThe 80 subjects in this study were all from the outpatients of rheumatology department and traditional Chinese Medicine Department of Wuhan First Hospital from March 2017 to August 2018.They met the diagnostic criteria of gouty arthritis in remission stage,and were differentiated into dampness-heat accumulation syndrome and Spleen-Kidney Deficiency syndrome.According to the random number table,80 cases were divided equally into observation group and control group,9 cases were removed after observation,35 cases were left in observation group and 36 cases in control group.The control group was given Febuxostat Tablets(Fengdingning)40mg once a day,with the duration of 12 weeks,and the observation group was given Febuxostat Tablets(usage is the same with observation group)plus traditional Chinese medicine(Guijing Danggui Niantong Decoction),one decoction a day,take it twice:one after breakfast and one after lunch,each time 200 ml and also last for 12 weeks.Quantitative statistics of TCM symptoms were performed before and after treatment.Changes of serum uric acid,erythrocyte sedimentation rate,C-reactive protein,urine routine and liver and kidney function were monitored.Frequency of acute gout attack and time of pain relief after acute gout attack were recorded during treatment.Statistical analysis of relevant experimental data was made.Result1.Comparison of clinical efficacy: After treatment,the total effective rate of the observation group was 85.71%,and that of the control group was 58.33%.The difference was statistically significant(P < 0.05).2.Comparing the scores of TCM symptoms: before and after treatment,the scores of TCM symptoms in the two groups decreased significantly,with significant difference(P < 0.01);after treatment,the scores of symptoms in the observation group decreased more than those in the control group,with significant difference(P < 0.01).3.Comparison of serum uric acid level: The level of serum uric acid in the two groups decreased significantly after 4,8 and 12 weeks of treatment compared with that before treatment,and the difference was statistically significant(P < 0.01);after treatment,there was no significant difference in serum uric acid level between the two groups at 4 and 8 weeks(P > 0.05).At the12 th week,the level of serum uric acid in the observation group was significantly lower than that in the control group,and the difference was statistically significant(P > 0.05).4.Inflammatory index comparison: The levels of erythrocyte sedimentation rate(ESR)and C-reactive protein(CRP)in both groups decreased significantly before and after treatment,with significant difference(P < 0.05);after treatment,there was no significant difference in the levels of ESR and CRP between the two groups(P > 0.05).5.Acute gout recurrence frequency comparison: during the treatment period,the total attack frequency of the observation group was 28.57%,while that of the control group was 38.89%.There was no significant difference(P > 0.05);after treatment for 4,8 and 12 weeks,with the passage of time,the attack frequency decrease,the difference was statistically significant(P < 0.05).6.Comparison of pain relief time after acute gout: During the treatment period,after relapse of acute gout,the pain relief time in the observation group was significantly shorter than that in the control group,the difference was statistically significant(P <0.05).7.Safety comparison: During the treatment period,the adverse events rate of the observation group was 8.57%,and that of the control group was 13.89%.There was no statistical difference(P >0.05).ConclusionUnder the guidance of the theory of disease attribution,the clinical effect of Guijing Danggui Niantong Decoction combined with Febuxostat Tablets in the treatment of gouty arthritis in remission stage is better than that of Febuxostat Tablets alone in reducing blood uric acid level,improving symptoms and the scores of TCM symptoms of patients,and in reducing pain time during relapse of acute gouty arthritis,it is also better than that of single use of Febuxostat Tablets.It shows that the curative effect of combination therapy of Chinese and Western medicine in the remission stage of gouty arthritis is better than that of Western medicine alone.