Clinical Observation Of Tongfengling Decoction Combined With Febuxostat In The Treatment Of Gouty Arthritis Of Foot And Ankle With Damp-Heat Accumulation

Objective:To observe the clinical effect of Tongfengling decoction combined with Febuxostat in the treatment of gouty arthritis of foot and ankle with damp-heat accumulation,in order to provide a new idea for clinical treatment of gouty arthritis of foot and ankle.Methods:84 outpatients with gouty arthritis of foot and ankle with damp-heat accumulation in the Department of Orthopaedics,Xiamen Hospital of Traditional Chinese Medicine from January1,2021 to December 31,2021 were randomly divided into the experimental group(n=42)and the control group(n=42).All patients were given general treatment and gout education,while the control group was treated with Febuxostat,and the experimental group was treated with Tongfengling decoction combined with Febuxostat.The total course of treatment in both groups was 6 weeks.After the treatment,compared the Maryland score,VAS score,serum uric acid level,musculoskeletal ultrasound image score and clinical effect between the two groups,and analyzed the safety and adverse reactions.Results:1.During the treatment,1 patient in both the experimental group and the control group fell off.Finally,the actual number of patients was 41 per group.2.There was no statistical difference in basic information(sex,age,invasion site,course)between the two groups(P>0.05).3.There was no statistical difference in the Maryland score between the two groups before treatment(P>0.05).After the treatment,Maryland score was improved in both groups.But there was no statistical difference in the improvement index between the two groups after treatment(P=0.183>0.05).So,it was indicating that there was no statistical difference in the improvement of foot function between the two groups.4.There was no statistical difference in VAS scores between the two groups before treatment(P>0.05).After the treatment,VAS score was improved in both groups,and the VAS score improvement index of the experimental group was better than that of the control group(P=0.049<0.05),which showed that the effect of improving pain in the experimental group was better than that in the control group.5.There was no statistical difference in the level of serum uric acid between the two groups before treatment(P>0.05).The level of serum uric acid decreased in both groups after treatment,and the effect of reducing uric acid in the experimental group was better than that in the control group(P=0.041<0.05),and there was statistical difference between the two groups at different time after treatment(P=0.000<0.05),which showed that the effect was the best in the sixth week after treatment,followed by the third week after treatment.6.There was no statistical difference in musculoskeletal ultrasound image score between the two groups before treatment(P>0.05).The musculoskeletal ultrasound image score decreased in both groups after treatment,and the improvement index of the experimental group was higher than that of the control group(P=0.033<0.05).Which indicating that the experimental group was better than the control group in changing the performance of musculoskeletal ultrasound image.7.Comparing the clinical effect of two groups with Mann-Whiteney,it showed that Z=2.078,P=0.038<0.05,there was statistical difference between the two groups.Which showed that the clinical effect of the experimental group was better than the control group.8.The incidence of adverse reactions between the two groups after treatment were performed with the chi-square test,the results showed thatX~2=4.496,P=0.034<0.05.There were statistical difference between the two groups.The results showed that the incidence of adverse reactions in the experimental group was lower than that in the control group.Conclusions:Both oral Tongfengling decoction combined with Febuxostat and oral Febuxostat alone in the treatment of patients with gouty arthritis of foot and ankle with damp-heat accumulation can reduce the level of serum uric acid,relieve pain,improve foot function and changing the performance of musculoskeletal ultrasound image.But oral Tongfengling decoction combined with Febuxostat was better than oral Febuxostat alone in reducing serum uric acid level,relieving pain and changing the performance of musculoskeletal ultrasound image,with higher clinical efficacy and lower incidence of adverse reactions.