栀黄止痛散外敷联合依托考昔治疗痛风性关节炎急性期30例临床观察(1)
【摘 要】目的：观察栀黄止痛散外敷联合依托考昔治疗痛风性关节炎急性期的临床疗效。方法：将60例痛风性关节炎急性期患者随机分为治疗组和对照组，每组30例。对照组口服依托考昔治疗，治疗组在对照组治疗基础上给予院内制剂栀黄止痛散外敷。2组均以2周为1个疗程。观察2组患者临床疗效，以及治疗前后疼痛视觉模拟评分法(VAS)评分、血尿酸(BUA)、红细胞沉降率(ESR)、C-反应蛋白(CRP)。结果：治疗组治愈21例，好转7例，无效2例，总有效率为93.33%;对照组治愈17例，好转4例，无效9例，总有效率为70.00%。2组比较，差异有统计学意义(P < 0.05)。治疗后，2组VAS评分、BUA、ESR、CRP较治疗前均有下降(P < 0.05)，且治疗组优于对照组(P < 0.05)。结论：栀黄止痛散外敷联合依托考昔对于控制痛风性关节炎急性期具有良好的疗效。
【关键词】 痛风性关节炎;急性期;栀黄止痛散;外敷;依托考昔;临床疗效
【ABSTRACT】Objective：To observe the clinical effect of Zhihuang Zhitong San(栀黄止痛散)on acuteattack of gouty arthritis.Methods：Sixty patients with acute attack of gouty arthritis were randomly divided into a treatment group and a control group，30 cases in each group.The control group was treated with etocoxib，and the treatment group was treated with Zhihuang Zhitong San based on the treatment for the control group.Both groups were treated for 2 weeks.The clinical effect，VAS，BUA，ESR and CRP of the two groups were observed before and after treatment.Results：In the treatment group，21 cases were recovered，7 cases were improved，2 cases were ineffective，and the total effective rate was 93.33%.In the control group，17 cases were recovered，4 cases were improved，9 cases were ineffective，and the total effective rate was 70.00%.The difference between the two groups was statistically significant(P < 0.05).After treatment，the VAS，BUA，ESR and CRP of the two groups were lower than those before treatment(P < 0.05)，and the treatment group was better than the control group(P < 0.05).Conclusion：Zhihuang Zhitong San combined with etocoxib has a good effect on the control of acute attack of gouty arthritis.
【Keywords】 gouty arthritis;acute stage;Zhihuang Zhitong San(栀黄止痛散);external application;etocoxib;clinical effeicacy
痛风性关节炎为嘌呤物质代谢紊乱引发的颗粒晶体沉积相关的关节疾病，红肿、皮温升高及剧烈疼痛是其主要表现[1-2]，病程进展，久不控制可损害关节并引发慢性间质性肾炎并成为尿酸性肾结石的主要“推手”[3]。笔者采用栀黄止痛散联合依托考昔治疗痛风性关节炎急性期患者30例，现总结报告如下。
1 临床资料
1.1 一般资料 选取2019年1月至2019年3月在河南省中医院风湿科就诊的痛风性关节炎急性期患者60例，随机分为治疗组和对照组，每组30例。
治疗组男23例，女7例;年龄24～56岁，平均(41.42±13.37)岁;病程0.25～1.40年，平均(0.48±0.05)年。對照组男26例，女4例;年龄27～62岁，平均(37.75±9.22)岁;病程0.42～2.10年，平均(0.60±0.10)年。2组患者在性别、年龄、病程等方面比较，差异无统计学意义(P > 0.05)，具有可比性。
1.2 诊断标准
1.2.1 西医诊断标准 按照1997年美国风湿病学会(ACR)制定的痛风诊断标准[4]。满足以下其一即可诊断：(1)关节腔穿刺存在尿酸盐晶体;(2)痛风石结节中检测到单钠尿酸盐或具备下列任意4项：①出现1次及以上的关节急性疼痛;②关节局部出现无菌炎症反应;③炎症反应达到高峰所需时间 < 24 h;④急性发作时局部皮肤红肿;⑤疼痛侧肢体包含跗骨或第一跖趾关节;⑥病变关节穿刺细菌培养非阳性。
1.2.2 中医证型标准 按照《中医病证诊断疗效标准》[5]，辨证属湿热蕴结型。主症：发病急骤，至少一个关节部位出现红肿热痛，痛处拒按，喜凉。次症：发热口渴、尿黄、舌红苔黄腻，脉滑数。, http://www.100md.com(张英杰 王上增 沈锦涛)
【关键词】 痛风性关节炎;急性期;栀黄止痛散;外敷;依托考昔;临床疗效
【ABSTRACT】Objective：To observe the clinical effect of Zhihuang Zhitong San(栀黄止痛散)on acuteattack of gouty arthritis.Methods：Sixty patients with acute attack of gouty arthritis were randomly divided into a treatment group and a control group，30 cases in each group.The control group was treated with etocoxib，and the treatment group was treated with Zhihuang Zhitong San based on the treatment for the control group.Both groups were treated for 2 weeks.The clinical effect，VAS，BUA，ESR and CRP of the two groups were observed before and after treatment.Results：In the treatment group，21 cases were recovered，7 cases were improved，2 cases were ineffective，and the total effective rate was 93.33%.In the control group，17 cases were recovered，4 cases were improved，9 cases were ineffective，and the total effective rate was 70.00%.The difference between the two groups was statistically significant(P < 0.05).After treatment，the VAS，BUA，ESR and CRP of the two groups were lower than those before treatment(P < 0.05)，and the treatment group was better than the control group(P < 0.05).Conclusion：Zhihuang Zhitong San combined with etocoxib has a good effect on the control of acute attack of gouty arthritis.
【Keywords】 gouty arthritis;acute stage;Zhihuang Zhitong San(栀黄止痛散);external application;etocoxib;clinical effeicacy
痛风性关节炎为嘌呤物质代谢紊乱引发的颗粒晶体沉积相关的关节疾病，红肿、皮温升高及剧烈疼痛是其主要表现[1-2]，病程进展，久不控制可损害关节并引发慢性间质性肾炎并成为尿酸性肾结石的主要“推手”[3]。笔者采用栀黄止痛散联合依托考昔治疗痛风性关节炎急性期患者30例，现总结报告如下。
1 临床资料
1.1 一般资料 选取2019年1月至2019年3月在河南省中医院风湿科就诊的痛风性关节炎急性期患者60例，随机分为治疗组和对照组，每组30例。
治疗组男23例，女7例;年龄24～56岁，平均(41.42±13.37)岁;病程0.25～1.40年，平均(0.48±0.05)年。對照组男26例，女4例;年龄27～62岁，平均(37.75±9.22)岁;病程0.42～2.10年，平均(0.60±0.10)年。2组患者在性别、年龄、病程等方面比较，差异无统计学意义(P > 0.05)，具有可比性。
1.2 诊断标准
1.2.1 西医诊断标准 按照1997年美国风湿病学会(ACR)制定的痛风诊断标准[4]。满足以下其一即可诊断：(1)关节腔穿刺存在尿酸盐晶体;(2)痛风石结节中检测到单钠尿酸盐或具备下列任意4项：①出现1次及以上的关节急性疼痛;②关节局部出现无菌炎症反应;③炎症反应达到高峰所需时间 < 24 h;④急性发作时局部皮肤红肿;⑤疼痛侧肢体包含跗骨或第一跖趾关节;⑥病变关节穿刺细菌培养非阳性。
1.2.2 中医证型标准 按照《中医病证诊断疗效标准》[5]，辨证属湿热蕴结型。主症：发病急骤，至少一个关节部位出现红肿热痛，痛处拒按，喜凉。次症：发热口渴、尿黄、舌红苔黄腻，脉滑数。, http://www.100md.com(张英杰 王上增 沈锦涛)
参见：首页 > 医疗版 > 疾病专题 > 骨科 > 慢性非化脓性关节炎或关节病 > 痛风性关节炎