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目的:探讨四妙散加味与秋水仙碱治疗湿热蕴结型痛风的临床疗效和安全性。方法:收集2015年内我院收治的湿热蕴结型痛风患者120例作为研究对象,采用随机数字表法将其分为A组、B组及C组,每组各包含患者40例。A患者采用四妙散加味治疗,B组患者采用秋水仙碱治疗,C组患者采用四妙散加味联合秋水仙碱治疗。对三组的治疗效果、症状得分、治疗前后炎性因子水平及其他生化指标、不良反应及复发情况进行检测与比较。结果:A组总有效率及总显效率分别为92.5%及57.5%,C组为95.0%及65.0%,均显著高于B组的77.5%及35.0%,差异有统计学意义(P<0.05)。三组治疗后症状得分均显著低于治疗前,实验室指标均较治疗前明显改善,差异显著(P<0.05)。其中,C组血沉(ESR)及血尿酸水平(UA)变化幅度最大,较其他两组比较有显著差异(P<0.05)。A组及C组不良反应发生率分别为5.0%及7.5%,显著低于B组的22.5%,差异有统计学意义(P<0.05)。C组SF-36评分明显低于A组及B组,差异有统计学意义(P<0.05)。结论:四妙散加味联合秋水仙碱治疗湿热蕴结型痛风对比任何一种单药治疗疗效更佳,显著改善患者的生活质量,安全性更高。
Objective: To investigate the clinical efficacy and safety of Si Miao San flavored with colchicine in the treatment of damp-heat accumulation gout. Methods: A total of 120 cases of gouty heat and dampness syndrome admitted to our hospital in 2015 were collected and divided into group A, group B and group C using random number table. Each group contained 40 patients. A patients with Si Miao San flavored treatment, patients in group B colchicine treatment, C group of patients with Simiao San flavors combined colchicine treatment. The three groups of treatment, symptom scores, levels of inflammatory cytokines before and after treatment and other biochemical indicators, adverse reactions and recurrence were detected and compared. Results: The total effective rate and total effective rate in group A were 92.5% and 57.5% respectively, and those in group C were 95.0% and 65.0%, which were significantly higher than those in group B (77.5% and 35.0%, P <0.05) ). The symptom scores of three groups after treatment were significantly lower than those before treatment, and the laboratory indexes were significantly improved compared with those before treatment (P <0.05). Among them, the ESR and UA in C group had the largest change, which was significantly different from the other two groups (P <0.05). The adverse reactions in group A and group C were 5.0% and 7.5%, respectively, which were significantly lower than those in group B (22.5%, P <0.05). The score of SF-36 in group C was significantly lower than that in group A and group B (P <0.05). Conclusion: Simiao San flavored combined with colchicine in the treatment of damp-heat accumulation gout is more effective than any single drug treatment and significantly improves the quality of life of patients with higher safety.