【作者】 朱畅；

【导师】 费兰波；

【作者基本信息】 湖北中医药大学 ， 针灸推拿学， 2011， 硕士

【摘要】 目的：通过对三组原发性急性痛风性关节炎患者的临床观察,比较针刺加刺血配合清热祛湿活血方、西药及针刺加刺血三组治疗方法的临床效果,并探索针刺加刺血配合清热祛湿活血方抗炎镇痛和降血尿酸的作用机理,以便在临床上得到推广应用。方法：将90例符合纳入标准的急性痛风性关节炎患者随机分成3组,针药组、西药组和针刺组治疗1疗程。其中针药组采用针刺加刺血和清热祛湿活血方煎服进行治疗,西药组口服吲哚美辛片(消炎痛)和别嘌呤醇(别嘌醇)进行治疗,针刺组治疗方法同针药组的针刺加刺血疗法。观察患者治疗前一般情况,关节肿痛总分数、血尿酸和血沉的变化,并对综合疗效进行比较,评价三组治疗手段的临床效果。结果：1针药组和西药组综合疗效高于针刺组。针药组总有效率为93.3%,西药组总有效率为96.7%,针刺组总有效率为83.3%。针药组和西药组之间比较无显著差异(P>0.05)。针药组和西药组分别和针刺组相比较,疗效均有显著性差异(P<0.05)。2三组患者治疗后局部症状均较前减轻,关节肿痛总分数均下降,差异有显著统计学意义(P<0.05)。针药组患者局部症状缓解较其它两组更明显,治疗效果更佳,差异有显著统计学意义(P<0.05)。西药组和针刺组临床疗效无显著差异(P>0.05)。3三组患者治疗后血尿酸均有明显的下降,差异有显著性统计学意义(P<0.05)。针药组与西药组比较,治疗后血尿酸含量无显著差异(P>0.05)。针药组和西药组降尿酸优于针刺组,治疗后分别与针刺组相比较,差异有高度显著统计学意义(P<0.01)。4三组患者治疗后血沉均有明显的下降,治疗后血沉差异有明显统计学意义(P<0.05)。三组治疗方法降血沉的效果一致,治疗后三组比较无显著差异(P>0.05)。结论：针药组对急性痛风性关节炎的治疗效果明显,不仅能迅速降低血尿酸,而且对关节局部症状有很好的缓解作用,能有效的减轻病人的疼痛,治疗效果佳,宜于临床推广。更多还原

【Abstract】 ObjectionIn the purpose of finding a more efficient and safe way of curing primary acute gouty arthritis to promote. Three groups of treatment of primary acute gouty arthritis will be carry out, such as acupuncture treatment combine with blood-lettirig and oral a prescription of the treatment of eliminating dampness cooling, taking indomethacin and allopurinol tablets and only acupuncture treament apply to pricking blood therapy. Finally we will compare with the therapeutic effect in this article.MethodWill 90 sufferer who match the standard of primary acute gouty arthritis are random divided into 3 sets, the needle medicine set, western medicine set and acupuncture set, to be cured by one treatment. Among them the needle medicine group (the group one) carrys acupuncture treatment combine with pricking blood therapy and a prescription of the treatment of eliminating dampness cooling to carry on a treatment, and the western medicine group(the group two) takes indomethacin and allopurinol tablets to progress a treatment, the acupuncture group (the group three) takes the same therapeutic strategy as the group one except having the prescription. After the treatments, we will observe the changes that the front general condition, the front and back total fraction of the joint swollen and painful, blood uric acid and erythrocyte sedimentation rate. At the same time, to compare the comprehensive curative effect progress, and evaluate three sets of the clinical effects in the treatment.ResultsIThe synthesis curative effect of the group one and two are higher than the group three. The group one’s total effective rate is 93.3%, the group two’s is 96.7%, and the group three’s is 83.3%. There no significant difference was found between the curing of the group one or two (P>0.05). Both the group one and the group two compare with the group three have a significant difference (P<0.05).2The partial symptom of three sets of sufferers after curing are all more previous to ease, total fraction of joint swollen and painful all descend, the discrepancy has already show a significant difference (P<0.05). The group one sufferer’s symptom alleviated more than the other two groups and the cure effect is better too. There have a significant difference (P<0.05).the group two and three have no significant difference (P>0.05).3The blood uric acid of sufferers after curing all have apparently droop, the discrepancy has a significant difference (P<0.05). After curing the group one and two have no significant difference (P>0.05). The group one and two are good at dropping blood uric acid than the group three, the difference is highly significant (P<0.01).4After curing the erythrocyte sedimentation rate of sufferers all have apparently droop, the erythrocyte sedimentation rate have significant difference (P<0.05). The effect of three sets of treatment methods of cutting erythrocyte sedimentation rate have no significant difference (P>0.05). ConclusionThe group one has obvious effect on the treatment of primary acute gouty arthritis. Particularly besides quickly decreasing blood uric acid, the group one is good at alleviating the joint partial symptom, specially can be useful to soothe the patient’s ache. We can say the group one has effect cure for the primary acute gouty arthritis.更多还原