【作者】 张高锋；

【导师】 邱英明；

【作者基本信息】 福建中医学院 ， 中医内科学， 2008， 硕士

【摘要】 目的:本研究旨在探讨历节汤治疗痛风的临床疗效、安全性及不良反应,通过设立对照组,进行治疗前后自身比较以及组间比较,探索更为有效安全的治疗方法。方法:将70例入选的急性痛风性关节炎发作期患者随机分成治疗组35例,对照组35例。治疗组急性痛风性关节炎发作期采用口服秋水仙碱和中药“历节汤”治疗,间歇期采用口服中药“历节汤”治疗;对照组急性痛风性关节炎发作期采用口服西药秋水仙碱和双氯芬酸钠缓释胶囊治疗,痛风发作间歇期采用别嘌醇。观察两组治疗前后临床症状改善、UA、ESR、ClIP、HOMA-IR、血脂的变化,并对上述结果进行统计学处理。结果:1、疗效评价:治疗组治疗总有效率为100.0%,对照组总有效率为96.77%,治疗组与对照组比较无显著性差异(P＞0.05)。2、观察指标的变化:(1)与治疗前相比,治疗后在降低UA、ESR、CRP方面两组治疗前后均有非常显著差异(P＜0.01)。(2)治疗组与对照组比较UA、HOMA-IR、TG方面差异显著(P＜0.05)。(3)在改善临床症状方面明治疗组显优于对照组(p＜0.01),二者有非常显著差异。3、不良反应:治疗组服用秋水仙碱后出现5例腹泻,4例呕吐,6例食欲不振,对照组服用秋水仙碱后出现7例腹泻,6例呕吐,5例食欲不振,服别嘌呤醇后2例出现皮疹。两组疗程结束后复查均未见血、尿、粪及肝肾功能异常。结论:治疗组能有效降低血尿酸、血沉及C反应蛋白水平,改善胰岛素抵抗指数,并能改善患者中医临床症状。在降血尿酸方面优于对照组,而在改善患者中医临床症状方面明显优于对照组,是治疗湿热夹瘀型痛风的有效方法。更多还原

【Abstract】 Objective:This study objective is to approach the clinic therapeutic effect,security and adverse effect of the Lijietang to gout,to search for a more secure and more effective treating method of Chinese Traditional Medicine,by setting up control group and comparing interclass transversally of the pretherapy and posttherapy.Methods:In this experiment,70 cases of patients with the acute gouty arthritis were selected in the research and they were divided into two groups randomly.35patients were selected as the treatment group(treated with"Lijietang" combined with Colchicine),The patients in control group(35 cases) were treated with routine therapy in Western medicine,including Colchicine、Diclofenac Sodium Enteric-Coated Sustained Release Capsules and Allopurinol Tablets.The clinical symptoms,UA,ESR,CRP,HOMA-IR, lipid(TC,TG,HDL,LDL) were measured and compared before and after treatment.Result:1、The evaluation of the curative effect:the treatment group is 100%,the control group is 96.77%,and the two groups have no statistical significant(P＞0.05)。2、The changs of guide line:1) Compared with pretherapy,the UA,ESR,CRP in the two groups in post-treatment are lower.The differences were highly significant (P＜0.01)。2) The differences of UA,HOMA-IR,TG between the treatment group and the control group were significant(P＜0.01)。3) The melioration of the marks of clinical symptoms in the treatment group is higher than control group,the differences were highly significant(P＜0.01).3、The adverse effects:In the two groups no abnormalities were found in the three routine examinations,hepatic function,renal function.In the acute gouty arthritis,5 patients had light diarrhea,4 patients had vomiting disease and 6 patients had poor appetite in the treatment goup;and in the control group,there is 7 patients had light diarrhea,6 patients had vomiting disease and 5 patients had poor appetite.In the gouty remission,2 patients had skin rash in the control group.Conclusions:The treatment group could reduce Serum uric acid,erythrocyte sedimentation rate(ESR) and C-reactive protein(CRP),improve insulin resistance index,and improve patients’ clinical symptoms.It’s a effective method to treat gout with moist heat and blood stasis syndrome.更多还原