[1]陈鹏,郭文韬,龙美兵,等.退癀消肿汤联合洛索洛芬钠片治疗急性痛风性关节炎的临床研究[J].中医正骨,2016,28(08):19-23.
　CHEN Peng,GUO Wentao,LONG Meibing,et al.Clinical study on Tuihuang Xiaozhong Tang(退癀消肿汤)combined with loxoprofen sodium tablets for treatment of acute gouty arthritis[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2016,28(08):19-23.
点击复制

退癀消肿汤联合洛索洛芬钠片治疗急性痛风性关节炎的临床研究()
分享到：

《中医正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第28卷
期数:
2016年08期
页码:
19-23
栏目:
临床研究
出版日期:
2016-08-20

文章信息/Info

Title:
Clinical study on Tuihuang Xiaozhong Tang(退癀消肿汤)combined with loxoprofen sodium tablets for treatment of acute gouty arthritis
作者:
陈鹏; 郭文韬; 龙美兵; 李楠
福建中医药大学,福建 福州 350122
Author(s):
CHEN Peng; GUO Wentao; LONG Meibing; LI Nan
Fujian University of Traditional Chinese Medicine,Fuzhou 350122,Fujian,China
关键词:
关节炎; 痛风性;  退癀消肿汤;  秋水仙碱;  洛索洛芬钠;  临床试验
Keywords:
arthritis; gouty;  Tuihuang Xiaozhong Tang;  colchicine;  loxoprofen sodium;  clinical trial
摘要:
目的:观察退癀消肿汤联合洛索洛芬钠片治疗急性痛风性关节炎的临床疗效和安全性。方法:将60例急性痛风性关节炎患者随机分为2组,每组30例,分别采用口服退癀消肿汤联合洛索洛芬钠片、口服秋水仙碱片联合洛索洛芬钠片治疗。退癀消肿汤每袋200 mL,每日早、晚餐后30 min服用1袋; 洛索洛芬钠片每次60 mg,每日2次,饭后服用; 秋水仙碱片每日服用3次,开始负荷剂量为1.0 mg,1 h后服用0.5 mg,12 h后服用0.5 mg; 上述药物连续服用2周。分别于治疗前和治疗结束后2周比较2组患者白细胞介素(interleukin-1,IL-1)、IL-6及肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)的血清含量,并于治疗结束后2周比较2组患者的临床疗效及并发症发生情况。结果:①炎性因子血清含量。治疗前2组患者IL-1、IL-6、TNF-α血清含量比较,组间差异均无统计学意义[(50.33±6.26)μg·g-1,(51.12±8.32)μg·g-1,t=-0.614,P=0.094;(43.27±7.14)μg·g-1,(41.35±8.27)μg·g-1,t=1.775,P=0.081;(55.23±9.71)pg·mL-1,(56.31±6.76)pg·mL-1,t=-0.587,P=0.075]。治疗结束后2周,退癀消肿汤联合洛索洛芬钠片组IL-1血清含量与秋水仙碱片联合洛索洛芬钠片组比较,差异无统计意义[(34.28±4.57)μg·g-1,(35.16±6.73)μg·g-1,t=-0.701,P=0.176]; 退癀消肿汤联合洛索洛芬钠片组IL-6、TNF-α血清含量均低于秋水仙碱片联合洛索洛芬钠片组[(24.25±3.36)μg·g-1,(30.21±3.13)μg·g-1,t=-11.619,P=0.000;(41.16±5.39)pg·mL-1,(47.57±2.31)pg·mL-1,t=-8.741,P=0.000]; 2组患者IL-1、IL-6、TNF-α血清含量均低于治疗前(t=56.716,P=0.000; t=28.734,P=0.000; t=25.524,P=0.000; t=12.062,P=0.000; t=23.538,P=0.000; t=18.330,P=0.000)。②临床疗效。治疗结束后2周,参照《中医病证诊断疗效标准》中痛风的疗效评定标准,退癀消肿汤联合洛索洛芬钠片组痊愈18例、显效6例、有效4例、无效2例,秋水仙碱片联合洛索洛芬钠片组痊愈10例、显效8例、有效6例、无效6例; 退癀消肿汤联合洛索洛芬钠片组的临床疗效优于秋水仙碱片联合洛索洛芬钠片组(Z=-2.176,P=0.030)。③安全性。退癀消肿汤联合洛索洛芬钠片组1例患者出现胃肠道反应; 秋水仙碱片联合洛索洛芬钠片组16例患者出现胃肠道反应,1例患者血常规异常,1例患者肝功能异常,1例患者肾功能异常。退癀消肿汤联合洛索洛芬钠片组不良反应发生率低于秋水仙碱片联合洛索洛芬钠片组(χ2=24.300,P=0.000)。结论:退癀消肿汤联合洛索洛芬钠片治疗急性痛风性关节炎,可以减轻关节炎症,缓解关节红肿和疼痛,不良反应轻微,其疗效和安全性优于秋水仙碱片联合洛索洛芬钠片,值得临床推广应用。
Abstract:
Objective:To observe the clinical curative effects and safety of Tuihuang Xiaozhong Tang(退癀消肿汤,THXZT)combined with loxoprofen sodium tablets for treatment of acute gouty arthritis.Methods:Sixty patients with acute gouty arthritis were enrolled in the study and were randomly divided into 2 groups,30 cases in each group.The patients were treated with oral application of THXZT and loxoprofen sodium tablets(group A)and oral application of colchicine tablets and loxoprofen sodium tablets(group B)respectively.The THXZT were taken at a dose of 200 mL at 30 minutes after breakfast and dinner respectively.The loxoprofen sodium tablets were taken at a dose of 60 mg after the meal,twice a day.The colchicine tablets were taken 3 times a day at a dose of 1.0 mg(initial loading dose),0.5 mg(1 hour later)and 0.5 mg(12 hours later)respectively.All of the drugs were taken for consecutive 2 weeks.The serum contents of interleukin-1(IL-1),IL-6 and tumor necrosis factor-α(TNF-α)were detected and compared between the 2 groups before treatment and at 2 weeksafter the end of the treatment respectively,and the clinical effects and complication rates were compared between the 2 groups at 2 weeks after the end of the treatment.Results:There was no statistical difference in the serum contents of IL-1,IL-6 and TNF-α between the 2 groups before treatment(50.33+/-6.26 vs 51.12+/-8.32 μg/g,t=-0.614,P=0.094; 43.27+/-7.14 vs 41.35+/-8.27 μg/g,t=1.775,P=0.081; 55.23+/-9.71 vs 56.31+/-6.76 pg/mL,t=-0.587,P=0.075).At 2 weeks after the end of the treatment,there was no statistical difference in the serum contents of IL-1 between group A and group B(34.28+/-4.57 vs 35.16+/-6.73 μg/g,t=-0.701,P=0.176)and the serum contents of IL-6 and TNF-α were lower in group A compared to group B(24.25+/-3.36 vs 30.21+/-3.13 μg/g,t=-11.619,P=0.000; 41.16+/-5.39 vs 47.57+/-2.31 pg/mL,t=-8.741,P=0.000).The serum contents of IL-1,IL-6 and TNF-α were lower in both of the 2 groups after treatment compared to pre-treatment(t=56.716,P=0.000; t=28.734,P=0.000; t=25.524,P=0.000; t=12.062,P=0.000; t=23.538,P=0.000; t=18.330,P=0.000).According to the therapeutic effects evaluation standard of gout which was extracted from Standard for diagnosis and therapeutic effectiveness evaluation of traditional Chinese medicine syndromes,18 patients were cured,6 good,4 fair and 2 poor in group A; while 10 patients were cured,8 good,6 fair and 6 poor in group B at 2 weeks after the end of the treatment.The group A surpassed the group B in the clinical curative effect(Z=-2.176,P=0.030).The gastrointestinal adverse reaction(1 case)was found in group A,while the gastrointestinal adverse reaction(16 cases),abnormal blood routine(1 case),hepatic dysfunction(1 case)and renal dysfunction(1 case)were found in group B.The incidence rate of adverse reactions was lower in group A compared to group B(χ2=24.300,P=0.000).Conclusion:Oral application of THXZT combined with loxoprofen sodium tablets can reduce joint inflammation and relieve joint swelling and pain with little adverse effects in treatment of acute gouty arthritis,and its curative effect is better than that of oral application of colchicine tablets combined with loxoprofen sodium tablets,so it is worthy of popularizing in clinic.

参考文献/References:

[1] Walters JL,Gangopadhyay P,Malay DS.Association of calcaneal and spinal fractures[J].J Foot Ankle Surg,2014,53(3):279-281. [2] Ding L,He Z,Xiao H,et al.Risk factors for postoperative wound complications of calcaneal fractures following plate fixation[J].Foot Ankle Int,2013,34(9):1238-1244. [3] Kumar S,Krishna LG,Singh D,et al.Evaluation of functional outcome and complications of locking calcaneum plate for fracture calcaneum[J].J Clin Orthop Trauma,2015,6(3):147-152. [4] 张世民,李海丰,黄轶刚.骨折分类与功能评定[M].北京:人民军医出版社,2008:210-212. [5] Kitaoka HB,Alexander IJ,Adelaar RS,et al.Clinical rating systems for the ankle-hindfoot,midfoot,hallux,and lesser toes[J].Foot Ankle Int,1994,15(7):349-353. [6] De Groot R,Frima AJ,Schepers T,et al.Complications following the extended lateral approach for calcaneal fractures do not influence mid-to long-term outcome[J].Injury,2013,44(11):1596-1600. [7] 温建强,李逸群,陈国涛,等.小切口结合手法整复克氏针内固定治疗Sanders Ⅳ型跟骨骨折[J].中华创伤骨科杂志,2014,16(3):271-273. [8] 钟宗雨,盛加根,殷文靖,等.临时应用外固定支架在内侧短缩型跟骨骨折切开复位内固定术中的价值[J].中华创伤骨科杂志,2014,16(3):268-270. [9] 谭新欢,聂伟志,朱育林,等.跟骨骨折微创治疗的研究进展[J].中医正骨,2015,27(5):73-76. [10] 吴勐,滕云升,郭永明,等.关节镜辅助下经跗骨窦切口内固定治疗跟骨关节内骨折[J].中国骨与关节损伤杂志,2015,30(10):1076-1078. [11] Labbe JL,Peres O,Leclair O,et al.Minimally invasive treatment of displaced intra-articular calcaneal fractures using the balloon kyphoplasty technique:preliminary study[J].Orthop Traumatol Surg Res,2013,99(7):829-836. [12] Mostafa MF,El-Adl G,Hassanin EY,et al.Surgical treatment of displaced intra-articular calcaneal fracture using a single small lateral approach[J].Strategies Trauma Limb Reconstr,2010,5(2):87-95. [13] Zeman J,Matějka J,Matějka T,et al.Open reduction and plate fixation(ORIF LCP)for treatment of bilateral calcaneal fractures[J].Acta Chir Orthop Traumatol Ceeh,2013,80(2):142-147. [14] Simon P,Goldzak M,Eschler A,et al.Reduction and internal fixation of displaced intra-articular calcaneal fractures with a locking nail:a prospective study of sixty nine cases[J].Int Orthop,2015,39(10):2061-2067. [15] 杨英果,王晓民,班兴平.内外侧联合弧形切口切开复位内固定治疗复杂跟骨骨折[J].中医正骨,2015,27(6):51-53. [16] 王小平,吴玮玮,黄俭,等.跟骨关节内移位骨折手术治疗螺钉并发症防范的探讨[J].实用医学杂志,2015,31(4):614-617.

相似文献/References:

[1]邓伟哲,王宏晶,王宇恒,等.微创针刀镜治疗难治性膝关节类风湿关节炎[J].中医正骨,2015,27(11):42.
[2]李艺彬,朱勇,吴昭克.关节镜下多入路全关节滑膜清理术治疗肘关节类风湿关节炎[J].中医正骨,2015,27(11):56.
[3]胡钢锋,肖鲁伟,童培建.关节液代谢组学在类风湿关节炎诊断 及寒热证候分型中的应用[J].中医正骨,2015,27(01):5.
　HU Gangfeng,XIAO Luwei,TONG Peijian.Application of joint fluid metabolomics to diagnosis and COLD-HEAT SYMPTOM COMPLEX typing in patients with rheumatoid arthritis[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2015,27(08):5.
[4]熊辉,曲良烨,向黎黎,等.痛风性关节炎湿热证病证结合模型的建立[J].中医正骨,2014,26(03):14.
　Xiong Hui*,Qu Liangye,Xiang Lili,et al.A rat model of gouty arthritis combined with dampness-heat syndrome[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2014,26(08):14.
[5]孙克民,王平,卢启贵,等.关节镜下滑膜切除术联合中药口服 治疗早期膝关节类风湿关节炎[J].中医正骨,2013,25(09):39.
[6]李峰,郭艳幸,曹向阳,等.贯叶连翘灌胃联合光动力疗法对类风湿关节炎白兔膝关节滑膜组织病理形态的影响[J].中医正骨,2014,26(09):6.
　Li Feng*,Guo Yanxing,Cao Xiangyang,et al.Effect of intragastric administration of hypericum perforatum combined with photodynamic therapy on the pathological morphology of synovial tissue of knee joints in rabbits with rheumatoid arthritis[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2014,26(08):6.
[7]严超,刘喜德,张金禄,等.蜂针疗法治疗膝骨性关节炎的护理[J].中医正骨,2013,25(01):74.
[8]王笑青,张永红,侯宏理,等.顽痹清丸联合非甾体抗炎药及改善病情的抗风湿药治疗湿热痹阻型类风湿关节炎[J].中医正骨,2013,25(03):41.
　WANG Xiao-qing*,ZHANG Yong-hong,HOU Hong-li,et al.Curative effect and safety of WANBIQING pills combined with nonsteroidal antiinflammatory drugs and disease modifying antirheumatic drugs in the treatment of rheumatoid arthritis of dampness-heat stagnation type[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2013,25(08):41.
[9]黄建武,黄建华,林爱丽.扶中清痹通络汤联合益赛普对活动期类风湿关节炎患者肿瘤坏死因子-α及血管内皮生长因子血清含量的影响[J].中医正骨,2013,25(05):9.
　HUANG Jian-wu*,HUANG Jian-hua,LIN Ai-li.*.Effect of FUZHONG QINGBI TONGLUO decoction combined with etanercept on the serum contents of tumor necrosis factor-alpha and vascular endothelial growth factor in patients with active rheumatoid arthritis[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2013,25(08):9.
[10]赫军,李丽华,王相奇,等.痛风四妙汤加味治疗痛风性关节炎[J].中医正骨,2013,25(05):56.
[11]齐新宇,向黎黎,熊辉,等.基于高蛋白饮食建立鸡痛风性关节炎模型的量效关系研究[J].中医正骨,2015,27(02):1.
　QI Xinyu,XIANG Lili,XIONG Hui,et al.A dose-effect relationship study of gouty arthritis chicken model built by high-protein diet[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2015,27(08):1.
[12]齐新宇,熊辉,周彪,等.蠲痹历节清方干预鸡急性痛风性关节炎模型的 实验研究[J].中医正骨,2015,27(03):5.
　QI Xinyu,XIONG Hui,ZHOU Biao,et al.Juanbilijieqing Fang(蠲痹历节清方)interfere with acute gouty arthritis chiken model[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2015,27(08):5.
[13]孙瑞,郭爱菊,杜梅红,等.能谱CT尿酸基(钙 图像在慢性痛风性关节炎诊断中的应用价值[J].中医正骨,2017,29(03):30.
[14]闵星星,王鹏鹏,刘佳欢,等.第1跖趾关节痛风性关节炎的手术治疗进展[J].中医正骨,2018,30(01):47.
[15]郭玉星,熊辉,周彪,等.Nod样受体家族含pyrin结构域蛋白3 和嘌呤能离子通道型受体7在急性痛风性 关节炎发病中的作用研究进展[J].中医正骨,2018,30(08):39.
[16]蒋恩宇,孙波.中药外敷法治疗急性痛风性关节炎的研究进展[J].中医正骨,2019,31(04):56.
[17]徐艳玲,杜献丽,杜敏,等.痛风性关节炎的延续护理[J].中医正骨,2020,32(05):74.
[18]陈兆军,梁欢,马玉峰,等.痛点超声电导透射清热利湿方药治疗急性痛风性关节炎湿热瘀结证[J].中医正骨,2021,33(12):48.
[19]邓志军,杨文龙,李典,等.杨凤云教授治疗旴江流域痛风性关节炎的经验[J].中医正骨,2023,35(05):64.
[20]顾富城,杨美鑫,林惠红,等.基于Toll样受体/髓系分化初级反应蛋白质88信号通路探讨四妙汤加土茯苓方治疗急性痛风性关节炎的作用机制[J].中医正骨,2024,36(08):9.
　GU Fucheng,YANG Meixin,LIN Huihong,et al.The mechanism of Simiaotang and Tufuling Fang(四妙汤加土茯苓方)for treatment of acute gouty arthritis:a Toll-like receptor/myeloid differentiation primary response protein 88 signaling pathway-based experimental study[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2024,36(08):9.

备注/Memo

备注/Memo:
基金项目:福建中医药大学校管科研课题项目(X2015003-平台) 通讯作者:李楠 E-mail:569116779@qq.com
更新日期/Last Update: 1900-01-01