杨鑫+范华雨+高文香+曹向阳+陈茜

【摘 要】目的：观察吲哚美辛肠溶片联合水调散外敷治疗急性痛风性关节炎的临床疗效。方法：将69例急性痛风性关节炎患者分为治疗组36例和对照组33例。对照组服用吲哚美辛肠溶片治疗，治疗组在对照组治疗的基础上联合水调散外敷。观察2组治疗前及治疗后3 h、24 h、72 h、5 d肿痛评分，并对不良反应进行评价。结果：用药5 d后，治疗组治愈7例，好转27例，未愈2例，总有效率94.44%；对照组治愈6例，好转24例，未愈3例，总有效率为90.91%。2组比较，差异无统计学意义

（χ2 = 0.324，P = 0.851 > 0.05）。用药3 h、24 h后，2組肿痛评分比较，差异有统计学意义（P < 0.05）；用药72 h、5 d后，2组肿痛评分差异无统计学意义（P > 0.05）。结论：口服吲哚美辛肠溶片联合水调散外敷可快速缓解痛风性关节炎急性发作期患者的肿痛症状。

【关键词】 痛风性关节炎；急性期；吲哚美辛；水调散

Clinical Observation on the Treatment of Acute Gouty Arthritis with Indomethacin Combined

with Shuitiao San （水调散）

YANG Xin，FAN Hua-yu，GAO Wen-xiang，CAO Xiang-yang，CHEN Xi

【ABSTRACT】Objective：To observe the clinical efficacy of Indometacin Enteric-coated Tablets combined with Shuitiao San（水调散）on acute gouty arthritis.Methods：Sixty-nine patients with acute gouty arthritis were divided into a treatment group（36 cases）and a control group（33 cases）.The control group was treated with Indometacin Enteric-coated Tablets，and the treatment group was treated with Shuitiao San by external application on the basis of the treatment for the control group.The swelling pain scores of two groups were observed before treatment and 3 h，24 h，72 h and 5 d after treatment，and the adverse reactions were evaluated.Results：After 5 d treatment，in the treatment group，7 cases were cured，27 cases were improved，2 cases were ineffective，and the total efficiency was 94.44%.While in the control group，6 cases were cured，24 cases were improved，3 cases were ineffective，and the total effective rate was 90.91%.The difference between the two groups was not statistically significant（χ2 = 0.324，P = 0.851 > 0.05）.After 3 h and 24 h treatment，the difference of the scores of swelling and pain in the two groups was statistically significant（P < 0.05）.After 72 h，5 d treatment，the difference of scores of swelling and pain between the two groups was not statistically significant（P > 0.05）.Conclusion：Oral administration of Indometacin Enteric-coated Tablets combined with Shuitiao San can relieve the swelling and pain of the patients with acute gouty arthritis at the acute stage.

【Keywords】gouty arthritis；acute phase；indomethacin；Shuitiao San（水调散）

痛风是一种单钠尿酸盐沉积所致的晶体相关性关节病，与嘌呤代谢紊乱和（或）尿酸排泄减少所致的高尿酸血症直接相关[1]。急性痛风性关节炎则是尿酸盐结晶沉积于关节处，以突然发作的单一或多关节“红、肿、热、痛”为主要表现的疾病，其中剧痛是患者就医的主要原因。笔者跟师学习期间，采用吲哚美辛肠溶片口服联合水调散外敷治疗急性痛风性关节炎69例，现总结报告如下。

1 临床资料

1.1 一般资料 选取2015年3月至2016年11月在河南省骨科医院门诊就诊的急性痛风性关节炎患者69例，根据患者就诊顺序标号，将患者分为治疗组36例和对照组33例。治疗组男35例，女1例；……