李红旗　周子朋　郑福增　庄红英 任敏之

【摘 要】 目的：观察栀黄止痛散外敷联合依托考昔治疗急性痛风性关节炎的临床疗效。方法：选取急性痛风性关节炎患者80例，随机分为治疗组40例和对照组40例，治疗组采用栀黄止痛散外敷联合依托考昔口服，对照组仅采用依托考昔，7d为1个疗程。将两组治疗后3h、1d、3d和7d的VAS评分结果与治疗前对比，并于7d后采取血清复查血尿酸（UA）、红细胞沉降率（ESR）、C反应蛋白（CRP），并观察临床疗效，收集不良反应。结果：治疗组总有效率95.0%，对照组总有效率82.5%，两组之间比较差异有统计学意义（P<0.05）。治疗后：治疗组VAS评分、UA、ESR和CRP结果均优于对照组，治疗组临床症状缓解明显高于对照组，差异具有统计学意义（P<0.05）。結论：栀黄止痛散外敷联合依托考昔治疗急性痛风性关节炎疗效较好。

【关键词】 急性痛风性关节炎；栀黄止痛散；依托考昔

【中图分类号】R589.7 【文献标志码】 A 【文章编号】1007-8517（2018）12-0124-04

Abstract：Objective To investigate the clinical efficacy of Zhihuang Zhitong Powder combined with etoricoxib on acute gouty arthritis. Methods 80 patients with acute gouty arthritis in Department of Rheumatology of Henan Provincial Hospital of Traditional Chinese Medicine were randomly divided into treatment group （40 cases） and control group （40 cases），the treatment Group use Zhihuang Zhitong powder external application + oral etoricoxib， the control group only based on etoricoxib， the course of treatment for 7 days. The VAS scores at 3h， 1d， 3d， and 7d after treatment were compared with those before treatment.After 7 days， serum uric acid （UA）， erythrocyte sedimentation rate （ESR） and C-reactive protein （CRP） were re-examined. Clinical efficacy was observed and adverse reactions were collected. Results The total effective rate was 95.0% in the treatment group and 82.5% in the control group.There was a statistically significant difference between the two groups （P<0.05）.After treatment：VAS scores， UA， ESR， and CRP results were better in the treatment group than in the control group.The clinical symptom relief in the treatment group was significantly better than that in the control group， and the difference was statistically significant （P<0.05）.Conclusion The treatment of acute gouty arthritis with Zhihuang Zhitong powder combined with etoposide has a significant effect.

Keywords：Acute Gouty Arthritis；Zhihuang Zhitong Powder；Etoricoxib

随着人们的饮食水平的提高，海鲜类食品的食用量大幅增加，痛风的发病率逐渐上升。痛风是因单钠尿酸盐（MSU）集聚所致的晶体相关性关节病，主要与嘌呤代谢紊乱和（或）尿酸排泄减少所致的高尿酸血症直接相关，归属为代谢性风湿病范畴[1]。急性痛风大多起病急骤、疼痛剧烈、午夜痛甚、以第一跖趾关节等小关节为主，发作时往往给患者造成难以忍受的痛苦，故在急性期缓解病人疼痛至关重要，依托考昔是新一代的解热镇痛药，对环氧化酶-2具有较高的选择性，能解热抗炎、缓解关节红肿、剧痛等临床症状[2]。笔者采用栀黄止痛散外敷患处联合依托考昔口服治疗急性痛风性关节炎，临床疗效明确，现汇总如下。

1 资料与方法

1.1 一般资料 选取河南省中医院2017年1月至2017年9月门诊急性痛风患者80例，随机分为治疗组和对照组各40例。……