谢丽娟 叶惠萍 王应琼

【摘 要】 目的：观察中西医结合治疗湿热蕴结证性痛风性关节炎急性发作的临床效果。方法：将70例符合纳入标准的患者随机分为对照组和观察组各35例。对照组给予口服布洛芬缓释胶囊，观察组在对照组的基础上外敷伤科黄水治疗，比较两组治疗前后关节疼痛评分、肿胀程度评分、血尿酸、C-反应蛋白、血沉水平变化，并观察治疗过程中的不良反应。结果：观察组关节疼痛肿胀评分显著低于对照组（P<0.05），尿酸水平两组对比差异无统计学意义（P>0.05），观察组C-反应蛋白、血沉水平较对照组显著降低，观察组总有效率94.28%高于对照组的85.71%（P<0.05）。结论：中西医结合治疗湿热蕴结证急性痛风性关节炎对临床疼痛及肿胀效果改善明显，抗炎作用及总有效率比单纯使用西药有优势，尚未发现对尿酸代谢有调控作用，值得进一步推广。

【关键词】 中西医结合;伤科黄水;湿热蕴结证;痛风性关节炎

【中图分类号】R684.3   【文献标志码】 A    【文章编号】1007-8517（2020）12-0118-05

Abstract：Objective To study the clinical effect and the incidence of adverse reactions in the treatment of acute attack of gouty arthritis with damp heat accumulation syndrome.Methods 70 patients who met the inclusion criteria were randomly divided into observation group and control group， with 35 cases in each group.In the control group， ibuprofen sustained-release capsule was taken orally， and in the observation group， ibuprofen sustained-release capsule was taken orally， and the external application of yellow water of the Department of injury was treated with the combination of traditional Chinese and Western medicine.Results The score of joint pain and swelling in the treatment group was significantly lower than that in the control group. There was no significant difference in the level of uric acid between the two groups. The level of C-reactive protein and ESR in the treatment group was significantly lower than that in the control group.the total effective rate in the treatment group was 94.28% higher than that in the control group（85.71%）. Conclusion external application of Traumatology yellow water combined with oral medicine can significantly improve the clinical pain and swelling of acute gouty arthritis with damp heat accumulation syndrome. Its anti-inflammatory effect and total effective rate are superior to that of non steroidal anti-inflammatory drugs alone. It has not been found that it can regulate the metabolism of uric acid， which is worthy of further promotion.

Keywords：Integration of Traditional Chinese and Western Medicine;Traumatology Yellow Water;Syndrome of Damp Heat Accumulation;Gouty Arthritis

痛風性关节炎是因为体内尿酸水平升高，以部分关节红肿热痛急性发作为主要症状的常见病之一，若发作次数多、病程较长的患者甚至可发生痛风石沉积、痛风肾等并发症[1]。发病机制主要为人体嘌呤的摄入与排泄失常，尿酸盐沉积在关节和肾脏部位，病因与日常饮食、药物反应、肾脏排泄能力及人体代谢相关。随着改革开放后，饮食及生活方式的改变，痛风性关节炎的患病率不断提高，反复发作对人们的工作生活造成了诸多不便。痛风性关节炎急性发作西医治疗主要是服用非甾体类抗炎药、秋水仙碱、糖皮质激素为主药物[2]，该方法缓解患者痛苦较快，但长期服用容易出现消化道不良反应。有研究表明，中医药治疗在缓解痛风性关节炎急……