佟颖　许雅萱　金汤　柯岷　张旭　向亚男　邵忠林　张伟平

【摘 要】目的：观察痹宁胶囊治疗湿浊瘀热型痛风性关节炎的临床疗效，以及对人尿酸盐转运体

（hURAT）基因表达水平的影响。方法：将40例痛风性关节炎患者随机分为治疗组和对照组，每组20例。

治疗组给予痹宁胶囊口服治疗，对照组给予秋水仙碱口服治疗。2组均以10 d为1个疗程。观察2组临床疗效，以及治疗前后血尿酸（SUA）、甘油三酯（TG）、白细胞计数（WBC）、关节疼痛积分、关节红肿积分、关节功能积分、hURAT基因表达水平。结果：治疗组临床控制4例，显效9例，有效6例，无效1例，总有效率为95.00%;对照组临床控制0例，显效7例，有效9例，无效4例，总有效率为80.00%。2组比较，差异有统计学意义（P < 0.05）。治疗后，2组SUA、TG、WBC、关节疼痛积分、关节红肿积分、关节功能积分、hURAT基因表达水平等较治疗前均有改善（P < 0.05）;且治疗组优于对照组（P < 0.05）。结论：痹宁胶囊能够减少尿酸生成，提高hURAT基因的表达，并可促进尿酸排泄，减少痛风的复发频率，减轻病情反复的症状，从而控制痛风性关节炎的发生和发展。

【关键词】 痛风性关节炎;痛风性肾病;湿浊瘀热型;痹宁胶囊;尿酸盐结晶;人尿酸盐转运体基因;临床疗效

Clinical Observation on 40 Cases of Gouty Arthritis of Dampness-turbidity-stasis-heat Type Treated by Bining Jiaonang（痹寧胶囊）

TONG Ying，XU Ya-xuan，JIN Tang，KE Min，ZHANG Xu，XIANG Ya-nan，SHAO Zhong-lin，ZHANG Wei-ping

【ABSTRACT】Objective：To observe the clinical efficacy of Bining Jiaonang（痹宁胶囊） in the treatment

of gouty arthritis of dampness-turbidity-stasis-heat type and its effect on the expression of hURAT gene.Methods：Forty patients with gouty arthritis were randomly divided into a treatment group and a control group，

20 cases in each group.The treatment group was treated with Bining Jiaonang，and the control group was treated with colchicine.Both groups were treated for 10 days as a course.The clinical efficacy，SUA，TG，WBC，joint pain，joint redness and swelling，joint function score，hURAT gene expression levels before and after treatment were observed.Results：In the treatment group，4 cases were controlled，9 cases were markedly effective，6 cases were effective and 1 case was ineffective，and the total effective rate was 95.00%;In the control group，there were no case of clinical control，7 cases were markedly effective，9 cases were effective and 4 cases were ineffective，and the total effective rate was 80.00%.The difference between the two groups was statistically significant（P < 0.05）.After treatment，SUA，TG，WBC，joint pain，joint redness and swelling，joint function score，hURAT gene expression levels of the two groups were improved compared with those before treatment（P < 0.05）;And the treatment group was better than the control group（P < 0.05）.

Conclusion：Bining Jiaonang can reduce the production of uric acid，increase the expression of hURAT gene，promote the excretion of uric acid，reduce the recurrence frequency of gout，alleviate repeated symptoms of the disease，so as to control the occurrence and development of joint disease.

【Keywords】 gouty arthritis;gouty nephropathy;dampness-turbidity-stasis-heat type;Bining Jiaonang

（痹宁胶囊）;urate crystal;hURAT gene;clinical efficacy

痛风性关节炎是患者血液中的尿酸水平较高，进而导致关节中出现尿酸盐结晶沉积现象，最终引发关节疾病。本病可造成机体免疫损伤，临床表现为单关节或多关节的红肿灼痛，疼痛剧烈难忍，犹如刀割[1]。本病起病急骤，平时可仅表现为单纯高尿酸血症状态，在發展过程中常伴有关节痛风石，缠绵不愈可导致痛风性肾病，早期可能会出现腰痛、血尿、蛋白尿，晚期表现为肾衰竭。对其他系统也具有一定损伤作用，例如心血管系统、内分泌系统[2]。本病发病原因主要为血尿酸生成增多（例如嘌呤代谢过程中关键酶合成障碍），和（或）血尿酸（SUA）排泄减少（例如肾小管上皮细胞尿酸转运蛋白功能减退）。……