范海霞 刘健 黄传兵 谌曦 万磊 葛瑶 燕伟 张文娟

摘要 目的：探討黄芩清热除痹胶囊治疗急性痛风性关节炎的临床效果。方法：选取2018年1月至2021年6月安徽中医药大学第一附属医院收治的急性痛风性关节炎患者80例作为研究对象，按照随机数字表法分为对照组和观察组，每组40例。对照组使用西药治疗。观察组在对照组用药基础上给予黄芩清热除痹胶囊。比较2组的治疗效果、自感关节疼痛治疗起效时间、超敏C反应蛋白（hs-CRP）、尿酸（UA）、红细胞沉降率（ESR）、Toll样受体4（TLR4）阳性比例、中医症状评分、视觉模拟评分（VAS）及不良反应发生率。结果：观察组的治疗效果（97.50%）优于对照组（75.00%）;观察组的自感关节疼痛治疗起效时间短于对照组;2组在治疗后的hs-CRP、UA、ESR、TLR4、VAS、中医症状评分均降低，观察组均低于对照组;观察组的不良反应发生率（7.50%）低于对照组（25.00%）（均P<0.05）。结论：针对急性痛风性关节炎的就诊患者，在常规使用西药治疗的基础上给予黄芩清热除痹胶囊，有助于减轻疼痛程度，改善各项血液相关指标及疾病的相关中医症状评分，提升疗效，不良反应发生率较低。

关键词 黄芩清热除痹胶囊;痛风性关节炎;疼痛;嘌呤;并发症;中医;尿酸;碳酸氢钠

Clinical Effects of Huangqin Qingre Chubi Capsules Combined with Western Medicine in the Treatment of Acute Gouty Arthritis

FAN Haixia1，LIU Jian1，HUANG Chuanbing1，CHEN Xi1，WAN Lei1，GE Yao1，YAN Wei2，ZHANG Wenjuan3

（1 Department of Rheumatology，First Affiliated Hospital of Anhui University of Traditional Chinese Medicine，Hefei 230031，China; 2 Department of Traditional Chinese Medicine，Hefei Second People′s Hospital，Hefei 230031，China; 3 Graduate School of Anhui University of Traditional Chinese Medicine，Hefei 230038，China）

Abstract Objective：To explore the clinical effects of Huangqinqingre Jiebi Capsules in the treatment of acute gouty arthritis.Methods：From January 2018 to June 2021，a total of 80 patients with acute gouty arthritis who were treated in the Department of Rheumatology，the First Affiliated Hospital of Anhui University of Traditional Chinese Medicine were selected as the research objects.According to the method of random number table，they were divided into a control group and an observation group，with 40 cases in each group.The control group was treated with Western medicine.The observation group was given Huangqin Qingre Chubi Capsules on the basis of the control group.The treatment effects of the 2 groups，the onset time of self-induced joint pain treatment，blood indicators[high-sensitivity C-reactive protein（hs-CRP），uric acid（UA），erythrocyte sedimentation rate（ESR），Toll-like receptor 4（TLR4） Positive ratio]，TCM symptom score，visual analog score（VAS） and incidence of adverse reactions were compared.Results：The treatment effect of the observation group（97.50%） was better than that of the control group（75.00%）; the self-induced joint pain treatment of the observation group has a shorter onset time than the control group; the hs-CRP，UA，ESR，TLR4，VAS，and TCM symptom scores of the 2 groups all decreased，and the observation group was lower than the control group; the incidence of adverse reactions in the observation group（7.50%） was lower than that of the control group（25.00%）（all P<0.05）.Conclusion：For patients with acute gouty arthritis，Huangqin Qingre Chubi Capsules given on the basis of conventional Western medicine treatment can help to improve pain，relieve various blood-related indicators，improve disease-related TCM symptom scores，and improve Efficacy，low incidence of adverse reactions.

Keywords Huangqin Qingre Jiebi Capsules; Gouty arthritis; Pain; Purine; Complication; Chinese medicine; Uric acid; Sodium bicarbonate

中图分类号：R274.1文献标识码：Adoi：10.3969/j.issn.1673-7202.2021.17.015

急性痛风性关节炎是常见的人体关节炎性疾病，该疾病疼痛程度较高，给患者带来极大的负面影响[1-2]。病理学研究显示，急性痛风性关节炎主要是人体内嘌呤代谢紊乱致使单钠尿酸盐结晶后，沉积在关节部位以及附近组织之中，对神经末梢造成刺激后诱发疼痛而出现的炎症反应疾病[3-4]。有关资料显示，全球范围内痛风性关节炎的人群发病率稳定在0.08%左右，且男性相对高发，这可能与男性的社会属性以及活动范围有关[5]。痛风性关节炎的存在不仅使人体的关节功能下降，且炎症反应水平增高，若不及时给予治疗，随着病情进展，会逐步出现肾功能损伤、动脉粥样硬化、冠心病以及心脑血管意外等严重并发症，对患者的健康造成严重威胁[6-7]。……