【摘要】：目的痛風(fēng)有著很久的歷史,被稱為“國王的疾病”和“不能行走的疾病”,是一系列的臨床條件下對血清尿酸過量的一個泛稱。痛風(fēng)性關(guān)節(jié)炎通常是痛風(fēng)的首發(fā)臨床表現(xiàn),一般表現(xiàn)為急性發(fā)作,有時候也可表現(xiàn)出或者發(fā)展成慢性關(guān)節(jié)炎。本研究旨在探討中西醫(yī)結(jié)合治療痛風(fēng)性關(guān)節(jié)炎的臨床療效,同時對其造成的不良反應(yīng)進(jìn)行分析,為中西醫(yī)結(jié)合治療痛風(fēng)性關(guān)節(jié)炎的有效性及安全性提供依據(jù)。方法選擇2012年06月~2015年06月新鄉(xiāng)市第一人民醫(yī)院風(fēng)濕免疫科160例資料齊全的痛風(fēng)性關(guān)節(jié)炎患者作為研究對象,根據(jù)隨機(jī)分組原則將160例患者分成中西醫(yī)結(jié)合治療組和西醫(yī)治療組,每組各80例。西醫(yī)治療組在痛風(fēng)性關(guān)節(jié)炎發(fā)作期給予西藥對癥治療,中西醫(yī)結(jié)合治療組在西醫(yī)治療組的基礎(chǔ)之上給予中藥外敷及中藥口服治療,2周后對兩組患者臨床療效、治療前后血液尿酸水平以及治療后不良反應(yīng)發(fā)生率之間進(jìn)行分析對比,同時采用SF-36生存質(zhì)量調(diào)查表對患者治療后1年的生存質(zhì)量進(jìn)行評價。結(jié)果中西醫(yī)結(jié)合治療組治療后痊愈患者53例,好轉(zhuǎn)患者24例,無效患者3例,痊愈率為66.25%(53/80),有效率為96.25%(77/80);西醫(yī)治療組治療后痊愈患者33例,好轉(zhuǎn)患者31例,無效患者16例,痊愈率為41.25%(33/80),有效率為80.00%(64/80);中西醫(yī)結(jié)合治療組在痊愈率和有效率方面均要優(yōu)于西醫(yī)治療組,兩組之間相比差異具有顯著性,P0.05。兩組患者血尿酸水平在治療前無顯著性差異,治療后中西醫(yī)結(jié)合治療組血尿酸水平要明顯低于西醫(yī)治療組,兩組之間相比差異具有顯著性,P0.05。中西醫(yī)結(jié)合治療組治療后發(fā)生胃腸道反應(yīng)3例,腎絞痛1例,急性關(guān)節(jié)炎發(fā)作1例,白細(xì)胞減少0例,肝功能異常0例,不良反應(yīng)發(fā)生率為6.25%(5/80);西醫(yī)治療組治療后發(fā)生胃腸道反應(yīng)6例,腎絞痛3例,急性關(guān)節(jié)炎發(fā)作2例,白細(xì)胞減少2例,肝功能異常1例,不良反應(yīng)發(fā)生率為17.50%(14/80);中西醫(yī)結(jié)合治療組在不良反應(yīng)發(fā)生率方面要優(yōu)于西醫(yī)治療組,兩組之間相比差異具有顯著性,P0.05。兩組患者治療前在心理健康總測表和生理健康總測表相比,差異無顯著性意義,具有統(tǒng)計學(xué)意義上的可比性;中西醫(yī)結(jié)合治療組患者治療后在生理功能、生理職能、軀體疼痛、總體健康以及社會功能方面均要優(yōu)于西醫(yī)治療組,兩組之間相比差異具有顯著性,P0.05;而在活力、情感職能和精神健康三個方面,兩組相比差異無顯著性,P0.05。結(jié)論1.中西醫(yī)結(jié)合治療痛風(fēng)性關(guān)節(jié)炎較西醫(yī)單獨治療的臨床效果更佳,降低患者血尿酸濃度更快;2.中西醫(yī)結(jié)合治療痛風(fēng)性關(guān)節(jié)炎較西醫(yī)單獨治療的不良反應(yīng)發(fā)生率更低,安全性更高;3.中西醫(yī)結(jié)合治療痛風(fēng)性關(guān)節(jié)炎對患者的生存質(zhì)量改善較為明顯,值得臨床上進(jìn)行推廣應(yīng)用。
[Abstract]:Objective gout has a long history, known as "King's disease" and "unable to walk disease", is a series of clinical conditions of serum uric acid excess is a generic term. Gout arthritis is usually the first clinical manifestation of gout, usually characterized by acute attacks and sometimes chronic arthritis. The purpose of this study is to explore the clinical efficacy of integrated traditional Chinese and western medicine in the treatment of gouty arthritis, and to analyze the adverse reactions caused by it, so as to provide evidence for the effectiveness and safety of integrated traditional Chinese and western medicine in the treatment of gouty arthritis. Methods from June 2012 to June 2015, 160 patients with gouty arthritis were selected from the Department of Rheumatology and Immunology, first people's Hospital of Xinxiang City. According to the principle of random grouping, 160 patients were divided into two groups: treatment group (80 cases) and western medicine treatment group (80 cases). The western medicine treatment group was given the symptomatic treatment of western medicine in the attack period of gouty arthritis. On the basis of the western medicine treatment group, the western medicine treatment group was treated with external application of traditional Chinese medicine and oral Chinese medicine. Two weeks later, the two groups of patients were treated clinically. The levels of serum uric acid and the incidence of adverse reactions were analyzed and compared before and after treatment. The quality of life (QOL) of the patients was evaluated by SF-36 quality of Life questionnaire (QOL) 1 year after treatment. Results in the treatment group, 53 cases were cured, 24 cases were improved and 3 cases were ineffective. The cure rate was 66.25% (53 / 80) and the effective rate was 96.25% (77 / 80). In the western medicine treatment group, 33 cases were cured, 31 cases were improved, and 16 cases were ineffective. The cure rate was 41.25% (33 / 80), and the effective rate was 80.00% (64 / 80). The cure rate and effective rate of the integrated Chinese and western medicine treatment group were better than those of the western medicine treatment group, and there was significant difference between the two groups (P 0.05). There was no significant difference in the serum uric acid level between the two groups before treatment. After treatment, the serum uric acid level in the integrated Chinese and western medicine treatment group was significantly lower than that in the western medicine treatment group, and there was a significant difference between the two groups (P 0.05). There were 3 cases of gastrointestinal reaction, 1 case of renal colic, 1 case of acute arthritis, 0 cases of leukopenia and 0 cases of abnormal liver function. The incidence of adverse reactions was 6.25% (5 / 80). In the western medicine treatment group, gastrointestinal reaction occurred in 6 cases, renal colic in 3 cases, acute arthritis in 2 cases, leukopenia in 2 cases, liver function abnormality in 1 case. The incidence of adverse reactions was 17.50% (14 / 80). The incidence of adverse reactions in the integrated Chinese and western medicine treatment group was better than that in the western medicine treatment group, and there was a significant difference between the two groups (P 0.05). There was no significant difference between the two groups in mental health and physiological health before treatment, and there was statistical comparability between the two groups. After treatment, the patients in the treatment group were better than the western medicine group in physiological function, body pain, general health and social function, and there was significant difference between the two groups (P0.05). In the three aspects of vitality, emotional function and mental health, there was no significant difference between the two groups (P 0.05). Conclusion 1. The clinical effect of combined traditional Chinese and western medicine on gouty arthritis is better than that of western medicine alone, and the decrease of serum uric acid concentration is faster than that of western medicine alone. 2. Treatment of gouty arthritis by combination of traditional Chinese and western medicine has a lower incidence of adverse reactions and higher safety than that of western medicine alone; 3. The treatment of gouty arthritis with combination of traditional Chinese and western medicine can improve the quality of life of patients obviously, and it is worth popularizing and applying in clinic.
【學(xué)位授予單位】：新鄉(xiāng)醫(yī)學(xué)院
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R589.7

【參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 尹崇波;;探討中藥治療痛風(fēng)的療效及不良反應(yīng)的32例臨床效果[J];世界最新醫(yī)學(xué)信息文摘;2015年66期

2 張佩琦;;用中藥治療痛風(fēng)的方法、療效及安全性綜述[J];當(dāng)代醫(yī)藥論叢;2014年20期

3 吳燕;;中藥外敷聯(lián)合西藥治療痛風(fēng)性關(guān)節(jié)炎Meta分析[J];西部中醫(yī)藥;2014年09期

4 蒙龍;李娟;龍銳;賈運濤;;小劑量與常規(guī)劑量秋水仙堿治療急性痛風(fēng)性關(guān)節(jié)炎的系統(tǒng)評價[J];中國臨床藥理學(xué)與治療學(xué);2014年06期

5 武東;趙金霞;孫琳;劉湘源;;痛風(fēng)炎癥機(jī)制的研究進(jìn)展[J];中華風(fēng)濕病學(xué)雜志;2014年02期

6 黨萬太;周京國;謝文光;蔡燕;青玉鳳;邱亞;趙明才;蔣紅;李玲琴;周暢;;原發(fā)性痛風(fēng)患者外周血單個核細(xì)胞核苷酸結(jié)合寡聚化結(jié)構(gòu)域樣受體3基因轉(zhuǎn)錄剪接體的研究[J];中華風(fēng)濕病學(xué)雜志;2014年02期

7 戴冽;;關(guān)于痛風(fēng)患者降尿酸藥物治療的幾點思考[J];中華風(fēng)濕病學(xué)雜志;2013年09期

8 吳華香;;2012年美國風(fēng)濕病學(xué)會痛風(fēng)治療指南解讀[J];現(xiàn)代實用醫(yī)學(xué);2013年08期

9 何秀珍;梁峭嶸;余壽益;楊焱;陳韻聰;;高頻超聲篩查高尿酸血癥患者關(guān)節(jié)病變的初步研究[J];中華風(fēng)濕病學(xué)雜志;2013年08期

10 佟穎;蘇冠霞;金湯;王博;楊福慶;孟潔;;原發(fā)性高尿酸血癥和痛風(fēng)相關(guān)基因的研究進(jìn)展[J];中國醫(yī)藥指南;2013年18期

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