本文關(guān)鍵詞： 急性痛風(fēng)性關(guān)節(jié)炎 加減木防己湯 香連金黃散 臨床研究　出處：《成都中醫(yī)藥大學(xué)》2016年碩士論文　論文類型：學(xué)位論文

【摘要】：目的：本課題采用中藥制劑加減木防己湯內(nèi)服聯(lián)合香連金黃散外敷治療濕熱蘊(yùn)結(jié)證急性痛風(fēng)性關(guān)節(jié)炎的方法,旨在評價(jià)其近期臨床療效、安全性,從而彰顯中醫(yī)治療優(yōu)勢,力求為廣大急性痛風(fēng)性關(guān)節(jié)炎患者提供一種方便、安全、實(shí)用的中醫(yī)治療方法,并推進(jìn)其臨床的進(jìn)一步應(yīng)用。方法：擇符合受試條件的急性痛風(fēng)性關(guān)節(jié)炎濕熱蘊(yùn)結(jié)證的患者60例,采用隨機(jī)數(shù)字表法按1：1分為中醫(yī)治療組(治療組)30例和西醫(yī)治療組(對照組)30例,治療組應(yīng)用內(nèi)服加減木防己湯聯(lián)合外敷香連金黃散的中醫(yī)綜合治療方案治療,對照組給予口服雙氯芬酸鈉雙釋放腸溶膠囊和碳酸氫鈉片,兩組療程均為7天。記錄各組治療前、治療3天后、治療7天后各項(xiàng)中醫(yī)癥狀體征積分、中醫(yī)證候積分、鎮(zhèn)痛起效時(shí)間、血沉、C-反應(yīng)蛋白、血尿酸指標(biāo)的變化以及不良事件。采用SPSS21.0統(tǒng)計(jì)軟件對所得數(shù)據(jù)進(jìn)行統(tǒng)計(jì)分析,然后對各組的臨床治療效果進(jìn)行深入探討,評價(jià)其臨床療效及安全性。結(jié)果：兩組患者治療七天后的總有效率、臨床痊愈率、愈顯率相當(dāng)(P0.05)。兩組的治療方案均可改善患者中醫(yī)證候積分,且治療組的治療方案在改善患者中醫(yī)證候積分方面優(yōu)于對照組(P0.05)。兩組的治療方案均可改善關(guān)節(jié)疼痛、關(guān)節(jié)壓痛、關(guān)節(jié)腫脹、關(guān)節(jié)屈伸不利、關(guān)節(jié)發(fā)熱、關(guān)節(jié)表面皮色、發(fā)熱、頭身困重、口干、汗出、心煩、小便短黃、大便黏滯不爽、舌質(zhì)、舌苔等方面(P0.05)。治療組在改善關(guān)節(jié)疼痛、關(guān)節(jié)腫脹、頭身困重、口干、 汗出、心煩、大便黏滯不爽、舌質(zhì)、舌苔、脈象等方面優(yōu)于對照組(P0.05)。兩組的治療方案在改善關(guān)節(jié)壓痛、關(guān)節(jié)屈伸不利、關(guān)節(jié)發(fā)熱、關(guān)節(jié)表面皮色、發(fā)熱、小便短黃等方面療效相當(dāng)(P0.05)。治療組患者的關(guān)節(jié)腫脹、頭身困重、口干、汗出、大便黏滯不爽、舌質(zhì)、舌苔表現(xiàn)的消失率優(yōu)于對照組(P0.05),而關(guān)節(jié)疼痛、關(guān)節(jié)壓痛、關(guān)節(jié)屈伸不利、關(guān)節(jié)發(fā)熱、關(guān)節(jié)表面皮色、發(fā)熱、心煩、小便短黃、脈象表現(xiàn)的消失率兩組療效相當(dāng)(P0.05)。兩組患者鎮(zhèn)痛起效時(shí)間方面比較無明顯差異(P0.05)。兩組治療方案均可降低患者C-反應(yīng)蛋白、血尿酸、血沉水平(P0.05),兩組的治療方案在降低患者C-反應(yīng)蛋白、血尿酸、血沉水平方面無明顯差異(P0.05)。本治療方案具有較好的安全性。結(jié)論：中藥制劑加減木防己湯內(nèi)服聯(lián)合香連金黃散外敷可以有效地治療急性痛風(fēng)性關(guān)節(jié)炎濕熱蘊(yùn)結(jié)證患者,改善患者臨床癥狀體征,并能降低血沉、C-反應(yīng)蛋白、血尿酸的濃度,且安全性良好,值得臨床推廣及應(yīng)用。
[Abstract]:Objective: to evaluate the clinical efficacy and safety of traditional Chinese medicine preparation plus Xianmu Fangji decoction combined with external application of Xianglian Jinhuang Powder in the treatment of acute gouty arthritis with dampness and heat accumulation syndrome. In order to highlight the advantages of traditional Chinese medicine treatment, and strive to provide a convenient, safe and practical Chinese medicine treatment for the vast number of patients with acute gouty arthritis. Methods: 60 cases of acute gouty arthritis with damp-heat accumulation syndrome were selected. According to 1: 1, randomly divided into Chinese medicine treatment group (treatment group, 30 cases) and western medicine treatment group (control group, 30 cases). The treatment group was treated with internal administration of Xianmu Fangji decoction combined with external application of Xianglianjin Huangsan. The control group was given oral diclofenac sodium double release enteric capsule and sodium bicarbonate tablet. The course of treatment in both groups was 7 days. The scores of symptoms and signs of TCM, symptoms and signs of TCM, onset time of analgesia, erythrocyte sedimentation rate and C-reactive protein were recorded before treatment, 3 days after treatment and 7 days after treatment. The changes of serum uric acid index and adverse events were analyzed by SPSS21.0 software, and then the clinical effect of each group was discussed. Results: the total effective rate, clinical recovery rate and effective rate of the two groups were similar to that of P0.050.The two treatment schemes could improve the score of TCM syndromes of the patients. And the treatment group in the improvement of TCM syndrome score is better than the control group P0.05. both groups of treatment can improve joint pain, joint tenderness, joint swelling, joint flexion and extension unfavorable. Joint fever, joint surface color, fever, head and body weight, dry mouth, sweat, upset, short yellow urine, stool sticky discomfort, tongue, tongue coating and other aspects of P0.05. the treatment group in the improvement of joint pain. Joint swelling, head weight, dry mouth, sweating, upset, sticky stool, tongue, tongue coating, pulse and so on are better than the control group P0.050.The two groups of treatment in improving joint tenderness. Joint flexion and extension, joint fever, joint surface skin color, fever, short yellow urine and other aspects of the curative effect is quite P0.05. the treatment group patients with joint swelling, head and body weight, dry mouth, sweating, stool viscosity is not cool. The disappearance rate of tongue quality and tongue coating was better than that of control group (P 0.05), but joint pain, joint tenderness, joint flexion and extension disadvantage, joint fever, skin color of joint surface, fever, upset, short yellow urination. There was no significant difference in the onset time of analgesia between the two groups. Serum uric acid, ESR level, P0.05N, two groups of treatment in the reduction of patients with C-reactive protein, blood uric acid. There was no significant difference in ESR level (P0.05). Conclusion: internal administration of traditional Chinese medicine preparation plus Xianmu Fangji decoction combined with external application of Xianglian Jinhuang Powder can effectively treat acute gouty arthritis patients with damp-heat accumulation syndrome. To improve the clinical symptoms and signs of patients, and can reduce the concentration of erythrocyte sedimentation rate (ESR) C-reactive protein and serum uric acid, and the safety is good, it is worthy of clinical promotion and application.
【學(xué)位授予單位】：成都中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2016
【分類號】：R259

【參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 邢志博;王鳳梅;王翠平;慕強(qiáng);王啟堂;;粉防己有效成分的藥理活性研究進(jìn)展[J];中國實(shí)驗(yàn)方劑學(xué)雜志;2014年09期

2 張汝衛(wèi);;健脾祛濕清熱涼血方配合消瘀止痛藥膏治療急性痛風(fēng)性關(guān)節(jié)炎48例臨床觀察[J];中醫(yī)雜志;2013年24期

3 李紅艷;曹陽;陶小軍;揣家良;;薏苡仁水提取物的抗炎、鎮(zhèn)痛、鎮(zhèn)靜作用研究[J];亞太傳統(tǒng)醫(yī)藥;2013年12期

4 蔡川海;;中西醫(yī)結(jié)合治療急性痛風(fēng)性關(guān)節(jié)炎44例[J];福建中醫(yī)藥;2013年04期

5 張培全;劉盈萍;張超;;川牛膝提取物清除自由基作用的研究[J];中藥材;2013年03期

6 石白;殷海波;張錦花;;痛風(fēng)現(xiàn)代流行病學(xué)及其發(fā)病機(jī)制研究進(jìn)展[J];風(fēng)濕病與關(guān)節(jié)炎;2012年06期

7 周順文;;中藥外敷內(nèi)服治療痛風(fēng)性關(guān)節(jié)炎52例[J];國醫(yī)論壇;2012年06期

8 朱婉華;張愛紅;顧冬梅;蔣熙;徐蕾;周正球;陳普建;高忠恩;王小超;陳志偉;;痛風(fēng)性關(guān)節(jié)炎中醫(yī)證候分布規(guī)律探討[J];中醫(yī)雜志;2012年19期

9 陳樹清;蔡友錦;周厚明;陳澤雄;;傷科八味散外敷配合四妙湯內(nèi)服治療急性痛風(fēng)性關(guān)節(jié)炎臨床療效觀察[J];中藥材;2012年08期

10 殷海波;石白;張錦花;;基于痰濁致痹辨治痛風(fēng)[J];中國中醫(yī)藥信息雜志;2012年08期

相關(guān)碩士學(xué)位論文 前2條

1 李洋;痛風(fēng)中醫(yī)證候的辨證要素及分布規(guī)律研究[D];安徽中醫(yī)藥大學(xué);2015年

2 盛錦輝;香連金黃散外敷在急性痛風(fēng)性關(guān)節(jié)炎止痛中的臨床療效觀察[D];成都中醫(yī)藥大學(xué);2009年

，

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