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郭 强, 赵 欢, 朱玉霞等.辨证论治痛风性关节炎的临床研究.四川大学学报(医学版),2015,46(5):764-769
辨证论治痛风性关节炎的临床研究
Traditional Chinese Medicine Treatment of Gouty Arthritis Based on Syndrome Differentiation
  
中文关键词:  中医药治疗 辨证论治 辨病论治 痛风性关节炎
英文关键词:Traditional Chinese medicine treatment Syndrome differentiation treatment Disease differentiation treatment Gouty arthritis
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中文摘要:
      目的 观察辨证论治痛风性关节炎(GA)的临床疗效及安全性指标。方法 收集2013年8月至2014年8月成都中医药大学附属医院内分泌科门诊及住院部符合条件的患者,将81例GA患者随机分为辨证论治组、辨病论治组和基础治疗组,每组27例。辨证论治组经中医辩证分型给予相应中药免煎制剂;辨病论治组,即不辨证,只辨病,给予以益气养阴、祛瘀利湿为治法的中药免煎制剂;基础治疗组急性期单用双氯芬酸钠缓释片治疗,慢性期单用苯溴马隆片治疗。各组在相应治疗基础上同时给予健康宣教。持续治疗12周。分别于治疗前及治疗后检测血尿酸(SUA)、血肌酐(SCr)、血尿素氮(BUN)、甘油三酯(TG)及胆固醇(TC)的改变,同时评价临床疗效,计算复发率及观察不良反应。结果 治疗前各组患者的SUA、SCr、BUN、TG、TC比较,差异无统计学意义( P>0.05)。各组治疗后SUA、SCr与本组治疗前比较,差异均有统计学意义( P<0.05)。基础治疗组与辨证论治组比较,临床疗效较低( P<0.05),与辨病论治组比较,差异无统计学意义( P>0.05);同时其在降低SUA 及SCr方面优于辨病论治组( P<0.05),但较辨证论治组差( P<0.05)。在改善复发率方面,辨证论治组优于辨病论治组,辨病论治组优于基础治疗组。治疗过程中,各组均未出现明显不良反应。治疗前及治疗后12周的血常规、尿常规和心电图等检查,其改变无临床意义。结论 中医分型辨证论治GA的临床疗效确切,并且在降低SUA、SCr及复发率方面具有优势,值得临床进一步探讨与推广。
英文摘要:
      Objective To observe the clinical effect and safety of traditional Chinese medicine (TCM) treatment in gouty arthritis (GA) based on syndrome differentiation. Methods 81 patients of GA were enrolled from August 2013 to August 2014. They were divided into syndrome differentiation treatment group (27 cases), disease differentiation treatment group (27 cases) and basic treatment group (27 cases). The patients in syndrome differentiation treatment group were given corresponding TCM drug granules prescription by dialectical syndromes classification. The patients in disease differentiation treatment group were given TCM drug granules prescription. The patients in basic treatment group were only given Diclofenac Sodium sustained-release tablets in acute phase, and Benzbromarone tablets in chronic phase. After 12 weeks treatments, all the patients received the measurements of serum uric acid (SUA), serum creatinine (SCr), blood urea nitrogen (BUN), triacylglycerol (TG), cholesterol (TC).The clinical efficacy, recurrence rate and adverse reactions were recorded and analyzed. Results Syndrome differentiation treatment group achieved higher clinical efficacy than basic treatment group and disease differentiation treatment group (P<0.05). Moreover, syndrome differentiation treatment were superior to disease differentiation treatment in improving of recurrence rate (P<0.05). There were no obvious adverse reactions occurred. There were no clinical significant changes in blood, urine routine analysis, and electrocardiogram examination before and 3 months after the treatments. Conclusion The treatment of TCM in patients with GA based on syndrome differentiation showed definite therapeutic effects.
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