| 周叶,洪鸣鸣.中西医结合治疗高龄肾功能不全患者合并急性痛风性关节炎的疗效分析[J].浙江中西医结合杂志,2016,26(7): |
| 中西医结合治疗高龄肾功能不全患者合并急性痛风性关节炎的疗效分析 |
| Observation of Gubi Huoxue Decoction in the treatment of acute gout of elderly patients with chronic renal insufficiency.ZHOU Ye,HONG Mingming,GAO Yue.Comprehensive Health Care Department ,Hangzhou First People’s Hospital,Hangzhou 310006,China |
| 投稿时间：2015-11-26 修订日期：2016-04-20 |
| DOI： |
| 中文关键词: 高龄 急性痛风性关节炎 慢性肾功能不全 骨痹活血汤 |
| 英文关键词:elderly chronic renal insufficiency acute gouty arthritis Gubi Huoxue decoction |
| 基金项目:浙江省中医药科技计划项目(2012EA104) |
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| 中文摘要: |
| 目的 评价骨痹活血汤治疗高龄肾功能不全患者合并急性痛风性关节炎的效果及其可能机制。方法：高龄（≥80岁）肾功能不全患者合并急性痛风性关节炎60例，随机分为治疗组和对照组，每组均为30例。对照组复方倍他米予松针1mL肌注1次。2周为1个疗程。治疗组在对照组基础上加用骨痹活络汤口服。比较两组治疗前后的临床疗效、肾功能、血糖以及血清IL-1β和TNF-α水平的变化。结果 (1)治疗后，治疗组与观察组WOMAC骨关节指数评分、关节肿痛评分较治疗前均有明显下降（P<0.01）。治疗组疗效明显优于对照组[疼痛评分：（5.42±1.07）分比（8.85±1.22）分，P<0.01；关节僵硬度评分：（2.27±0.98）分比（3.87±1.15）分，P<0.01；日常生活评分：（25.4±3.74）分比（33.25±4.29）分，P<0.01；综合评分：（27.4±4.12）分比（42.52±6.24）分，P<0.01；关节休息痛评分：（1.14±0.22）分比（1.74±0.35）分，P<0.05；关节压痛评分：（1.85±0.37）分比（2.28±0.49）分，P<0.05，关节肿胀评分：（0.42±0.19）分比（0.78±0.18）分，P<0.05]。(2)治疗前后，两组肾功能、空腹血糖均差异无统计学意义（P>0.05）。两组血尿酸水平治疗后均较治疗前下降，差异有统计学意义（P<0.05），但治疗组与对照组比较，差异无明显统计学意义(P>0.05)。(3)治疗后，两组血清IL-1β和TNF-α水平均有明显下降（P<0.05）。治疗组下降值明显高于对照组[IL-1β：（13.14±4.22）pg/mL比（18.52±3.35）pg/mL，P<0.05；TNF-α：（82.17±9.19）pg/mL比（95.02±10.18）pg/mL，P<0.05]。结论 骨痹活血汤联合复方倍他米松注射液治疗高龄慢性肾功能不全患者合并急性痛风性关节炎，临床症状迅速缓解，安全性高。 |
| 英文摘要: |
| Objective:To observe the effect of Gubi Huoxue Decoction in the treatment of acute gout of elderly patients with chronic renal insufficiency.
Methods: 60 samples are acute gout of elderly patients(more than 80 years old) with chronic renal insufficiency who are in and out patients selected from Comprehensive Health Care Department of Hangzhou First People’s Hospital. These samples were randomly divided into control group and treatment group,30 cases for each. The patients in control group adopted intramuscular injection of compound betamethasone 1ml once. 2 weeks as one cycle. The treatment group took Gubi Huoxue Decoction for treatment on the control group basis. Clinical efficacy was compared between two groups before and after treatment.While biochemical indexes and symptom scores were observed before and after treatment.Results: ① The WOMAC bone-joint evalution indexes,articular rest pain scores,swelling scores and tenderness scores were improved in both group after treatment (P<0.01).Compared to patients in control group,those in treatment group had lower scores of [pain score:（5.42±1.07）marks vs（8.85±1.22）marks，P<0.01；joint stiffness score:（2.27±0.98）marks vs（3.87±1.15）marks，P<0.01；daily life score: （25.4±3.74）marks vs（33.25±4.29）marks，P<0.01；comprehensive score:（27.4±4.12）marks vs (42.52±6.24）marks，P<0.01；joint rest pain score（1.14±0.22）marks vs（1.74±0.35）marks，P<0.05；joint tenderness scroe（1.85±0.37）marks vs（2.28±0.49）marks，P<0.05；joint swelling score（0.42±0.19）marks vs（0.78±0.18）marks，P<0.05]②The biochemical indexes including fasting blood-glucose,kidney function in two groups were no significant difference before and after therapy(P>0.05).After therapy, it showed a lower blood uric acid in both group,differences were statistically significant (p<0.05). However,there was no statistically significant difference between treatment group and control group(p>0.05). ③ After therapy, the level of serum IL-1β and TNF-α in two groups obviously declined（P<0.05）,and the declining rate in treatment group was much higher than that in control group[IL-1β:（13.14±4.22）pg/ml vs （18.52±3.35）pg/ml，P<0.05；TNF-α:（82.17±9.19）pg/ml vs （95.02±10.18）pg/ml，P<0.05]。Conclusion: Gubi Huoxue Decoction combited with betamethasone to cure acute gout of elderly patients with chronic renal insufficiency proved to have minor side-effects to renal function, but quick and safe treatment results. |
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