腕关节镜清理术联合宣痹汤治疗急性痛风性腕关节炎OACSTPCD

Objective To explore the wrist arthroscopy debridement combined with xuanbi decoction in the treatment of acute gouty wrist arthritis effect.Methods From September 2015to June 2020,a total of 70patients with acute gouty wrist arthritis were treated in Sichuan orthopaedic hospital.According to the principle of randomization,the patients were divided into two groups,the patients in the observation group were treated with wrist arthroscopic debridement combined with xuanbi decoction(n=35),while those in the control group were treated with Colchicine combined with Erhuang Xinshang Zhitong ointment(n=35).The curative effects of the two groups were compared after 2weeks,3months and 6months.Observation Indexes:Blood Biochemical Indexes(ESR,CRP,UA),Visual Analogue Scale(Vas),Cooney wrist score,recurrence,operative complications,adverse drug reac-tions and so on.Results After treatment,the biochemical indexes(ERS,CRP,UA)of both groups showed a decreasing trend.Compared with the control group,the level in the observation group increased after 2weeks and decreased after 3months and 6months,and there was significant difference between the two groups at different time points(P＜0.05).The Visual Analogue Scale(VAS)scores of the two groups decreased with time,and the pain relief was greater at 2weeks after treatment,pain scores were lower than in the control group.In the control group,the pain score increased slightly after 3months.There were significant differences between groups at different time points(P＜0.05).The scores of each dimension of Cooney wrist joint score in the two groups showed an increasing trend with time.After 3months,the improvement of the observation group was greater than that of the control group.After 2weeks,the wrist joint score of the control group was basically stable without further improvement,there were significant differences between groups at different time points(P＜0.05).The recurrence rate of gouty wrist arthritis in the obser-vation group was significantly lower than that in the control group at 6months after treatment(0.00％vs.28.57％,P＜0.05).Postoperative complications and adverse drug reactions:in the Observation Group,1 patient had joint hematoma,1 patient had de-layed healing of incision,and no gastrointestinal reaction.In the control group,there were 3cases of simple gastrointestinal reac-tion,2cases of simple drug allergy,and 3cases of gastrointestinal reaction combined with drug allergy.The incidence of adverse reactions in the control group was significantly higher than that in the control group(5.71％vs.22.86％,P＜0.05).After two weeks of treatment,the total effective rate in the observation group was higher than that in the control group(94.82％vs.80.16％,P＜0.05).Conclusion Wrist arthroscopic debridement combined with xuanbi decoction in the treatment of acute gouty wrist arthritis is safe and long-lasting clinical efficacy.