中国骨伤2025，Vol.38Issue(12)：1201-1209,9.DOI:10.12200/j.issn.1003-0034.20250884
化浊散结除痹方治疗慢性痛风性关节炎低度炎症的临床疗效观察
Observation on the clinical efficacy of Huazhuo Sanjie Chubi decoction(化浊散结除痹方)in the treatment of low-grade inflammation in chronic gouty arthritis
摘要
Abstract
Objective To explore clinical efficacy of Huazhuo Sanjie Chubi decoction(化浊散结除痹方)in treating low-grade inflammation in chronic gouty arthritis(CGA).Methods From May to December 2024,68 male patients with CGA were admitted and divided into traditional Chinese medicine group and Western medicine group(1 patient dropped out and 4 pa-tients excluded).There were 31 patients in traditional Chinese medicine group,aged from 21 to 63 years old with an average of(42.35±11.93)years old,body mass index(BMI)ranged from 21.0 to 37.5 kg·m-2 with an average of(26.87±3.58)kg·m-2,and courses of disease raged from 3 to 30 years with an average of(9.55±6.25)years;treated with orally administered Huazhuo Sanjie Chubi decoction(化浊散 结除痹方).There were 32 patients in Western medicine group,aged from 21 to 65 years old with an average of(37.47±10.79)years old,BMI ranged from 19.5 to 30.7 kg·m-2 with an average of(25.30±2.87)kg·m-2,and courses of disease ranged from 4 to 21 years with an average of(8.50±4.15)years;treated with oral allopurinol.TCM syndrome score,Likert score for joint swelling and pain,visual analogue scale(VAS)for pain,serum uric acid and serum low-grade inflammation-related indicators of patients before and after treatment,including tumornecrosis factor-α(tumornecro-sis factor-α)TNF-α,interleukin-1β(IL-1β),interleukin-6(IL-6),chemokine 2(c-c motif chemokine ligand 2),changes of CCL2)and S100 calcium binding protein A8/A9(S100 calcium binding protein A8/A9,S100A8/A9)were observed and com-pared.Spearman correlation analysis was used to analyze correlations between SUA and IL-1β,IL-6,TNF-α,CCL2,and S100A8/A9.Results Sixty-three patients were followed up for two months,and no adverse reactions occurred in any of them.Af-ter 2 months of treatment,the scores of TCM syndrome,Likert score of joint swelling and pain,and VAS in traditional Chinese medicine group were 9.00(8.00,11.00),2.00(1.00,3.00),and 0.00(0.00,1.00)points respectively;which were lower than 16.00(15.00,18.00),4.00(4.00,5.00),and 2.00(1.00,2.00)in Western medicine group,and the differences were statistical-ly significant(P＜0.05).The serum uric acid level in Western medicine group was 465.68(429.02,500.94)μmol·L-1,which was lower than that in traditional Chinese medicine group 496.03(484.90,522.73)μmol·L-1,and the difference was statistically sig-nificant(P＜0.05).The levels of serum IL-1β,IL-6,TNF-α,CCL2 and S100A8/A9 in traditional Chinese medicine group were(25.01±8.18)pg·ml-1,(16.97±5.01)ng·L-1,(229.08±45.10)ng·L-1 and(503.50±72.16)pg·ml-1,(13.35±2.80)pg·ml-1,re-spectively;which were lower than those of Western medicine group(35.51±6.35)pg·ml-1,(21.13±2.49)ng·L-1,(250.14±34.23)ng·L-1,(567.64±76.12)pg·ml-1,(19.36±4.24)pg·ml-1;there were statistically significant differences between two groups(P＜0.05).SUA was positively correlated with serum IL-1β(r=0.57),IL-6(r=0.43),TNF-α(r=0.39),CCL2(r=0.27),and S100A8/A9(r=0.36).Serums IL-1β,IL-6,TNF-α were positively correlated with levels of CCL2 and S100A8/A9(P＜0.05).ConclusionHuazhuo Sanjie Chubi decoction(化浊散结除痹方)could improve clinical symptoms,TCM syndromes and low-grade inflammation-related indicators of patients with CGA,and has the dual effects of lowering uric acid and anti-low-grade inflammation.关键词
中药复方/痛风性关节炎/低度炎症/中西医结合/病例对照研究Key words
Chinese herbal compound/Gouty arthritis/Low-grade inflammation/Intergative medicine/Case-con-trol study分类
医药卫生引用本文复制引用
林巳塬,苏友新,陈小华,郑卓铭,杨帆,张铸谋,刘俊,罗家利,肖艳,郭洁梅..化浊散结除痹方治疗慢性痛风性关节炎低度炎症的临床疗效观察[J].中国骨伤,2025,38(12):1201-1209,9.基金项目
国家中医药管理局2021年岐黄学者支持项目[编号:国中医药人教函(2022)6号] （2022）
国家重点研发计划项目"中医药现代化"重点专项(编号:2022YFC3501200) （编号:2022YFC3501200）
福建中医药大学苏友新岐黄学者传承工作室[编号:闽中医(2023)56号]The 2021 Qihuang Scholars Support Project of National Administration of Traditional Chinese Medicine[No.Personal and Education De-partment(2022)6] （2023）
