四妙勇安汤联合火针治疗急性痛风性关节炎的临床研究

Clinical Research on the Treatment of Acute Gouty Arthritis with Simiao Yong’an Decoction Combined with Fire Needle Therapy

摘要: 目的：探讨四妙勇安汤联合火针疗法对急性痛风性关节炎的临床疗效。方法：选取2021年7月至2024年6月期间在我院收治的60例湿热蕴结型痛风性关节炎患者作为研究对象，采用随机数字法将其分为对照组和观察组，每组各30例。对照组给予依托考昔片(60 mg/d)口服治疗；观察组在对照组治疗的基础上，予加用四妙勇安汤内服与火针外治。两组疗程均为7天。观察比较两组治疗后的关节症状(疼痛、肿胀、功能)缓解情况及实验室指标(ESR、CRP、SUA)改善情况。结果：关节症状与功能比较：治疗前，两组患者的关节疼痛指数、肿胀积分及关节功能无显著差异(P > 0.05)。治疗后，两组患者的关节症状各项指标均较前改善，但观察组改善幅度显著大于对照组，差异有统计学意义(P < 0.05)。实验室指标比较：治疗前，两组ESR、CRP、SUA等指标基线水平相当(P > 0.05)。治疗后，两组ESR、CRP均明显下降，且观察组ESR、CRP下降幅度较对照组更大，差异有统计学意义(P < 0.05)。在SUA方面，观察组治疗后明显下降，但对照组变化不显著，组间比较，差异有统计学意义(P < 0.05)。安全性方面：对照组出现1例胃肠道不适，1例肝酶升高，观察后均可恢复。结论：结果表明四妙勇安汤联合火针治疗方案，能有效促进急性痛风性关节炎患者的关节症状缓解并改善炎症指标(ESR、CRP)及降低血尿酸(SUA)水平方面展现出显著优势。

Abstract: Objective: To explore the clinical efficacy of Simiao Yong’an Decoction combined with fire needle therapy in the treatment of acute gouty arthritis. Methods: Sixty patients with acute gouty arthritis of damp-heat accumulation type admitted to the hospital from July 2021 to June 2024 were selected as the study subjects and randomly divided into a control group and an observation group using a random number method, with 30 patients in each group. The control group was given oral etoricoxib tablets 60 mg/day, while the observation group received additional treatment with Simiao Yong’an Decoction combined with fire needle therapy on top of the control group’s treatment. Both groups underwent a 7-day treatment course. The changes in joint pain index, swelling score, joint function, as well as laboratory indicators such as erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and serum uric acid (SUA) were compared between the two groups after treatment. Results: Comparison of joint symptoms and function: Before treatment, there were no significant differences in joint pain index, swelling score, and joint function between the two groups of patients (P > 0.05). After treatment, all indicators of joint symptoms in both groups improved compared to before, but the improvement in the observation group was significantly greater than that in the control group, with the difference being statistically significant (P < 0.05). Comparison of laboratory indicators: Before treatment, the baseline levels of ESR, CRP, SUA, and other indicators were comparable between the two groups (P > 0.05). After treatment, both ESR and CRP levels in both groups decreased significantly, and the decrease in ESR and CRP levels was greater in the observation group than in the control group, with the difference being statistically significant (P < 0.05). In terms of SUA, the observation group showed a significant decrease after treatment, while there was no significant change in the control group. The comparison between the two groups showed a statistically significant difference (P < 0.05). Safety aspect: In the control group, there was one case of gastrointestinal discomfort and one case of elevated liver enzymes, both of which resolved after observation. Conclusion: Simiao Yong’an Decoction combined with fire needle therapy can promote the relief of joint symptoms in patients with acute gouty arthritis, and also play a certain role in improving inflammatory indicators and serum uric acid.