痛风性关节炎的中医特色外治法临床研究进展

Clinical Research Progress of Characteristic External Therapies of Traditional Chinese Medicine for Gouty Arthritis

摘要: 痛风性关节炎是临床高发的晶体性炎性关节病，近年发病率持续攀升且呈年轻化态势，病情迁延反复发作可诱发关节骨质破坏、痛风石形成甚至肾功能损伤，显著降低患者生活质量并加重社会医疗负担。西医常规抗炎、降尿酸治疗存在胃肠道不良反应突出、肝肾功能风险及停药易复发等局限。中医特色外治法凭借起效快、局部靶向性强、无胃肠道刺激、患者依从性好等优势，可从局部抗炎镇痛、全身调控代谢多维度起效，已成为本病综合诊疗体系的重要组成部分。本文综述2020~2025年国内外相关研究，分类阐述中药外用、针刺及灸法等外治方案的临床疗效与作用机制，指出现有研究循证等级偏低、机制研究不深、操作规范欠缺等不足，并展望未来研究方向，为痛风性关节炎的中医外治临床应用与规范化研究提供参考。

Abstract: Gouty arthritis is a high-prevalence crystal-induced inflammatory joint disease in clinical practice. In recent years, its incidence has continued to rise and exhibits a trend of younger onset. Chronic recurrent episodes can induce joint bone destruction, tophus formation, and even renal function damage, significantly reducing patients’ quality of life and increasing the social medical burden. Conventional Western medical anti-inflammatory and urate-lowering therapies have limitations such as prominent gastrointestinal adverse reactions, risks to liver and kidney function, and a high likelihood of recurrence after discontinuation. Traditional Chinese Medicine (TCM) characteristic external treatment methods, with advantages including rapid onset, strong local targeting, absence of gastrointestinal irritation, and good patient compliance, exert therapeutic effects through multiple dimensions, including local anti-inflammatory analgesia and systemic metabolic regulation. They have become an important component of the comprehensive diagnosis and treatment system for this disease. This article reviews relevant domestic and international studies from 2020 to 2025, classifies and elaborates on the clinical efficacy and mechanisms of external treatment regimens such as herbal medicine application, acupuncture and moxibustion. It points out existing shortcomings, including low level of evidence-based research, insufficient mechanistic studies, and lack of standardized operating procedures. Furthermore, it prospects future research directions to provide reference for the clinical application and standardized research of TCM external treatments for gouty arthritis.