消块止痛丹联合西药治疗痛风性关节炎气虚湿阻型的临床观察
Clinical Observation of Xiaokuai Zhitong Dan Combined with Western Medicine in the Treatment of Gouty Arthritis with Spleen Deficiency and Dampness Obstruction Type

目的：观察消块止痛丹联合西药治疗慢性痛风性关节炎气虚湿阻型的临床疗效及对肿瘤坏死因子-α (tumor necrosis factor alpha, TNF-α)、白细胞介素-6 (interleukin-6, IL-6)、白细胞介素-8 (interleukin-8, IL-8)和超敏C反应蛋白(hypersensitive C-reactive protein, hs-CRP)水平的影响。方法：对照组60例接受非布司他片，40 mg/次，1次/d，饭后服用，美洛昔康分散片7.2 mg/次，2次/d，口服。观察组60例患者在对照组的基础上接受消块止痛丹中草药治疗。治疗12周后，观察治疗前后中医症状评分、症状体征、手足关节X线评分。检测治疗前后血尿酸、TNF-α、IL-6、IL-8、hs-CRP水平。结果：治疗后观察组患者肿胀度评分、关节疼痛VAS评分、痛风石数量评分、触诊压痛评分、皮肤红晕评分、关节畸形评分、手足关节X线评分、中医症状评分、血清尿酸、TNF-α、IIL-6、IL-8、hs-CRP水平均低于对照组。结论：消块止痛丹联合西药治疗痛风性关节炎患者能明显改善临床症状及体征，减轻手足关节X线表现，降低血清尿酸及炎症因子水平。
Objective: To observe the clinical efficacy of Xiaokuai Zhitong Dan combined with Western medicine in the treatment of chronic gouty arthritis with qi deficiency and dampness obstruction, and its effects on the levels of tumor necrosis factor alpha (TNF-α), interleukin-6 (IL-6), interleukin-8 (IL-8), and hypersensitive C-reactive protein (hs-CRP). Method: A control group of 60 patients received febuxostat tablets, 40 mg/time, once a day, taken after meals, and Meloxicam dispersible tablets, 7.2 mg/time, twice a day, orally. 60 patients in the observation group received herbal treatment with Xiaokuan Zhitong Dan on the basis of the control group. After 12 weeks of treatment, the TCM symptom scores, symptom signs, and hand-foot joint X-ray scores before and after treatment were observed. The levels of blood uric acid, TNF-α, IL-6, IL-8, and hs-CRP before and after treatment were measured. Result: After treatment, the swelling score, joint pain VAS score, gouty stone count score, palpation tenderness score, skin redness score, joint deformity score, hand-foot joint X-ray score, traditional Chinese medicine symptom score, serum uric acid, TNF-α, IIL-6, IL-8, and hs-CRP levels in the observation group were lower than those in the control group on average. Conclusion: The combination of Xiaokuai Zhitong Dan combined with Western medicine can significantly improve clinical symptoms and signs, alleviate X-ray manifestations of hand and foot joints, and reduce serum uric acid and inflammatory factor levels in patients with gouty arthritis.