来源：风湿病与关节炎,2017,6（5）:28-30,44.

微创针刀镜联合药物治疗难治性痛风急性期的临床观察

（临床研究）

何东初，张　勇，阮小风

　　【摘　要】目的：观察微创针刀镜联合常规药物治疗难治性痛风急性期的临床疗效。方法：将62例难治性痛风急性期患者随机分为对照组30例和治疗组32例。对照组采用常规药物（秋水仙碱、碳酸氢钠、塞来昔布、别嘌呤醇等）治疗，治疗组在对照组基础上加用微创针刀镜治疗。2组均以14 d为1个疗程。观察2组临床疗效及治疗前后血尿酸、关节疼痛消失时间及主要临床症状（关节疼痛、肿胀、活动受限）积分。结果：治疗组临床治愈18例，显效6例，有效7例，无效1例，总有效率为96.88%；对照组临床治愈15例，显效5例，有效3例，无效7例，总有效率为76.67%。2组比较，差异有统计学意义（P < 0.05）。治疗后，2组血尿酸、关节疼痛消失时间、主要临床症状（关节疼痛、肿胀、活动受限）积分较治疗前均显著下降（P < 0.01），且治疗组优于对照组（P < 0.05或P < 0.01）。结论：微创针刀镜联合常规药物治疗难治性痛风急性期效果显著。

　　【关键词】　难治性痛风；急性期；微创针刀镜；疗效观察

Clinical Observation of Treating Intractable Gout in the Acute Stage with Needlescope Combining Medicine

HE Dong-chu,ZHANG Yong,RUAN Xiao-feng

　　【ABSTRACT】Objective:To observe the clinical efficacy of needlescope combined with conventional medicine in the treatment of acute stage of intractable gout.Methods:Sixty two patients with acute phase of intractable gout were randomly divided into a control group（30 cases）and a treatment group（32 cases）.The control group was treated with conventional drugs（colchicine,sodium bicarbonate,celecoxib,allopurinol,etc.）,and the treatment group,based on the treatment for the control group,was treated with needlescope.Both groups were treated for 14 days as a course of treatment.The clinical efficacy,serum uric acid before and after treatment,the disappearance time of joint pain,and scores of main clinical symptoms（joint pain,swelling and limitation of activity）were observed in the two groups.Results:In the treatment group,18 cases were cured,6 cases were markedly effective,7 cases were effective,and 1 case was ineffective,and the total effective rate was 96.88%.In the control group,15 cases were cured,5 cases were markedly effective,3 cases were effective,and 7 cases were ineffective,and the total effective rate was 76.67%.The difference between the two groups was statistically significant（P < 0.05）.After treatment,the blood uric acid,the disappearance time of joint pain,and scores of main clinical symptoms（joint pain,swelling and limitation of activity）of the two groups were significantly lowered than before treatment（P < 0.01）,and the treatment group was better than the control group（P < 0.05 or P < 0.01）.Conclusion:Needlescope combined with conventional medicine is effective in the treatment of acute stage of intractable gout.

　　【Keywords】 intractable gout;acute stage;needlescope;observation on the clinical efficacy