来源：风湿病与关节炎,2019,8（12）:27-30,42.

外用中药治疗痛风性关节炎文献分析（文献研究）

孟得世，李　沛，胡盼盼

　　【摘　要】目的：总结近5年公开发表的文献，分析治疗痛风性关节炎外用中药的基本规律。方法：检索2014年1月至2018年7月中国知网、万方、维普等数据库中收录的外用中药治疗痛风性关节炎的相关文献，统计文献中药物及药对频次。结果：检索出130篇符合标准的文献，外用中药的剂型主要有外敷膏剂、熏洗剂、涂擦剂及巴布膏剂等，其中以湿热蕴结、瘀热阻滞为主要证型，共载方剂139首，包括185味中药，应用中药总频次1142次，用药频次10次以上的中药共30味，累计频次721次，频次最高的10味中药依次为大黄、黄柏、白芷、苍术、冰片、姜黄、黄芩、天花粉、黄连、甘草。30味中药药性以寒、温、平为主，药味以苦、辛、甘为主，药物归经以肝、胃、脾、心、肺为主，功效以清热燥湿、活血化瘀等为主，涉及现代药理学研究主要有抗菌、抗炎、镇痛、抗凝等作用。所载方剂中药对总使用频次为301次，其中使用频次在10次以上的有黄柏-大黄、苍术-黄柏、黄芩-大黄、黄连-大黄、黄连-黄芩-黄柏、乳香-没药、栀子-大黄、苍术-厚朴。结论：应用外用中药治疗痛风，强调从肝脾胃论治，兼顾心肺，用药以清热燥湿、泻火解毒、凉血消肿为主，祛风止痛、活血化瘀为辅，寒温并用，辛开苦降，局部应用于患处，以求短期获得显著的临床疗效。

　　【关键词】　痛风性关节炎；中医；中药外用；药理

Literature Analysis of Gouty Arthritis Treated by External Application of Chinese Medicine

MENG De-shi,LI Pei,HU Pan-pan

【ABSTRACT】Objective:To summarize the published literature in the past five years and analyze the basic rules of external application of Chinese medicine in the treatment of gouty arthritis.Methods:Relevant literature on external application of Chinese medicine in the treatment of gouty arthritis from January 2014 to July 2018 in databases such as CNKI,WANFANG DATA,VIP was retrieved and the frequency of drugs and drug pairs in the literature were counted.Results:One hundred and thirty papers following standards were searched out,and the main externally applied dosages were external plaster,fumigant,inunction and cataplasm,most of which were for syndrome types as damp heat accumulation and stasis heat blocking.There were 139 prescriptions in total,including 185 Chinese medicinals.The total application frequency of these medicinals was 1142 times,30 of them were more than 10 times and with the cumulative frequency of 721 times.Medicinals with the highest frequency are as follows:Dahuang（Radix et Rhizoma Rhei）,Huangbai（Cortex Phellodendri Chinensis）,Baizhi（Radix Angelicae Dahuricae）,Cangzhu（Rhizoma Atractylodis）,Bingpian（Borneolum Syntheticum）,Jianghuang（Rhizoma Curcumae Longae）,Huangqin（Radix Scutellariae）,Tianhuafen（Radix Trichosanthis）,Huanglian（Rhizoma Coptidis）and Gancao（Radix et Rhizoma Glycyrrhizae）.The natures of the thirty Chinese medicinals are mainly cold,warm and neutral;their flavors are mainly bitter,pungent and sweet;their channel entries are mainly the liver,stomach,spleen,heart and lung channels;and their efficacy are mainly heat clearing,dryness and dampness removing,blood activ-ating and stasis removing.The modern pharmacology research are mainly antibacterial,anti-inflammatory,analgesic and anticoagulant.The total use frequency of drug pairs is 301 times,among which those used more than 10 times are Huangbai-Dahuang,Cangzhu-Huangbai,Huangqin-Dahuang,Huanglian-Dahuang,Huanglian-Huangqin-Huangbai,Ruxiang（Olibanum）-Moyao（Myrrha）,Zhizi（Fructus Gardeniae）-Dahuang and Cangzhu-Houpo（Cortex Magnoliae Officinalis）.Conclusion:The external use of TCM in the treatment of gout,emphasizing the treatment from the liver,spleen and stomach,taking into account the heart and lung,is mainly used to clear heat and dry dampness,relieve fire and toxin,cool blood and eliminate swelling,supplemented by dispelling wind and relieve pain,promoting blood circulation and removing blood stasis,combined with cold and temperature,and reducing pain and bitterness,and applied locally in the affected area,in order to obtain significant short-term clinical efficacy.

　　【Keywords】 gouty arthritis;Chinese medicine;external application of Chinese medicine;pharmacology