来源：风湿病与关节炎,2020,9（3）:22-24,39.

热痹方外敷治疗急性痛风性关节炎的临床观察（临床研究）

赵增艳，谢美芳，沈思钰，张紫嫣，高雪琴，曹　燕

　　【摘　要】目的：观察热痹方外敷联合塞来昔布治疗急性痛风性关节炎的临床疗效及安全性。方法：采用简单随机化对照的临床试验设计，将80例急性痛风性关节炎患者分为治疗组和对照组，每组40例。对照组口服塞来昔布，每次200 mg，每日2次；治疗组在对照组治疗基础上予以自拟热痹方患处外敷，每日1次。2组均治疗5 d。观察2组临床疗效，治疗前和治疗后第3，5天VAS评分，以及治疗前后红细胞沉降率（ESR）、C-反应蛋白（CRP），并观察不良反应。结果：治疗组显效24例，有效13例，无效3例，总有效率为92.50%；对照组显效12例，有效23例，无效5例，总有效率为87.50%。2组间比较，差异无统计学意义（P > 0.05）；但治疗组的显效例数明显高于对照组。治疗后第3天，2组VAS评分均有改善（P < 0.01或P < 0.05），且治疗组较对照组改善明显（P < 0.05）。治疗后第5天，2组VAS评分均继续改善（P < 0.05），2组间比较，治疗组虽较对照组数值偏低，但差异无统计学意义（P > 0.05）。治疗后，2组ESR、CRP较治疗前均降低（P < 0.05）；2组间比较，治疗组数值虽较对照组偏低，但差异无统计学意义（P > 0.05）。2组治疗前后血常规、肝肾功能比较，差异均无统计学意义（P > 0.05）。结论：热痹方外敷联合塞来昔布治疗急性痛风性关节炎起效快、疗效显著，无不良反应，值得临床推广。

　　【关键词】　急性痛风性关节炎；热痹方；临床疗效；安全性

Clinical Observation on the Treatment of Acute Gouty Arthritis with Rebi Fang（热痹方）

ZHAO Zeng-yan,XIE Mei-fang,SHEN Si-yu,ZHANG Zi-yan,GAO Xue-qin,CAO Yan

　　【ABSTRACT】Objective:To observe the clinical efficacy and safety of external application of Rebi Fang（热痹方）combined with celecoxib in the treatment of acute gouty arthritis.Methods:Eighty patients with acute gouty arthritis were randomly divided into a treatment group and a control group with 40 cases in each group.Patients in the control group took 200 mg of celecoxib ,twice a day;while the treatment group was treated with self-made Rebi Fang based on the treatment for the control group,once a day.Both groups were treated for 5 days.The clinical effect,VAS scores respectively before treatment,three and five days after treatment, ESR and CRP were observed before and after the treatment were observed.Results:In the treatment group,24 cases were markedly effective,13 cases were effective,and 3 cases were ineffective,the total effective rate being 92.50%,while in the control group,12 cases were markedly effective,23 cases were effective,and 5 cases were ineffective,the total effective rate being 87.50%.There was no significant difference between the two groups（P > 0.05）,but the number of markedly effective cases in the treatment group was significantly higher than those in the control group.On the third day after treatment,the VAS scores of the two groups were improved（P < 0.01 or P < 0.05）,and the treatment group was significantly improved compared with the control group（P < 0.05）;on the fifth day after treatment,the VAS scores of the two groups continued to improve（P < 0.05）,the value of the treatment group was lower than that of the control group,and there was no significant difference between the two groups（P > 0.05）.After treatment,ESR and CRP of the two groups were lower than before treatment（P < 0.05）.The value of the treatment group was lower than that of the control group,but there was no significant difference between the two groups（P > 0.05）.Before and after treatment,there were no significant abnormalities in blood routine and liver and kidney function in the two groups.Conclusion:The external application of Rebi Fang combined with celecoxib has a rapid and significant effect in the treatment of acute gouty arthritis,with no adverse reactions and worthy of clinical promotion.

　　【Keywords】acute gouty arthritis;Rebi Fang（热痹方）;clinical efficacy;safety