来源：风湿病与关节炎,2020,9（5）:14-18.

问荆合剂联合非布司他治疗湿热蕴结型痛风的临床疗效研究（临床研究）

贾　璐¹，汪荣盛²，贾胜洪¹，何东仪²

　　【摘　要】目的：观察问荆合剂联合小剂量非布司他治疗湿热蕴结型痛风的临床疗效和不良反应，寻求低成本治疗痛风的有效方案。方法：采用多中心、随机、双盲双模拟、阳性药物平行对照的方法，将符合纳入标准的72例湿热蕴结型痛风患者随机分为治疗组和对照组，每组36例。治疗组给予问荆合剂及小剂量非布司他，对照组给予大剂量非布司他。2组均以12周为1个疗程。观察并评价2组患者的临床疗效和安全性。结果：治疗后，2组血尿酸水平、中医证候总积分较治疗前均有改善，差异有统计学意义

（P < 0.05）；2组尿酸达标疗效评价显示，总有效率差异无统计学意义（P > 0.05）；2组中医证候疗效评价比较，差异无统计学意义（P > 0.05）；2组急性发作频率比较，差异无统计学意义（P > 0.05）；2组痛风石变小例数比较，差异无统计学意义（P > 0.05）。整个随访期间，2组患者的不良反应发生率和严重不良反应发生率比较，差异无统计学意义（P > 0.05）。结论：问荆合剂联合小剂量非布司他可有效降低血尿酸，对于湿热蕴结型痛风的治疗与大剂量非布司他单药疗效相当，安全性良好，且节约治疗成本。

　　【关键词】　痛风性关节炎；问荆合剂；非布司他；湿热蕴结型；临床疗效

Study on the Clinical Effect of Wenjing Mixture Combined with Febuxostat in the Treatment of Gout with Damp-heat Accumulation

JIA Lu,WANG Rong-sheng,JIA Sheng-hong,HE Dong-yi

　　【ABSTRACT】Objective:To observe the clinical efficacy and adverse reactions of Wenjing mixture combined with low-dose Febuxostat in the treatment of gout with damp-heat accumulation in order to seek an effective treatment scheme with low cost for gout.Methods:Seventy-two gout with damp-heat accumulation patients were randomly divided into a treatment group and a control group with 36 cases in each.The treatment group was treated with Wenjing mixture and low-dose Febuxostat,while the control group was treated with high-dose of it.Both groups were treated for 12 weeks as a course.The clinical efficacy and safety of the two groups were observed and evaluated.Results:After treatment,the level of serum uric acid and the total score of TCM syndrome in the two groups were improved,and the difference was statistically significant（P < 0.05）.After treatment,there was no statistical significance in the evaluation of the effect of reaching the standard of uric acid in the two groups（P > 0.05）.After treatment,there was no statistical significance in the evaluation of TCM syndrome in the two groups（P > 0.05）.There was no significant difference between the two groups in the frequency of acute attack（P > 0.05）.There was no significant difference between the two groups in the number of small cases of gouty stone after treatment（P > 0.05）.During the whole follow-up period,there was no significant difference in the incidence of adverse reactions and serious adverse reactions between the two groups（P > 0.05）.Conclusion:The combination of Wenjing mixture and low-dose Febuxostat can effectively reduce the blood uric acid.It's clinical effect for gout with damp-heat accumulation is equivalent to that with high-dose Febuxostat alone,safe and economical.

　　【Keywords】 gouty arthritis;Wenjing mixture;Febuxostat;damp-heat accumulation;clinical effect