Department of Rheumatology and Immunology, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin 300381, China.
National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin 300381, China.
J Tradit Chin Med. 2021 Oct;41(5):806-816. doi: 10.19852/j.cnki.jtcm.20210702.001.
To evaluate the curative effect of integrated Traditional Chinese and Western Medicine on gout, and to investigate the therapy timing and exact treatment options of integrated medicine.
Totally 860 patients were enrolled, including 460 patients with intermittent gout, 200 patients with active Traditional Chinese Medicine (TCM) syndrome (TCM syndrome score ≥ 6) and 200 patients with stable TCM syndrome (score < 6). They were randomly divided into intervention and control groups. The control group was treated according to Western Medicine guidelines. The intervention group was treated with integrated Traditional Chinese and Western Medicine. The efficacy of TCM syndrome, joint pain score, joint swelling score, ESR, C-reactive protein, serum uric acid, liver and kidney function, and the duration of remission of TCM syndrome were compared between the two groups before and after treatments.
For the patients with stable TCM syndrome, there was no significant difference in the effective rate and inefficiency between the intervention group and the control group. For the active type, the effective rate of the intervention group is better than the control group significantly. For the stable type, there was no significant difference between the intervention group and the control group in improving the scores of joint pain and swelling, reducing the level of ESR, C-reactive protein, serum uric acid and improving liver and kidney function. For the active type, the differences between the two groups were significant. The stable stage of gout in the intervention group was longer than the control group.
For the gout patients with stable TCM syndrome in the acute stage of gout, we can use TCM treatment or Western Medicine alternatively; for the patients with active TCM syndrome, the scheme of combination of Traditional Chinese and Western Medicine can be applied, with the better curative effect than any medicine alone.
评价中西医结合治疗痛风的疗效，并探讨中西医结合治疗的时机和具体治疗方案。
共纳入 860 例患者，其中间歇期痛风患者 460 例，活动期中医证候（中医证候评分≥6）患者 200 例，稳定期中医证候（评分<6）患者 200 例。将患者随机分为干预组和对照组。对照组按西医指南治疗，干预组采用中西医结合治疗。比较两组治疗前后中医证候疗效、关节疼痛评分、关节肿胀评分、红细胞沉降率（ESR）、C 反应蛋白、血尿酸、肝肾功能及中医证候缓解持续时间。
对于稳定期中医证候患者，干预组与对照组的有效率和无效率差异无统计学意义。对于活动期患者，干预组的有效率明显优于对照组。对于稳定期患者，干预组与对照组在改善关节疼痛和肿胀评分、降低 ESR、C 反应蛋白、血尿酸水平以及改善肝肾功能方面差异无统计学意义。对于活动期患者，两组间差异有统计学意义。干预组痛风稳定期较对照组长。
对于痛风稳定期中医证候患者，可交替采用中医或西医治疗；对于活动期中医证候患者，可采用中西医结合方案，疗效优于单纯西药或中药。
