目的 观察祛风通络利湿中药治疗湿热痹阻证痛风性关节炎疗效及对MMP-3、COX-2的影响.方法 将150例湿热痹阻证痛风性关节炎患者随机分为2组,对照组75例给予西药治疗,观察组75例在此基础上加用祛风通络利湿中药辅助治疗,比较2组患者近期疗效,统计2组治疗前后中医证候积分,疼痛VAS评分,血尿酸、ESR、CRP、IL-13、TNF-α、MMP-3、COX-2水平及随访复发率.结果 观察组近期总有效率显著高于对照组(P＜0.05);2组治疗后关节红肿热痛、活动不利、发热烦闷、口渴便黄、舌质红或暗、舌苔黄及脉滑数积分均显著低于治疗前(P均＜0.05),且观察组治疗后各项积分均显著低于对照组(P均＜0.05);2组治疗后疼痛VAS评分和血尿酸、ESR、CRP、IL-1β、TNF-α、MMP-3及COX-2水平均显著低于治疗前(P均＜0.05),且观察组治疗后各项指标水平均显著低于对照组(P均＜0.05);观察组随访复发率显著低于对照组(P＜0.05).结论 祛风通络利湿中药治疗湿热痹阻证痛风性关节炎可有效缓解临床症状体征,减轻关节疼痛,降低血尿酸水平和复发风险,并有助于下调炎症指标及MMP-3及COX-2水平.%Objective It is to observe the effect of Qufeng Tongluo Lishi Chinese medicine on gouty arthritis of heat-damp stasis syndrome and on MMP-3,COX-2.Methods 150 cases of patients with gouty arthritis of heat-damp stasis syndrome were randomly divided into 2 groups,75 cases in control group were treated with western medicine,75 cases in the observation group were treated with Qufeng Tongluo Lishi Chinese medicine additionally.The recent curative effect,scores of TCM syndrome,pain VAS scores,and the levels of blood uric acid,ESR,CRP,IL-1β,TNF-α,MMP-3,Cox-2 before and after treatment and follow-up recurrence rate were observed and compared in both groups.Results The recent total effectiveness of observation group was significantly higher than that in control group (P ＜ 0.05).After treatment the TCM syndrome scores such as joint pain and swelling,bad action,thirst and yellow urine,and red or dark tongue,yellow coating on the tongue and pulse sliding were significantly lower than those before treatment in both groups (P ＜ 0.05),and the scores in observation group were significantly lower than that in the control group (P ＜ 0.05);the pain VAS scores,the levels of blood uric acid,ESR,CRP,IL-1β,TNF-α,MMP-3,Cox-2 were significantly lower than those before treatment in both groups,and the indexes in observation group were significantly lower than those in control group (P ＜ 0.05).The follow-up rate of the observed group was significantly lower than that of the control group (P ＜ 0.05).Conclusion Qufeng Tongluo Lishi Chinese medicine can effectively relieve clinical symptoms and signs,relieve joint pain,reduce the blood uric acid levels and the risk of recurrence,and is helpful for downregulating inflammation index and MMP-3 and cox-2 levels in the treatment for gouty arthritis of heat-damp stasis syndrome.
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