Effect of Addition and Subtraction Therapy of Yiyiren Tang with External Application Therapy on Inflammatory Factors of Patients with Acute Gouty Arthritis and Damp-heat Obstruction Syndrome / 中国实验方剂学杂志

ABSTRACT

Objective:To observe the clinical effect of addition and subtraction therapy of Yiyiren Tang with external application therapy in the patients with acute gouty arthritis (AGA) and damp-heat obstruction syndrome, and to investigate its effect on inflammatory factors. Method:One hundred and fifty-three patients were randomly divided into control group (77 cases) and observation group (76 cases) by random number table. Patients in control group got meloxicam tablets after the meal, 1 tablet/day, 1 time/day, diclofenac sodium gel, 3 times/days. On the basis of meloxicam tablets, patients in observation group additionally received addition and subtraction therapy of Yiyiren Tang by oral and topical applications. The course of treatment was 7 days in both groups. Scores of visual analogue score of pain (VAS) were graded everyday, and the relief time and disappearance time of pain were recorded. Before and after treatment, scores of damp-heat obstruction syndrome were recorded. Levels of uric acid (UA), C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), interleukin-1 beta (IL-1β), interleukin-6 (IL-6), interleukin-8 (IL-8), tumor necrosis factor-alpha (TNF-α), serum cyclooxygenase-2 (COX-2), prostaglandin E2 (PGE2), thromboxane B2 (TXB2) and 6-keto-prostatic factor F1alpha (6-keto-PGF1α) were all detected, and the safety was evaluated. Result:The clinical efficacy in observation group was better than that in control group (Z=2.205, P<0.05). The relief time and disappearance time of pain were shorter than those in control group (P<0.01). At the 1st, 3rd, 5th and 7th day after treatment, scores of VAS were lower than those in control group (P<0.01). After treatment, the scores of main symptoms such as joint pain, tenderness, swelling and dyskinesia, scores of the secondary symptoms and the total scores of damp-heat obstruction syndrome were all lower than those in control group (P<0.01). After treatment, levels of ESR, CRP, UA, IL-1β, IL-6, IL-8, TNF-α, COX-2, PGE2 and TXB2 were all lower than those in control group (P<0.01). Conclusion:Based on the treatment of meloxicam, addition and subtraction therapy of Yiyiren Tang by oral and topical administration methods can quickly relieve and eliminate pain, alleviate the main clinical symptoms and inhibit inflammation in patients with damp-heat obstruction syndrome, showing good clinical efficacy and safety.