新型乌蔹莓水凝胶对湿热蕴结型痛风性关节炎的干预效果

徐媚媚; 郭亮; 陈月月; 景嵘月; 朱亚梅; 徐大可; 何静; 徐波; 周琰; 徐蕾

doi:10.7619/jcmp.20233058

新型乌蔹莓水凝胶对湿热蕴结型痛风性关节炎的干预效果

Effect of a new type of ampelopsis hydrogel on gouty arthritis with accumulation of dampness-heat syndrome

摘要

摘要:
目的探讨新型乌蔹莓水凝胶对湿热蕴结型痛风性关节炎的干预效果及作用机制。
方法选取90例符合痛风性关节炎西医诊断标准、中医辨证属湿热蕴结证的患者作为研究对象，随机分成治疗组、对照组和空白组，每组30例。空白组仅采用依托考昔治疗，对照组采用依托考昔联合乌蔹莓膏治疗，治疗组采用依托考昔联合外敷乌蔹莓水凝胶治疗。比较3组临床疗效、症状改善时间、安全性、舒适性和治疗前后中医证候积分、血清炎性因子C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)、血沉(ESR)、NF-κB信号通路相关蛋白、疼痛视觉模拟评分法(VAS)评分、关节活动度变化情况。
结果治疗组、对照组治疗总有效率分别为93.33%、90.00%, 高于空白组的70.00%, 差异有统计学意义(P < 0.05); 治疗组疼痛、红肿、压痛、关节活动受限症状改善的时间短于对照组、空白组，差异有统计学意义(P < 0.05); 治疗7 d后，治疗组中医证候积分低于对照组、空白组，治疗组、对照组血清CRP、TNF-α、ESR水平和NF-κB信号通路相关蛋白P50、P65表达低于空白组，差异有统计学意义(P < 0.05); 治疗组治疗7 d后VAS评分低于对照组、空白组，且治疗组用药舒适度评分高于对照组，差异有统计学意义(P < 0.05); 3组不良反应发生率比较，差异无统计学意义(P>0.05)。
结论乌蔹莓水凝胶对痛风性关节炎的治疗效果优于乌蔹莓膏，其作用机制可能与调控NF-κB通路、抑制炎性因子表达有关，且水凝胶使用方便卫生，舒适性高，有望成为安全、有效、便捷的痛风性关节炎外敷中药。

Abstract:
Objective To investigate the interventional effect and mechanism of a novel ampelopsis hydrogel on dampness-heat accumulation syndrome of gouty arthritis.
Methods A total of 90 patients with gouty arthritis who met the diagnostic criteria of western medicine and were differentiated as damp-heat accumulation syndrome of traditional Chinese medicine(TCM) were randomly divided into treatment group, control group and blank group, with 30 patients in each group. The blank group was treated with etoricoxib only, the control group was treated with etoricoxib combined with ampelopsis hydrogel, and the treatment group was treated with etoricoxib combined with external application of ampelopsis hydrogel. The clinical efficacy, time to symptom improvement, safety, comfort, changes in syndrome scores of TCM, serum inflammatory factorsC-reactive protein (CRP), tumor necrosis factor-α (TNF-α), erythrocyte sedimentation rate (ESR), NF-κB signaling pathway-related proteins, Visual Analogue Scale (VAS) scores for pain, and joint mobility were compared among the three groups before and after treatment.
Results The total effective rates in the treatment group and control group were 93.33% and 90.00%, respectively, which were higher than 70.00% in the blank group (P < 0.05). The time for improvement of pain, redness, tenderness, and limited joint mobility in the treatment group was shorter than that in the control group and blank group (P < 0.05). After 7 days of treatment, the TCM syndrome score in the treatment group was lower than that in the control group and blank group, and the levels of serum CRP, TNF-α, and ESR and the expressions of NF-κB signalingpathway-related proteins P50 and P65 in the treatment group and control group were lower than those in the blank group (P < 0.05). After 7 days of treatment, the VAS score in the treatment group was lower than that in the control group and blank group, and the comfort score in the treatment group was higher than that in the control group (P < 0.05). There was no significant difference in the incidence of adverse reactions among the three groups (P>0.05).
Conclusion The effect of ampelopsis hydrogel in treating gouty arthritis is better than that of ampelopsis paste, and its mechanism may be related to the regulation of the NF-κB pathway and inhibition of inflammatory factor expression. The hydrogel is easy to use, hygienic, and comfortable, and is expected to become a safe, effective, and convenient external medicine for gouty arthritis.

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