【摘要】 目的 探讨四妙散联合伤科黄水治疗急性痛风性关节炎患者的临床疗效。方法 选取2023年2月—2024年1月佛山市中医院收治的急性痛风性关节炎患者90例作为研究对象，按随机数字表法分为对照组和治疗组，每组各45例。两组患者均给予膳食指导和基础治疗(依托考昔120 mg,1次/d)。在此基础上，对照组患者联合四妙散汤剂进行治疗。治疗组患者在对照组治疗的基础上，联合伤科黄水进行外敷治疗。治疗7 d后，观察比较两组患者的临床疗效、不良反应情况，治疗前后视觉模拟评分(Visual analogue scale,VAS)、中医证候积分，血尿酸水平(Blood uric acid,BUA)、血沉速率(Erythrocyte sedimentation rate,ESR)和C反应蛋白(C-reactive protein,CRP)水平。结果 治疗后两组患者中医证候积分均较治疗前降低，差异有统计学意义(P<0.05)；且治疗组中医证候积分明显低于对照组，差异有统计学意义(P<0.05)。治疗后治疗组临床总有效率97.50%(39/40)明显高于对照组75.00%(30/40)，差异有统计学意义(P<0.05)。治疗后两组患者VAS评分均较治疗前降低，差异有统计学意义(P<0.05)；且治疗组VAS评分明显低于对照组，差异有统计学意义(P<0.05)。治疗后两组患者BUA水平均较治疗前降低，差异有统计学意义(P<0.05)；而两组间BUA水平比较，差异无统计学意义(P>0.05)。治疗后两组患者ESR水平均较治疗前降低，差异有统计学意义(P<0.05)；且治疗组ESR水平明显低于对照组，差异有统计学意义(P<0.05)。治疗后两组患者CRP水平均较治疗前降低，差异有统计学意义(P<0.05)；且治疗组CRP水平明显低于对照组，差异有统计学意义(P<0.05)。治疗期间，两组患者不良反应发生率比较，差异无统计学意义(P>0.05)。结论 四妙散联合伤科黄水外敷法在治疗急性痛风性关节炎方面疗效确切，同时具有较好的安全性。更多还原

【Abstract】 Objective To explore the clinical efficacy of Simiao Powder combined with Shangke Huangshui medicated gauze for patients with acute gouty arthritis.Methods Ninety patients with acute gouty arthritis who visited Foshan Hospital of Traditional Chinese Medicine from February 2023 to January 2024 were selected as the research subjects and divided into a control group and a treatment group by the random number table method, with 45 cases in each group.Both groups received diet guidance,basic treatment(etoricoxib 120 mg once daily), and Simiao Powder Decoction, while the treatment group additionally received external application of Shangke Huangshui medicated gauze.After treatment for 7 days, clinical efficacy and adverse reactions were compared between the two groups.The following parameters were assessed before and after treatment:the visual analogue scale(VAS)score, traditional Chinese medicine(TCM)syndrome scores, as well as blood uric acid(BUA), erythrocyte sedimentation rate(ESR), and C-reactive protein(CRP)levels.Results After treatment, TCM syndrome scores were decreased in both groups(P<0.05), with these scores being significantly lower in the treatment group(P<0.05).The total clinical effectiveness rate was 97.50%(39/40)in the treatment group, which was significantly higher than 75.00%(30/40) in the control group(P<0.05).VAS scores were reduced in both groups(P<0.05), with these scores being significantly lower in the treatment group(P<0.05).Similarly, ESR and CRP levels were significantly reduced in both groups(P<0.05), with these levels being significantly lower in the treatment group(P<0.05).However, BUA levels were reduced in both groups(P<0.05), without inter-group significance(P>0.05).During treatment, there were no statistically significant differences in the incidence of adverse reactions between the two groups(P>0.05).Conclusion For acute gouty arthritis, Simiao Powder combined with the external application of Shangke Huangshui medicated gauze demonstrates significant efficacy and a satisfactory safety profile.更多还原