Dissertation
Dissertation > Medicine, health > Chinese Medicine > TCM Internal Medicine > Modern medicine, internal diseases

Clinical observation of gout Treatment of acute gouty arthritis ( heat Accumulation card)

Author WangLin
Tutor ZhouCaiYun
School Beijing University of Traditional Chinese Medicine
Course Chinese medical science
Keywords acute gouty arthritis the heatness and dampness removing theory Tongfeng Recipe Chinese medicine symptom
CLC R259
Type Master's thesis
Year 2011
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Gout is a kind of disease caused by purine metabolic disturbance increasing the blood uric acid (BUA). Its clinical characteristics are hyperuricemia and reduplicated mark acute arthritis. In some cases without proper cure it can result in damage to joint and nephro, chalkstone’s production and even destruction of joint or renal failure. In the past, Gout was once considered a rare disease and usually to happen in Occident. However, in recent years, with the rise of the living standard and changes of the dietary structure, nutritional diseases caused by dietary behavior are becoming more and more popular. As one of these nutritional diseases, Gout is getting common and the incidence age of patients is getting younger, just like the adiposity, diabetes mellitus and hypertension. Gout can not only bring on agony of joint and also indicate some dangerous cardiovascular and cerebrovascular diseases such as the coronary heart disease, cerebral infarction and cerebral hemorrhage. Like the other Metabolic diseases, Gout is a ’hidden killer’which can bring on great harm to people’s health and quality of life. Research Objective:At present, though Western Medicine can do the deeds fast and effective in treatment to Gout, its serious side-effect is unacceptable to the patients and it cannot completely cure Gout. This research is supervised by professor Zhou Caiyun and based on the heatness and dampness removing theory proposed by professor Fang Dingya. In this research, we analyzed Chinese medicine symptom scores, clinical symptom, pain rating index (PRI), blood uric acid and inflammatory factor before and after the treatment in the patients of acute gouty arthritis by tongfeng recipe in order to observe the clinical effect and provide a new way to cure this disease. Research Method:Perspective and positive research method with randomized control trial is adopted in this paper. Patients with acute gouty arthritis (symptom of dampness mixed with heatness) are chosen as objects of study and are treated by the heatness and dampness removing and blood activating method, meanwhile, we use diclofenac sodium sustained release tablets as positive contrastive medicine, besides, The Visual Analogue Scale/Score (VAS) and Chinese medicine symptom scores are taken as criteria for judging the treatment. The patients’renal and hepatic function, blood uric acid, inflammatory factor and side effects before and after the treatment are also recorded. This research can provide useful information for judging the effects and safety of Chinese traditional medicine and establishing the disease treatment norm on curing acute gouty arthritis. Research Content:Case investigation form is designed to collect cases of Gout in Xiyuan hospital from Dec.2009 to Mar.2011. The cases which match the features of acute gouty arthritis in both Western Medicine and Chinese Medicine are randomly divided into two groups:the treatment group and the contrast group. With the equal basic treatment, the treatment group is given the Chinese medicine(Tongfeng Recipe, Qd); while the contrast group given diclofenac sodium sustained release tablets (75mg/disci, Bid). For both groups, one week is considered as a observing period. The patients’renal and hepatic function, blood uric acid, inflammatory factor and side effects before and after the treatment are respectively evaluated. All the data is calculated by using SPSS13.0 for statistical analysis.Research Result:There are totally 60 cases of illness and during the treatment there occurs one fallen case in each group. So there are actually 29 cased observed in both the treatment group and contrast group.①For both groups before cure, the gender, age distribution and relative physico-chemical examination after statistical treatment are comparable without apparent differences.②Illness curative effect: For the treatment group, there are 2 cases healed,14 cases with apparent effect,10 cases with effect and 3 cases with no effect. The effective rate is 89.66%. For the contrast group, there are 1 cases healed,11 cases with apparent effect,15 cases with effect and 2 cases with no effect. The effective rate is 93.10%. But there are no apparent differences on the effect between the two groups with multiple comparisons (P>0.05).③Effect to the Chinese medicine illness points: There are obvious decrease of the Chinese medicine illness points for both groups with clear differences (P<0.01), but there are no apparent differences between the two groups with multiple comparisons (P>0.05).④Pain rating index (PRI) by VAS:There are obvious decrease of the PRI for both groups with clear differences (P<0.01), but there are no apparent differences between the two groups with multiple comparisons (P>0.05).⑤lood uric acid:There are no obvious changes of the blood uric acid for both groups (P>0.05) and no apparent differences between the two groups with multiple comparisons (P>0.05).⑥Inflammatory factor(CRP):There are obvious decrease of the inflammatory factor for both groups with clear differences (P<0.01), but there are no apparent differences between the two groups with multiple comparisons (P>0.05).⑦Safety indicator:For the contrast group, the ALT value lightly rises after the cure (P<0.05). But there is no clinical meaning for all the patients’ALT values are in the normal range. For both groups, there are no apparent differences on the renal function (P>0.05) and the values are in normal range.⑧Untoward effect:There exists no untoward effect in the treatment group while there is 1 case with anabole and inappetence in the contrast group. But it doesn’t stop the patient finishing the course of treatment with proper therapy to the untoward effect. And there are no apparent differences between the two groups with multiple comparisons (P>0.05). Research Conclusion:From the clinical research results, using the Tongfeng recipe to treat the acute gouty arthritis can effectively decrease the pain rating index of joint, improving the action of inflammatory reaction and relieving the traditional Chinese medicine symptom with less toxic side-effect and has wise and vast application prospects which deserve deeper research. However, limited by the 7-day course of clinical observing, whether the Tongfeng recipe can achieve the goal of preventing the appearance of acute syndrome from chronical clinical gouty arthritis remains to be confirmed.

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