[Stage-based treatment of gouty arthritis by combination therapy of traditional Chinese and Western medicines: a randomized controlled trial]

Abstract

Objective: To evaluate the clinical therapeutic effect of the combination therapy of traditional Chinese and Western medicines in treating gouty arthritis based on the stage of disease, and to explore a safe, effective and reasonable therapeutic regimen for prevention and treatment of gouty arthritis.

Methods: One hundred and sixty-six cases of gouty arthritis were divided into three groups randomly, 58 cases in traditional Chinese drug (TCD)-treated group, 56 cases in Western medicine (WM)-treated group and 52 cases in TCD plus WM-treated group. They were all treated for 12 weeks. In the acute stage, patients in TCD-treated group were treated with Huzhang Gout Granule and Jinhuang Ointment, and patients in WM-treated group were treated with diclofenac sodium dual release enteric-coated capsules. In the intermission, patients in TCD-treated group were given Yinlian Gout Granule, and patients in WM-treated group were given benzbromarone or allopurinol. Patients in TCD plus WM-treated group were given both TCD and WM. Clinical symptom score and blood uric acid (BUA) level were measured. The effect initiating time, relapse rate, efficacy rate and the incidence rate of adverse effects were also studied.

Results: There were no significant differences in the efficacy rate and effect initiating time among the three groups in the acute stage. The clinical symptom score and BUA level were obviously reduced in three groups. In the intermission, BUA level in the WM-treated group and TCD plus WM-treated group were obviously reduced. Although there was a drop tendency in the BUA level in TCD-treated group, there was no statistical difference. The relapse rates in TCD-, WM- and TCD plus WM-treated groups were 12.07%, 26.79% and 9.62%, respectively. There was statistical difference in relapse rates among the three groups (P<0.05). The relapse rate was decreased in TCD plus WM-treated group as compared with those in TCD-treated and WM-treated groups. The average clinical symptom scores during recurrence in the three groups were (10.00+/-3.61), (12.38+/-1.85) and (10.75+/-1.89), respectively. The incidence of adverse effects in TCD-treated group (3.45%) was lower than the other two groups (21.43% and 15.38%).

Conclusion: The combination therapy of traditional Chinese and Western medicines based on the stage of disease can control the symptoms of gouty arthritis in the acute stage, improve joint function, and can control the BUA level during the intermission, prevent recurrence and relieve the adverse effects.