[Observation on the clinical efficacy of Huazhuo Sanjie Chubi decoction() in the treatment of low-grade inflammation in chronic gouty arthritis].

OBJECTIVE

To explore clinical efficacy of Huazhuo Sanjie Chubi decoction() in treating low-grade inflammation in chronic gouty arthritis (CGA).

METHODS

From May to December 2024, 68 male patients with CGA were admitted and divided into traditional Chinese medicine group and Western medicine group (1 patient dropped out and 4 patients excluded). There were 31 patients in traditional Chinese medicine group, aged from 21 to 63 years old with an average of (42.35±11.93) years old, body mass index (BMI) ranged from 21.0 to 37.5 kg·m-2 with an average of (26.87±3.58) kg·m-2, and courses of disease raged from 3 to 30 years with an average of (9.55±6.25) years;treated with orally administered Huazhuo Sanjie Chubi decoction(). There were 32 patients in Western medicine group, aged from 21 to 65 years old with an average of (37.47±10.79) years old, BMI ranged from 19.5 to 30.7 kg·m-2 with an average of (25.30±2.87) kg·m-2, and courses of disease ranged from 4 to 21 years with an average of (8.50±4.15) years;treated with oral allopurinol. TCM syndrome score, Likert score for joint swelling and pain, visual analogue scale (VAS) for pain, serum uric acid and serum low-grade inflammation-related indicators of patients before and after treatment, including tumornecrosis factor-α (tumornecrosis factor-α) TNF-α, interleukin-1β (IL-1β), interleukin-6(IL-6), chemokine 2 (c-c motif chemokine ligand 2), changes of CCL2) and S100 calcium binding protein A8/A9(S100 calcium binding protein A8/A9, S100A8/A9) were observed and compared. Spearman correlation analysis was used to analyze correlations between SUA and IL-1β, IL-6, TNF-α, CCL2, and S100A8/A9.

RESULTS

Sixty-three patients were followed up for two months, and no adverse reactions occurred in any of them. After 2 months of treatment, the scores of TCM syndrome, Likert score of joint swelling and pain, and VAS in traditional Chinese medicine group were 9.00(8.00, 11.00), 2.00 (1.00, 3.00), and 0.00 (0.00, 1.00) points respectively;which were lower than 16.00 (15.00, 18.00), 4.00 (4.00, 5.00), and 2.00 (1.00, 2.00) in Western medicine group, and the differences were statistically significant(P<0.05). The serum uric acid level in Western medicine group was 465.68 (429.02, 500.94) μmol·L-1, which was lower than that in traditional Chinese medicine group 496.03 (484.90, 522.73) μmol·L-1, and the difference was statistically significant(P<0.05). The levels of serum IL-1β, IL-6, TNF-α, CCL2 and S100A8/A9 in traditional Chinese medicine group were (25.01±8.18) pg·ml-1, (16.97±5.01) ng·L-1, (229.08±45.10) ng·L-1 and (503.50±72.16) pg·ml-1, (13.35±2.80) pg·ml-1, respectively;which were lower than those of Western medicine group (35.51±6.35) pg·ml-1, (21.13±2.49) ng·L-1, (250.14±34.23) ng·L-1, (567.64±76.12) pg·ml-1, (19.36±4.24) pg·ml-1;there were statistically significant differences between two groups (P<0.05). SUA was positively correlated with serum IL-1β (r=0.57), IL-6 (r=0.43), TNF-α (r=0.39), CCL2 (r=0.27), and S100A8/A9 (r=0.36). Serums IL-1β, IL-6, TNF-α were positively correlated with levels of CCL2 and S100A8/A9 (P<0.05).

CONCLUSION

Huazhuo Sanjie Chubi decoction() could improve clinical symptoms, TCM syndromes and low-grade inflammation-related indicators of patients with CGA, and has the dual effects of lowering uric acid and anti-low-grade inflammation.