The Clinical Study Of Taking Simiaosan In The Treatment Of Acute Gouty Arthritis Caused By Heat-Damp Syndrome

Gout is a crystal deposition disease hallmarked by elevated levels of uric acid in the bloodstream.It is characterized by excruciating,sudden, burning pain caused by chronic and acute gouty arthritis.Other symptoms include joint deformation,urinary stones and kidney disease.The first line of treatment is pain relief,and the drug options are non-steroidal anti-inflammatory drugs,colchicine and oral glucocorticoids,such as probenecid,narcaricin and allopurinol.Though they act in lowering the blood uric acid level,they do not modify and regulate the system's uric acid metabolism,thus often causing adverse reactions to drug.In Traditional Chinese Medicine,gout is categorized in the "Bi"-syndrome and "Li Jie".We believe that it's caused by poor diet and nutrition,overweight and obesity,and poor habits.The etiology has to do with poor constitution of the spleen and kidneys,thus affecting the system' s ability to properly excrete unwanted wastes from the body,which then forming harmful toxins,such as excess heat,dampness,and blood stagnation.In acute cases,both heat and dampness' s activity is at its peak, thus noted to belong to the TCM category of "Heat Bi" syndrome.The treatment of gout by ways of TCM has its long history;vast amount of research has been done in this field.Its treatment is based on relieving the dampness,coldness,and easing the heat that' s blocking the channels, the cause of pain.The treatment of "Heat Bi" syndrome is therefore cooling down the heat and promoting blood circulation to alleviate meridian obstruction.Simiaosan is the formulation composed of huangbai,cangzhu, niuxi,and yiyiren.Huangbai is the most essential heat-reducing ingredient in this formula,while cangzhu removes dampness by strengthening the spleen function.Niuxi tones the liver and kidney function,promotes blood circulation and removes blockage in the meridians.Yiyiren is a diuretic which induces urination,thus allowing the dampness to leave the system.The combined use of cangzhu and yiyiren works to tone the spleen function which help to regulate the body fluid.In all,the complete formulation brings about a reliable treatment for "Heat Bi" syndrome,characterized by weakness of the lower extremity,inflammation of the knees and feet,pain and stiffness in the joints.Lab experiments have been done to prove that Simiaosan can suppress the dilation of capillaries,increase permeability,thus reducing the inflammatory reaction during acute gouty arthritis.Moreover,Simiaosan can elevate the threshold of pain in lab mice,thus able to manage pain as a result of inflammation as well as reducing the increased level of blood uric acid.Considerable research regarding the use of Simiaosan in the treatment of gout has been done.With regards to the individual gout syndromes,studies are limited,its diagnosis is not standardized,and clinical research lacks the criteria of curative effect.Thus,this study' s objective is to observe the curative effect of Simiaosan in the treatment of acute gouty arthritis caused by heat-damp syndrome.Method:This study is a controlled experiment,monitoring the before and after effect of prescribing Simiaosan granules to 80 gouty arthritis patients diagnosed with heat-damp syndrome.The treatment period is 7 continuous days. On the second,forth and seventh day,the time for the joint pain to alleviate, the time for the swelling to diminish and the level of pain(including the pain at rest,under pressure,and during swelling) are recorded.The index of pain expressed in percentage can then be calculated.Subsequently,the curative effect can be determined according to The Guide to Clinical Study of Chinese Medicine and New Drugs,released by the National Department of Health.Results:1.After treatment,most patients are able to manage the pain better.On average,the pain relieving time is approximately 2 days,and the time to reduce the joint swelling is about 3 to 4 days.2.After 2 days of treatment,the index of pain is lower than that of before treatment,yet,the difference is not statistically significant.After 4 days of treatment,the index continues to decrease,when compared with that of before treatment,the difference is statistically significant.After 7 days of treatment,the index drastically dropped as compared with before treatment,thus,the difference is very significant.3.The treatment using Simiaosan in acute gouty arthritis with heat-damp syndrome resulted in the following:19 patients clinically cured(23.75%), 14 patients very effective(51.25%),14 patients effect(17.5%),and 6 patients ineffective(7.5%).Conclusions:1.Simiaosan can relief the swelling and pain of the arthritic joint.In the experiment,all patients are diagnosed with the heat-damp syndrome.The treatment with Simiaosan is effect due to its ability to alleviate the heat and dampness,and to promote blood circulation to reduce meridian obstruction.2.Simiaosan significantly reduced the index of pain.By removing the excess heat and dampness in the joints,the pain and swelling both reduced as a consequent.3.The curative effect of treating acute gouty patients with heat-damp syndrome with Simiaosan is significant.After a week' s treatment,the excess heat and dampness in the body are readily removed,the joints are less painful and swollen;thus,the index of pain is observed to be significantly lower.4.Gout requires a combined therapy.In addition to medical care,the patients also need to pay attention to their daily habits.For instance,a low purina diet and frequent water consumption are important.Moreover, adequate rest of the joint in acute attacks is part of a good prognosis and prevention.This study not only provides clinical evidence for the treatment of acute gouty arthritis with heat-damp syndrome with Simiaosan,but also helps to promote TCM therapy in clinical practice.