| Objective: By analyzing the correlation between chronic gout, interleukin-1β, interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), TCM symptoms and clinical indicators, as well as the changes of inflammatory factors, TCM syndrome scores and clinical indicators before and after treatment,Explored the mechanism of modified Simiaosan in the treatment of chronic gout . Method: General clinical data, TCM syndrome score,biochemical indicators were observed. The levels of IL-1β, tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) were determined by enzyme-linked immunosorbent assay (ELISA). The correlations of IL-1β, TNF-6 and TNF-α with TCM syndrome scores.Sixty patients with chronic gouty arthritis with damp-heat obstruction syndrome were divided into 2 groups by random number table method, with 30 cases in observation group and 30 cases in control group. At the same time, 30 healthy patients were set up. The control group was given oral febuxostat treatment; Observation group was additionally treated with Modified Simiaosan, the treatment cycle was 4 weeks. Results: Compared with healthy group, the levels of IL-1β, TNF-α and IL-6 in chronic gout patients were significantly increased, and the difference was statistically significant (P<0.01). In chronic gout patients, joint pain, joint swelling, sticky stool and tongue image were positively correlated with IL-1β, TNF-α and IL-6, while joint tenderness, joint fever and body burnout were positively correlated with IL-1β and TNF-α. Viscosity, bitter mouth and urine were positively correlated with TNF-α, pulse pattern was positively correlated with IL-1β, IL-1β was positively correlated with FPG, TC, ESR and VAS score, TNF-α was positively correlated with BMI, UA, HDL, ESR and VAS score. IL-6 was negatively correlated with HDL, and positively correlated with SBP, UA and CRP (P < 0.05 or P < 0.01). After treatment, the levels of IL-1β, TNF-α and IL-6 were significantly decreased in two groups (P < 0.01), and the levels of IL-1β in observation group were significantly decreased compared with treatment group (P < 0.05). Compared with the two groups before treatment, joint pain, joint tenderness, joint swelling, joint fever, activity disorder, lethargy, stickiness, bitter mouth, yellow urine, tongue score were significantly reduced in the two groups,(P<0.05, P<0.01). Compared with the control group after treatment, the observation group of patients with joint fever, body fatigue, sticky, bitter mouth, sticky stool, yellow urine, tongue, pulse scores were significantly reduced (P<0.05); Compared with the group before treatment, the levels of BMI, SBP, DBP, UA, Scr, BUN, FPG, LDL, TG, TC, ESR, CRP, IL-1β, TNF-α, IL-6 and VAS score were significantly increased (P<0.05, P<0.01). Compared with the control group after treatment, the levels of BMI, ESR, IL-1β and VAS score in observation group were significantly decreased (P<0.05). The total effective rate of the observation group was 80.0% (24/30) and that of the control group was 56.7% (17/30). The total effective rate of the observation group was significantly higher than that of the control group, and the difference was statistically significant (2=11.916, P<0.05). Conclusions: The levels of IL-1β, IL-6 and TNF-α in gout patients are closely related to obesity, blood glucose, blood lipid, UA, joint swelling and pain, inflammation and systemic symptoms. modified Simiaosan can effectively improve the clinical symptoms of chronic gouty arthritis with Damp-Heat Obstruction Type and reduce inflammation, and has good safety. The mechanism may be related to the inhibition of IL-1β-related inflammatory signaling pathways. |
