【目的】 观察通元针法治疗急性痛风性关节炎的临床疗效。【方法】 选取2023年11月至2024年6月广州市南沙区中医医 院病房及门诊收治的 126例明确诊断为急性痛风性关节炎的患者为研究对象。按随机数字表将患者随机分为观察组和对照 组，每组63例。对照组给予健康宣教及常规治疗，观察组在对照组常规治疗的基础上，给予通元针法治疗。2组患者均连续 治疗 14 d。治疗 2周后，评价 2组临床疗效，观察 2组患者治疗前后临床症状评分和疼痛视觉模拟量表（VAS）评分的变化情 况，以及肌骨超声（滑膜增生、血流信号、关节积液）水平的情况。比较 2 组患者治疗前后血尿酸（UA）、红细胞沉降率 （ESR）、C 反应蛋白（CRP）、肿瘤坏死因子 α（TNF-α）、白细胞介素 1（IL-1）的变化情况。【结果】（1）观察组总有效率为 95.24%（60/63），对照组为84.13%（53/63）。观察组疗效优于对照组，差异有统计学意义（P < 0.05）。（2）治疗后，2组患者的临 床症状评分与VAS评分均明显改善（P < 0.05），且观察组在改善临床症状评分与VAS评分方面明显优于对照组，差异有统计 学意义（P < 0.05）。（3）治疗后，2 组患者的血清 UA、ESR、CRP 水平明显改善（P < 0.05），且观察组在改善血清 UA、ESR、 CRP水平方面明显优于对照组，差异有统计学意义（P < 0.05）。（4）治疗后，2组患者的TNF-α和IL-1水平明显改善（P < 0.05）， 且观察组在改善TNF-α和IL-1水平方面明显优于对照组，差异有统计学意义（P < 0.05）。（5）治疗后，2组患者的肌骨超声指 标均明显改善（P < 0.05），且观察组在改善肌骨超声指标方面明显优于对照组，差异有统计学意义（P < 0.05）。【结论】 通元针 法治疗急性痛风性关节炎，能明显改善患者的临床症状，降低患者血尿酸和炎性因子水平，疗效显著。

Objective To observe the clinical efficacy of Tongyuan acupuncture in the treatment of acute gouty arthritis. Methods A total of 126 cases of patients with definitive diagnosis of acute gouty arthritis admitted to the wards and outpatient clinics of Guangzhou Nansha District Hospital of Traditional Chinese Medicine from November 2023 to June 2024 were selected as the study subjects. The patients were randomly divided into observation group and control group according to the random number table method，with 63 cases in each group. The control group was given health training and conventional treatment， while the observation group was given Tongyuan acupuncture on the basis of treatment in the control group. Patients in both groups were treated for 14 consecutive days. After two weeks of treatment， the clinical efficacy of the two groups was evaluated. The changes in the clinical symptom scores， the Visual Analogue Scale （VAS） scores of pain， the levels of musculoskeletal ultrasonography（synovial proliferation，blood flow signals，and joint fluid）before and after the treatment were observed in patients of both groups. The changes of blood uric acid（UA），erythrocyte sedimentation rate（ESR）， C-reactive protein（CRP）， tumor necrosis factor α（TNF - α）， and interleukin 1（IL-1）before and after treatment were compared between the two groups. Results（1）The total effective rate was 95.24%（60/63）in the observation group and 84.13%（53/63）in the control group. The efficacy of the observation group was superior to that of the control group，the difference being statistically significant（P < 0.05）.（2）After treatment，the clinical symptom scores and VAS scores of the patients in the two groups were improved significantly（P < 0.05），and the improvement in the observation group was significantly superior to that in the control group，the difference being statistically significant（P < 0.05）.（3）After treatment，the serum UA，ESR，and CRP levels of patients in the two groups were improved significantly（P < 0.05），and the improvement in the observation group was significantly superior to that in the control group，the difference being statistically significant（P < 0.05）.（4）After treatment， the TNF-α and IL-1 levels of patients in the two groups were improved significantly（P < 0.05），and the improvement in the observation group was significantly superior to that in the control group，the difference being statistically significant（P < 0.05）.（5）After treatment，the musculoskeletal ultrasound indicators of the two groups of patients were improved significantly（P < 0.05），and the improvement in the observation group was significantly superior to that in the control group， the difference being statistically significant （P < 0.05）. Conclusion Tongyuan acupuncture in the treatment of acute gouty arthritis can significantly improve the clinical symptoms of patients， reduce the level of patients􀆳 blood UA and inflammatory factor.

R246.9

国家中医药管理局资助项目（编号：20232YCCYT02-20）；广州市南沙区科技计划项目（编号：2023MS009）