观察采用个体化护理联合三黄膏在治疗痛风性关节炎中的临床效果。

回顾性分析2015年6月至2019年6月暨南大学附属顺德医院收治的痛风性关节炎患者共67人，个体化护理联合三黄膏者(n＝18)为联合组；个体化护理而未使用三黄膏者(n＝16)未个体组；常规护理并使用三黄膏者(n＝20)为三黄组；常规护理未使用三黄膏者(n＝13)为对照组。收集患者入院与出院时疼痛视觉模拟评分(VAS评分)、心理健康评分、疼痛缓解和住院时间、患者出院时满意度，出院后6个月内每月定期电话随访。计数资料采用卡方检验；计量资料正态分布且方差齐性者用单因素方差分析；计量资料不符合正态分布或方差不齐者采用秩和检验。

4组患者的年龄、性别、入院时及出院时的VAS评分，入院时的心理评分差异无统计学意义(P>0.05)，联合组和三黄组的疼痛缓解时间明显小于个体组和对照组(F＝31.507，P<0.05)，但三黄组住院时间更长。联合组和个体组出院时心理评分低于其他两组(F＝4.817，P<0.05)。联合组和个体组的护理满意度明显高于其他两组(F＝23.978，P<0.05)。出院后6个月内痛风性关节炎复发率：联合组16.7%(3/18)，个体组18.8%(3/16)，显著低于三黄组50%(10/10)，对照组53.8%(7/13)(χ²＝8.589，P<0.05)，住院期间出现8例皮肤过敏，联合组1例，三黄组7例。

个体化护理联合三黄膏治疗痛风性关节炎有一定临床效果，个体化护理是避免痛风关节炎复发的关键之一。

To explore the clinical effects of individualized nursing combined with Sanhuang plaster in the treatment of gouty arthritis.

Sixty-seven patients with gout arthritis who were admitted to the AffiliatedShundeHospitalof Jinan University from June 2015 to June 2019 were retrospectively analyzed. The patients used individualized nursing combined with Sanhuang plaster (n=18) were the combined group, the patients used individualized nursing without Sanhuang plaster (n=16) werethe individual group, the patients used routine nursing and Sanhuangplaster (n=20) were the Sanhuang group, and the patients used routine nursing only(n=13) werethe control group. The visual analogue scale (VAS score), psychological scoring, the pain relief time, hospital stay time, nursing satisfaction were collected and the monthly telephone follow-up records within six months after the discharge was applied. The enumeration data were tested by chi-square test. Single variance analysis was used for measurement data conforming to normal distribution and homogeneity of variance. Kruskal-Wallistest was used for those whose measurement data did not conform to the normal distribution or variance.

There was no significant difference in age, gender, VAS score, or psychological scoring before admission among the four groups(P>0.05). The pain relief time of the combined group and Sanhuang group was significantly shorter than that of the individual group and the control group (F=31.507, P<0.05), but the hospitalization time of the Sanhuang group was longer. The psychological scoring before discharging of the combined group and the individual group were lower than that of the other two groups (F=4.817, P<0.05). The nursing satisfaction of the combined group and the individual group was significantly better than that of the other two groups (F=23.978, P<0.05). Within six months after discharge, the recurrence rate of gouty arthritis was 16.7% in the combined group, 18.8%in the individual group, significantly lower than 50% in the Sanhuang group, 53.8% in the control group(χ²=8.589, P<0.05). Eight cases of skin allergy occurred during hospitalization, one case in the combined group and seven in the Sanhuanggroup.

Individualized nursing combined with Sanhuang plaster has a positive role in the treatment of gouty arthritis, it is one of the keys to avoid the recurrence of gout arthritis.