826例痛风住院病例的临床特征分析  

Analysis of Clinical Characteristics of 826 Hospitalized Patients with Gout

作　　者：李君霞 黄闰月[2,3] 陈秀敏 孙嗣龙[4] 赵越 黄清春 LI Jun-xia;HUANG Run-yue;CHNE Xiu-min;SUN Si-long;ZHAO Yue;HUANG Qing-chun(The Second Clinical Medical College,Guangzhou University of Traditional Chinese Medicine,Guangzhou,510405;Department of Rheumatology. Guangzhou Provincial Hospital of Traditional Chinese Medicine,Guangzhou,510006;Guangdong Provincial Key Laboratory of TCM Syndrome Clinical Research,Guangzhou,510006;Beijing Genomics Institute-Shenzhen,Shenzhen,518031)

机构地区：[1]广州中医药大学第二临床医学院,广州510415 [2]广东省中医院风湿科,广州510006 [3]广东省中医证候临床研究重点实验室,广州510006 [4]深圳华大基因研究院,深圳518031

出　　处：《中国中西医结合杂志》2019年第3期293-298,共6页Chinese Journal of Integrated Traditional and Western Medicine

基　　金：国家中医药管理局国家中医临床研究基地项目(No.JDZX2015197);广东省自然科学基金(No.2017KT1805);广东省中医院院内专项(No.YN2015 mS05)

摘　　要：目的探讨痛风发病、中医证候及合并病特点,为该病的预防及诊治提供参考依据。方法对2012年2月—2017年1月广东省中医院收治的826例痛风患者的临床资料进行回顾性分析。分析不同性别患者年龄、病程、住院时间及其分布,记录患者中医证候、舌质、舌苔及脉象分布,同时比较合并不同疾病患者及同时合并不同数量疾病患者的情况。结果 826例痛风患者中男性709例(85.84%),女性117例(14.16%)。与女性患者比较,男性患者年龄更小,病程更长(P<0.05),但住院时间比较差异无统计学意义(P>0.05)。男性痛风患者主要年龄阶段为40～83岁,而女性的主要年龄阶段为54～86岁。男性患者及女性患者前3位病程为:0～36个月、36～72个月、108～144个月。患者前3位中医证候为:湿热瘀阻[44.55%(368/826)]、湿瘀阻络[6.42%(53/826)]、气阴两虚,湿热瘀阻[5.57%(46/826)];舌质前2位为:舌暗红[40.32%(333/826)]、舌淡暗[30.75%(254/826)];舌苔前3位为:苔黄腻[39.23%(324/826)]、苔白腻[21.91%(181/826)]、苔薄白[11.38%(94/826)];脉象第1位为脉弦[60.29%(498/826)]。合并病前3位为:高血压病[55.33%(457/826)]、脂肪肝[31.60%(291/826)]、高血脂[29.42%(243/826)]。男性合并相关疾病的人数为614例(86.36%),女性合并相关疾病的人数为107例(91.45%),两者比较,差异无统计学意义(P=0.128)。结论与女性痛风患者比较,男性痛风患者具有基数大、年龄小、病程长的特点。同时痛风患者易合并其他疾病,特别是高血压病、脂肪肝、高血脂,而"浊瘀"是痛风发病的关键病机,是基本的病机证素之一。Objective To investigate the pathogenesis of gouty arthritis(GA), characteristics of Chinese medicine(CM) syndromes and comorbidities, and provide reference for the prevention, diagnosis and treatment of the disease. Methods Clinical data of 826 patients with gout admitted to Guangdong Provincial Hospital of Traditional Chinese Medicine from February 2012 to January 2017 were retrospectively analyzed. The age, medical history, length of stay and their distribution of patients with different genders were analyzed and the distribution of the CM syndrome,texture of tongue,coating on the tongue and pulse of patients were recorded. Meanwhile, the conditions of patients with different diseases and patients with different numbers of diseases were both compared. Results A total of 826 cases were included in this trial, 709(85.84%) cases were male and 117(14.16%) cases were female. Compared with female patients, male patients were younger and had a longer medical history(P<0.05), but the difference in length of stay was not statistically significant(P>0.05).The main age distribution of male patients with gout was 40-83 years old, while the main age distribution of female patients was 54-86 years old. The medical history of the former three were 0-36 months, 36-72 months and 108-144 months in patient with GA among male and female. The CM syndromes of the former three were the syndrome of damp heat and blood stasis [44.55%(368/826)], collaterals obstructed by dampness and blood stasis[6.42%(53/826)] and deficiency of Qi and Yin and damp heat and blood stasis [5.57%(46/826)]. The textures of tongue the former two were dark red tongue[40.32%(333/826)] and light dark tongue[30.75%(254/826)]. The coatings on the tongue of the former three were the coating of yellow greasy[39.23%(324/826)], the coating of white greasy[21.91%(181/826)] and the coating of thin white[11.38%(94/826)]. The string pulse was champion in all type of pulse[60.29%(498/826)]. The diseases which are associated with GA of the former three were hypertension [

关 键 词：痛风 临床特征 中医证候特征 

分 类 号：R259[医药卫生—中西医结合]