730例难治性痛风患者中医证候和临床特征分析  

Analysis of TCM Symptoms and Clinical Features of 730 Patients with Refractory Gout

作　　者：唐海倩 殷建美 晏蔚田 刘念 杨显娜 凌丽 张昊哲 王兴强 粟荣[2] 彭江云[2] TANG Haiqian;YIN Jianmei;YAN Weitian;LIU Nian;YANG Xianna;LING Li;ZHANG Haozhe;WANG Xingqiang;SU Rong;PENG Jiangyun(Yunnan University of Chinese Medicine,Kunming 650500,China;Yunnan Provincial Hospital of Traditional Chinese Medicine,Kunming 650021,China)

机构地区：[1]云南中医药大学,云南昆明650500 [2]云南省中医医院,云南昆明650021

出　　处：《云南中医学院学报》2021年第3期39-43,51,共6页Journal of Yunnan University of Traditional Chinese Medicine

基　　金：国家中医临床研究基地项目(国中医药科技函[2018]131号);国家自然科学基金(81760868);云南省科技厅云南中医学院应用基础研究联合专项(2019FF002[-082]);云南省医疗卫生单位内设研究机构科研项目基金-云南省中西医风湿病研究所课题(2018NS0045);民族医药防治重大疾病诊疗方案及经典方剂安全性有效性评价研究(2017YFC1704005);云南省中医(风湿病)临床医学研究中心项目(202102AA310006)。

摘　　要：目的分析难治性痛风患者中医证候特点及其流行病学、病史情况、用药情况等临床特征。方法对2016年1月-2021年6月于云南省中医医院风湿病科住院的难治性痛风患者进行回顾性分析,统计患者的性别、年龄、诱因、病程、合并症分布情况,并记录不同患者既往及院内用药情况,分析院内最常用药组合。结果本次研究共纳入730例患者,其中男性696例,女性34例,年龄40~80岁,证候以湿热蕴结证、脾虚湿阻证、寒湿痹阻证为主。急性期多见湿热蕴结证、寒湿痹阻证,间歇期以脾虚湿阻证为主,慢性期则以痰瘀痹阻证、肝肾亏虚证为主;常合并高血压、脂肪肝、骨关节炎等病,治疗上多以中西医结合治疗为主,急性期多使用抗炎止痛药物,间歇期及慢性期以降尿酸药物为主。结论难治性痛风患者以男性为主,具有年龄大、病程长等特点,同时容易合并其它疾病,特别是高血压、脂肪肝、骨关节炎,“痰瘀”是发病的关键病机。Objective To analyse the characteristics of TCM syndrome in patients with refractory gout and its epidemiology,medical conditions,medications and other clinical features.Methods From January 2016 to June 2021,a retrospective analysis was conducted on refractory gout patients hospitalized in the Rheumatology Department of Yunnan Provincial Hospital of Traditional Chinese Medicine,and the sex,age,precipitating causes,course and comorbidity distribution of patients were counted,and the previous and in-hospital medications of different patients were recorded,and the most commonly used drug combinations in the hospital were analyzed.Results A total of 730 patients were enrolled in this study,including 696 males and 34 females,and the age groups were mainly concentrated between 40 and 80 years old,and the symptoms were mainly damp and heat,spleen deficiency and dampness resistance,and cold and wet paralysis.In the acute stage,it is mostly seen that the damp heat contains the evidence and the cold and wet paralysis obstruction,the remission period is mainly the spleen deficiency and wet obstruction,and the chronic stage is mainly the sputum stasis obstruction and liver and kidney deficiency;often combined with hypertension,fatty liver,osteoarthritis and other diseases,the treatment is mainly based on the combination of traditional Chinese and Western medicine,the early use of anti-inflammatory and analgesic drugs,and the later stage is mainly based on uric acid-lowering drugs.Conclusion Refractory gout patients are mainly male,with the characteristics of age,long course and other characteristics,and are easy to combine other diseases,especially hypertension,fatty liver,osteoarthritis,“sputum stasis”is the key pathogenesis.

关 键 词：回顾性分析 难治性痛风 中医证候 临床特征 

分 类 号：R259[医药卫生—中西医结合]