1017例痛风中医证候学调查研究分析  

Investigation and Analysis of TCM Syn-dromes of 1017 Cases of Gout

作　　者：狄朋桃[1] 王兴强 朱婉华 张玲 靖卫霞 张明[5] 区培英 章丽萍 秦天楠 汪学良 赵钟文[10] 董秋梅[11] 镇东鑫 曹文萍 张丽秀 和智勇 李学英 胡俊桥 张国峰 曾慧 刘春丽 赵博 韦欧林 张娴 彭江云[1] DI Peng-tao;WANG Xing-qiang;ZHU Wan-hua;ZHANG Ling;JING Wei-xia;ZHANG Ming;QU Pei-ying;ZHANG Li-ping;QIN Tian-nan;WANG Xue-liang;ZHAO Zhong-wen;DONG Qiu-mei;ZHEN Dong-xin;CAO Wen-ping;ZHANG Li-xiu;HE Zhi-yong;LI Xue-ying;HU Jun-qiao;ZHANG Guo-feng;ZENG Hui;LIU Chun-li;ZHAO Bo;WEI Ou-lin;ZHANG Xian;PENG Jiang-yun

机构地区：[1]云南省中医医院,云南昆明650021 [2]南通良春中医医院,江苏南通226010 [3]云南中医药大学,云南昆明650500 [4]北京中医药大学第三附属医院,北京100029 [5]上海中医药大学附属岳阳中西医结合医院,上海200437 [6]罗平县中医医院,云南罗平655899 [7]楚雄州中医医院,云南楚雄675000 [8]保山市中医院,云南保山678099 [9]昭通市中医医院,云南昭通657099 [10]福建中医药大学附属第二人民医院,福建福州350003 [11]内蒙古医科大学,内蒙古呼和浩特010000 [12]咸宁麻塘风湿病医院,湖北咸宁437000 [13]开远市中医院,云南开远661699 [14]宁洱县中医院,云南宁洱665199 [15]兰坪县中医院,云南兰坪671499 [16]宁蒗县中医院,云南宁蒗674399 [17]垫江县中医院,重庆垫江408399 [18]柳州市中医医院,广西柳州545001 [19]咸丰县中医院,湖北咸丰445608 [20]曲靖市中医院,云南曲靖655000 [21]临沧市中医院,云南临沧677000 [22]罗城县中医医院,广西罗城546400 [23]勐海县中医院,云南勐海666200

出　　处：《风湿病与关节炎》2022年第5期21-25,36,共6页Rheumatism and Arthritis

基　　金：国家自然科学基金(82160901,81960863,81960870);国家中医药管理局国家中医(类风湿关节炎)临床研究基地建设项目(国中医药科技函〔2018〕131号);云南省中医(风湿病)临床医学研究中心项目(202102AA310006);云南省科技厅云南中医学院应用基础研究联合专项[2019FF002(-031),2019FF002(-082)];云南省医疗卫生单位内设研究机构项目基金(2017NS168,2018NS0045,2018NS0046,2018NS0042)。

摘　　要：目的:调查和分析当前痛风发病情况和中医证候分布规律。方法:收集2019年1月至2022年1月云南省中医医院、南通良春中医医院等23家医院的1017例痛风患者,分析痛风患者基本情况、中医证候分布规律,中医证候在年龄、病情分期、血脂、血尿酸等方面的分布情况。结果:湿热蕴结证是痛风患者主要的中医证候,占70.21%。湿热蕴结证、寒湿痹阻证、痰瘀痹阻证均以急性期为主,分别占61.62%、54.65%、45.36%。脾虚湿阻证及肝肾阴虚证多见于间歇期及慢性期分别占46.81%和46.15%。不同证候年龄分布比较,差异有统计学意义(P<0.01);不同证候患者之间血尿酸水平比较,差异有统计学意义(P<0.05)。结论:痛风发病年龄呈现年轻化趋势,中医证候分布与患者年龄、部分伴发疾病和血尿酸水平存在明显差异;痛风不同时期、证候分布也不相同。可为痛风辨证论治、规范治疗提供参考依据。Objective:To investigate and analyze the current incidence and TCM syndrome distribution of gout.Methods:1,017 patients with gout treated in 23 hospitals including Yunnan Provincial Hosoital of Traditional Chinese Medicine and Nantong Liangchun Hospital of Traditional Chinese Medicine from January 2019 to January 2022 were collected to analyze the basic condition,the distribution law of TCM syndromes,and the distributions of TCM syndromes in age,disease stage,blood lipid and blood uric acid.Results:Dampness heat accumulation syndrome is the main TCM syndrome of gout patients,Accounting for 70.21%.Dampness heat accumulation syndrome,cold dampness obstruction syndrome and phlegm stasis obstruction syndrome are mainly in acute stage,61.62%,54.65%and 45.36%respectively.Spleen deficiency and dampness obstruction syndrome and liver and kidney yin deficiency syndrome are mostly in intermittent stage and chronic stage,46.81%and 46.15%respectively.The age distribution difference of different syndromes is statistically significant(P<0.05),and there are significant differences in blood uric acid level among patients with different syndromes(P<0.05).Conclusion:The age of onset of gout shows a younger trend.There are significant differences between the distribution of TCM syndromes and the age of patients,some concomitant diseases and the level of blood uric acid.The distribution of syndromes is also different in different periods of gout,which can provide a reference for syndrome differentiation and treatment of gout and standardized treatment.

关 键 词：痛风 中医证候 分布规律 流行病学 调查研究 

分 类 号：R259[医药卫生—中西医结合]