基于美国国家健康和营养检查调查数据库的痛风病证素研究  

TCM Syndrome Elements of Gout Disease Based on NHANES Database

作　　者：黄锦坚 王雨[1] 林志健[1] 张冰[1] HUANG Jinjian;WANG Yu;LIN Zhijian;ZHANG Bing(School of Chinese Materia Medica,Beijing University of Chinese Medicine,Beijing 102488,China)

机构地区：[1]北京中医药大学中药学院,北京102488

出　　处：《世界中医药》2024年第13期1889-1895,共7页World Chinese Medicine

基　　金：国家自然科学基金联合基金项目(U20A20406);国家自然科学基金青年科学基金项目(82104475);国家中医药领军人才支持计划“岐黄学者”项目(10400633210004);张冰全国名老中医药专家传承工作室建设项目(国家中医药人教函[2022]75)。

摘　　要：目的:探讨痛风病高尿酸血症及尿酸盐沉积阶段的证素特点。方法:系统梳理美国国家健康和营养检查调查(NHANES)数据库中与中医症状/体征相对应的调查项目,采集NHANES数据库2007—2018年健康人群、高尿酸血症人群及尿酸盐沉积人群相关中医症状/体征数据进行频率分析,用χ^(2)检验确定不同人群中医症状/体征的变化,并以发生频率为权重,对证素诊断贡献度进行加权求和。结果:从NHANES数据库中确认与中医症状/体征相关的调查项目58个,证素分析结果表明痛风病高尿酸血症及尿酸盐沉积人群的病位证素均集中在肾、脾,病性证素均集中在气虚、湿、痰和阳虚;与健康人群比较,高尿酸血症人群病位证素变化主要为肾、脾、肝,病性证素变化主要为痰、湿、气虚;与高尿酸血症人群比较,尿酸盐沉积人群病位证素变化主要为肾,病性证素变化主要为痰。结论:痛风病高尿酸血症及尿酸盐沉积阶段的主要证素均为肾、脾、痰、湿、气虚,脾肾亏虚可能为高尿酸血症的发病基础,湿痰转化可能为尿酸盐沉积的发病过程。Objective:To explore the characteristics of syndrome elements at the stages of hyperuricemia and urate deposition in gout.Methods:A systematic review of the National Health and Nutrition Examination Survey(NHANES) database was conducted,focusing on survey items corresponding to traditional Chinese medicine(TCM) symptoms/signs.Data on TCM symptoms/signs were collected from the NHANES database for the period 2007 to 2018,covering healthy individuals,those with hyperuricemia,and those with urate deposition.Frequency analysis was performed,and the χ^(2) test was used to determine changes in TCM symptoms/signs among different groups.The contribution of syndrome elements to diagnosis was calculated by weighted summation based on occurrence frequency.Results:Fifty-eight survey items related to TCM symptoms/signs were identified from the NHANES database.Syndrome element analysis showed that the syndrome elements of pathological locations for both hyperuricemia and urate deposition in gout were concentrated in the kidneys and spleen,while those of pathological nature were focused on qi deficiency,dampness,phlegm,and yang deficiency.Compared to the healthy population,individuals with hyperuricemia showed changes in pathological locations mainly in the kidneys,spleen,and liver,and in pathological nature mainly in phlegm,dampness,and qi deficiency.Compared to the hyperuricemia group,those with urate deposition showed changes in pathological locations mainly in the kidneys,and in pathological nature mainly in phlegm.Conclusion:The main syndrome elements in the stages of hyperuricemia and urate deposition in gout are the kidneys,spleen,phlegm,dampness,and qi deficiency.Spleen and kidney deficiency may be the basis for the development of hyperuricemia,while the transformation of dampness into phlegm may be the process underlying urate deposition.

关 键 词：痛风病 高尿酸血症 尿酸盐沉积 中医证候 病性证素 病位证素 美国国家健康和营养检查调查数据库 频率 

分 类 号：R255.6[医药卫生—中医内科学] R228[医药卫生—中医学]