芪茯化浊方治疗脾肾阳虚痛风的回顾性队列研究  

A Retrospective Cohort Study on the Qifu Huazhuo Recipe for the Treatment of Gout Due to Spleen and Kidney Yang Deficiency

作　　者：张磊[1] 黄闰月 欧爱华[3] 李文杰[1] 郑育涛 陈嘉杰 张玉婷[1] 储永良[1] 宁静 沈正东 ZHANG Le;HUANG Runyue;OU Aihua;LI Wenjie;ZHENG Yutao;CHEN Jiajie;ZHANG Yuting;CHU Yongliang;NING Jing;SHEN Zhengdong(Guangdong Provincial Hospital of Traditional Chinese Medicine,LI Jiren Academic Experience Inheritance Studio,Guangdong Zhuhai 519015,China;Guangdong Provincial Key Laboratory of Clinical Research on TCM Syndrome,Guangdong Guangzhou 510120,China;Guangdong Provincial Hospital of Traditional Chinese Medicine,Guangdong Guangzhou 510120,China;Zhuhai Hospital of Integrated Traditional Chinese and Western Medicine,Guangdong Zhuhai 519020,China)

机构地区：[1]广东省中医院珠海医院李济仁学术经验传承工作室,广东珠海519015 [2]广东省中医证候临床研究重点实验室,广东广州510120 [3]广东省中医院,广东广州510120 [4]珠海市中西医结合医院,广东珠海519020

出　　处：《中医药临床杂志》2024年第8期1573-1577,共5页Clinical Journal of Traditional Chinese Medicine

基　　金：珠海市科技计划医疗卫生项目(NO.ZH2202200018HJL);李济仁学术经验传承工作室(NO.DF02201);广东省中医院院内专项课题(NO.YN2019ML15);广东省科技计划项目(NO.2023B1212060063)。

摘　　要：目的:探究芪茯化浊方治疗脾肾阳虚痛风的临床疗效和安全性。方法:收集2020年9月—2022年8月广东省中医院风湿科门诊和广东省中医院珠海医院风湿血液科门诊就诊的脾肾阳虚痛风患者,以是否服用芪茯化浊方为暴露因素,分为对照组和治疗组。收集患者一般资料,比较2组在治疗后尿酸变化率,尿酸达标率和安全指标的差异。通过聚类分析法探究治疗组的优势人群。结果:共纳入139例痛风患者,其中对照组62例(44.6%),治疗组77例(55.4%),治疗组尿酸变化率明显低于西药组;治疗组尿酸达标率优于西药组,差异有统计学意义。治疗组治疗后肾功能异常患者较治疗前减少,但无统计学差异。聚类分析提示中西药组对平均年龄在48.5岁,平均病程在2.42年的痛风有较好的降尿酸效果。结论:对使用西药降尿酸药物尿酸控制不佳的脾肾阳虚患者,联合芪茯化浊方是一个有效的强化治疗手段;芪茯化浊方联合降尿酸药物更适合年龄在48岁左右,病程较短的脾肾阳虚痛风患者。Objective: To explore the clinical efficacy and safety of Qifu Huazhuo prescription in the treatment of gout due to spleen and kidney yang deficiency. Methods: Patients with gout due to spleen and kidney yang deficiency who visited the outpatient clinic of the Department of Rheumatology of Guangdong Provincial Hospital of Traditional Chinese Medicine and the outpatient clinic of the Department of Rheumatology and Hematology of Guangdong Provin-cial Hospital of Traditional Chinese Medicine Zhuhai from September 2020 to August 2022 were enrolled and divided into a treatment group and a control group based on whether they took Qifu Huazhuo prescription as the exposure fac-tor. The general data of the patients were collected, and the differences in uric acid change rate, uric acid compliance rate and safety indicators between the two groups after treatment were compared. Cluster analysis was used to explore the dominant population in the treatment group. Results: A total of 139 gout patients were included, including 62 cases (44.6%) in the control group and 77 cases (55.4%) in the treatment group. The uric acid change rate in the treatment group was significantly lower than that in the western medicine group;the uric acid compliance rate in the treatment group was better than that in the western medicine group, and the difference was statistically significant. The number of patients with abnormal renal function in the treatment group decreased after treatment compared with before treat-ment, but there was no statistical difference. Cluster analysis showed that the Chinese and Western medicine group had a better uric acid-lowering effect on gout patients with an average age of 48.5 years and an average disease course of 2.42 years. Conclusion: For patients with spleen and kidney yang deficiency who have poor uric acid control using Western medicine, Qifu Huazhuo prescription combined with uric acid-lowering drugs is an effective intensive treatment meth-od;Qifu Huazhuo prescription combined with uric acid-lowering dru

关 键 词：痛风 芪茯化浊方 脾肾阳虚 回顾性队列研究 

分 类 号：R589.7[医药卫生—内分泌]