老年痛风性关节炎发病危险因素及其中医证候分布特点分析  

Analysis on Risk Factors of Onset of Elderly Gouty Arthritis and Distribution Characteristics of TCM Syndromes

作　　者：王婕[1] 张晓东 鲍凤和 WANG Jie;ZHANG Xiaodong;BAO Fenghe(Tianjin Hospital,Tianjin 300050,China)

机构地区：[1]天津医院,天津300050

出　　处：《辽宁中医杂志》2024年第12期82-85,共4页Liaoning Journal of Traditional Chinese Medicine

摘　　要：目的分析探讨老年痛风性关节炎(gouty arthritis,GA)发病危险因素及其中医证候分布特点。方法以2017年5月—2019年5月天津医院收治的40例老年GA患者作为研究对象,同时纳入40例无症状老年高尿酸血症(hyperuricemia,HUA)患者作为对照,收集两组患者身体质量指数(body mass index,BMI)、烟酒史、日饮水量等一般资料,以及总胆固醇(total cholesterol,TC)、总胆红素(total bilirubin,TBil)、血小板计数(platelet count,PLT)、尿酸(uric acid,UA)等血清指标并进行对比,运用Logistic回归分析法分析老年GA发病危险因素。同时分析老年GA患者中不同中医证候人数分布与占比,并比较不同证候老年GA患者间尿UA水平、病程以及骨质侵蚀情况差异。结果两组患者性别、BMI、饮酒史、日饮水量、TC、PLT、UA水平差异具有统计学意义(P<0.05)。Logistic回归分析显示,男性、日饮水量<1000 mL、PLT>300×10^(9)/L、UA>460μmol/L是老年GA发病的独立危险因素。40例老年GA患者最常见单一证候为湿热蕴结证,占比25.00%(10/40),最常见复合证候为湿热蕴结痰浊阻滞证,占比15.00%(6/40),不同证候间UA水平、病程、是否伴骨质侵蚀差异具有统计学意义(P<0.05),其中湿热蕴结痰浊阻滞证、湿热蕴结证、瘀热阻滞证UA水平高于其他证候(P<0.05),肝肾阴虚证、湿热蕴结肝肾阴虚证、痰浊阻滞肝肾阴虚证病程时间高于其他证候(P<0.05),痰浊阻滞、湿热蕴结痰浊阻滞伴骨质侵蚀占比高于其他证候,差异无统计学意义(P>0.05)。结论男性、日饮水量<1000 mL、PLT>300×10^(9)/L、UA>460μmol/L是老年GA发病的独立危险因素,老年GA患者中单一证候以湿热蕴结证为主,复合证候以湿热蕴结痰浊阻滞证为主,不同证候间UA水平、病程、是否伴骨质侵蚀差异均有统计学意义。Objective To analyze the risk factors of onset of elderly gouty arthritis(GA)and the distribution characteristics of TCM syndromes.Methods Forty elderly patients with GA admitted to the hospital from May 2017 to May 2019 were selected as the study subjects,and 40 elderly patients with asymptomatic hyperuricemia(HUA)were enrolled as controls.The general data such as body mass index(BMI),tobacco and alcohol history and daily water intake and serum indicators such as total cholesterol(TC),total bilirubin(TBil),platelet count(PLT)and uric acid(UA)were collected and compared between both groups,and the risk factors of onset of elderly GA were analyzed by Logistic regression analysis.The distribution status and proportions of elderly GA patients with different TCM syndromes were analyzed,and the differences in UA level,disease course and bone erosion were compared among elderly GA patients with different syndromes.Results There were statistically significant differences in gender,BMI,drinking history,TC,PLT and UA between the two groups of patients(P<0.05).Logistic regression analysis showed that male,daily water intake<1000 mL,PLT>300×10^(9)/L and UA>460μmol/L were independent risk factors for the onset of elderly GA.Among the 40 elderly GA patients,the most common single syndrome was damp-heat accumulation syndrome,accounting for 25.00%(10/40),and the most common complex syndrome was the syndrome of damp-heat accumulation with phlegm-turbid obstruction,accounting for 15.00%(6/40).There were statistical differences in UA level,disease course and presence or absence of bone erosion among different syndromes(P<0.05).The UA level in patients with syndrome of dampness-heat accumulation with phlegm-turbid obstruction,dampness-heat accumulation syndrome and blood stasis-heat obstruction syndrome was higher than that in patients with other syndromes(P<0.05),and the disease course in patients with liver-kidney Yin deficiency syndrome,syndrome of dampness-heat accumulation with liver-kidney Yin deficiency and syndrome of phl

关 键 词：老年痛风性关节炎 危险因素 血小板计数 中医证候 尿酸 

分 类 号：R274[医药卫生—中医骨伤科学]