来源：风湿病与关节炎,2021,10（2）:1-4.

健脾泄浊法对痛风患者肠道微生态的影响及疗效观察

（临床研究）

孟博文¹，黄传兵²

　　【摘　要】目的：观察健脾泄浊法干预痛风的疗效以及其对肠道微生态的影响，并从肠道菌群方面探讨其作用机制。方法：将60例痛风患者随机分为治疗组和对照组，每组30例。对照组仅用非布司他治疗，治疗组在对照组的基础上加用健脾泄浊方治疗。2组均以4周为1个疗程。观察2组临床疗效，以及治疗前后双歧杆菌、乳酸杆菌、拟杆菌、实验室指标、中医证候等的变化。结果：治疗组临床痊愈9例，显效11例，有效8例，无效2例，总有效率为93.33%；对照组临床痊愈4例，显效8例，有效9例，无效9例，总有效率为70.00%。2组比较，差异有统计学意义（P < 0.05）。治疗后，2组双歧杆菌、乳酸杆菌、拟杆菌、实验室指标、中医证候较治疗前均有改善（P < 0.05或P < 0.01），且治疗组双歧杆菌、乳酸杆菌上升幅度，拟杆菌下降幅度较对照组更显著（P < 0.05或P < 0.01）；治疗组在降低中医证候积分、尿酸、红细胞沉降率方面明显优于对照组（P < 0.01）。结论：健脾泄浊法可明显改善痛风患者肠道微生态，能降低尿酸和炎症指标。

　　【关键词】　痛风；健脾泄浊法；脾虚痰浊痹阻；肠道微生态；临床疗效

Effect of Fortifying the Spleen to Direct the Turbid Downward on Intestinal Microecology in Patients with Gout

MENG Bo-wen,HUANG Chuan-bing

　　【ABSTRACT】Objective:To observe the effect of fortifying the spleen to direct the turbid downward on gout and its effect on intestinal microecology,and to explore its mechanism from the aspect of intestinal flora.Methods:Sixty patients with gout were randomly divided into a treatment group and a control group,30 cases in each group.The control group was only treated with febuxostat,while the treatment group was additionally treated by fortifying the spleen to direct the turbid downward based on the treatment for the control group.Both groups were treated for 4 weeks as a course.The clinical efficacy,changes of bifidobacterium,lactobacillus,bacteroides,laboratory indexes and TCM syndromes were observed.Results:In the treatment group,9 cases were recovered,11 cases were markedly effective,8 cases were effective and 2 cases were ineffective,the total effective rate being 93.33%;while in the control group,4 cases were recovered,8 cases were markedly effective,9 cases were effective and 9 cases were ineffective,the total effective rate being 70.00%.The difference between the two groups was statistically significant（P < 0.05）.After treatment,bifidobacterium,lactobacillus,bacteroides,laboratory indexes and TCM Syndromes of the two groups were improved compared with those before treatment（P < 0.05 or P < 0.01）.The increase of bifidobacterium and lactobacillus,and the decrease of bacteroides in the treatment group were more significant than those in the control group（P < 0.05 or P < 0.01）.The treatment group was significantly better than the control group in reducing TCM syndrome score,uric acid and erythrocyte sedimentation rate（P < 0.01）.Conclusion:Method of fortifying the spleen to direct the turbid downward can significantly improve the intestinal microecology in patients with gout,and is better than the method used in the control group in reducing uric acid and inflammation.

　　【Keywords】 gout;method of fortifying the spleen to direct the turbid downward;spleen

 deficiency phlegm turbid obstruction;intestinal microecology;clinical efficacy