来源：风湿病与关节炎,2022,11（10）:7-10,19.

深圳痛风患者现状分析：一项基于电子化数据管理系统的真实世界研究（临床研究）

谢静静^1,2，何东仪³，姜玉宝²，邱　侠²，张剑勇²

　　【摘　要】目的：收集真实临床背景下深圳地区痛风患者的临床特点和治疗现状。方法：基于上海市光华中西医结合医院所建立的电子化数据管理系统，收集2015年1月28日至2017年11月10日诊治的痛风患者。在不影响医院实际医疗的情况下，精确记录在真实条件下患者的临床特点、诊断、治疗、疗效和安全性情况。结果：①深圳地区51.93%的痛风患者发作有明确诱因，前三大诱因依次为高嘌呤饮食、饮酒、剧烈运动。②患者膳食结构不合理，偏好肉食、海鲜和荤汤类，仅46.02%的患者在急性发作期有低嘌呤饮食，24.78%的患者在间歇期有低嘌呤饮食。③23.42%的患者有合并症，前4位依次为高血压病、糖尿病、骨关节炎、高脂血症。④80.24%的痛风患者急性发作期就诊，最主要的中医证型为湿热蕴结证，占54.87%，其次为脾虚湿阻证、痰瘀互结证。不同证型有其临床特点，湿热蕴结证患者痛风急性发作最多，占67.21%，且患者视觉模拟评分法评分最高，炎症指标C反应蛋白升高最显著；痰瘀互结证患者首诊年龄最大，确诊病程、发作病程均最长，尿酸水平更高。⑤患者血尿酸控制欠佳，仅1/3的患者使用降尿酸药治疗，有74.86%的患者血尿酸水平 > 7 mg·dL^-1，其中 > 9 mg·dL^-1者占35.20%。结论：深圳地区痛风患者在中医辨证及临床特点上有其独特性，通过对真实数据的分析，进一步指导治疗及实行健康管理，为患者带来真实获益的临床价值。

　　【关键词】　痛风；电子医疗数据；真实世界研究；临床特点；深圳

Analysis of the Current Situation of Gout Patients in Shenzhen:An Empirical Study Based on Electronic Data Management System

XIE Jing-jing,HE Dong-yi,JIANG Yu-bao,QIU Xia,ZHANG Jian-yong

　　【ABSTRACT】Objective:To make clear the clinical characteristics and treatment status of gout patients in Shenzhen.Methods:Based on the Electronic Data Management System established by Shanghai Guanghua Hospital of Integrated Traditional Chinese and Western Medicine,the gout patients diagnosed and treated from January 28,2015 to November 10,2017 were collected.The clinical characteristics,diagnosis,treatment,efficacy and safety of patients under real conditions shall be accurately recorded without affecting the actual medical treatment of the hospital.Results:①51.93% of the gout patients in Shenzhen had definite inducements,and the top three inducements were high purine diet,alcohol consumption and strenuous exercise in turn.②The dietary structure of the patients was unreasonable,preferring meat,seafood and meat soup.Only 46.02% of the patients had a low purine diet in the acute attack period,and 24.78% had a low purine diet in the intermittent period.③23.42% of the patients had complications,and the first four were hypertension,diabetes,osteoarthritis and hyperlipidemia.④80.24% of gout patients in Shenzhen went to see a doctor during the acute attack period.The main TCM syndrome type was damp-heat accumulation syndrome,accounting for 54.87%,followed by spleen deficiency and dampness stagnation syndrome,phlegm and blood stasis syndrome.Different syndrome types have their clinical characteristics.The patients with damp-heat accumulation syndrome have the most acute gout attacks,accounting for 67.21%,with the highest VAS score and the most significant increase in the inflammatory index CRP.The patients with phlegm and blood stasis syndrome had the oldest age at the first diagnosis,the longest course of diagnosis and attack,and the higher level of uric acid.⑤The blood uric acid of patients was poorly controlled.Only 1/3 of them were treated with uric acid-lowering drugs.74.86% of them had a blood uric acid level of more than 7 mg·dL^-1,of which 35.20% of them had more than 9 mg·dL^-1 blood uric acid level.Conclusion:The gout patients in Shenzhen have their own uniqueness in TCM syndrome differentiation and clinical characteristics.Through the analysis of real data,further guidance on treatment and implementation of health management can bring the clinical value of real benefits to patients.

　　【Keywords】 gout;electronic medical data;empirical study;clinical characteristics;Shenzhen