来源：风湿病与关节炎,2019,8（6）:9-12.

深圳地区急性期痛风患者不同中医证型的临床特点分析

（临床研究）

谢静静¹，宁　静²，张燕英¹，贾二涛¹，张剑勇¹

　　【摘　要】目的：了解深圳地区急性期痛风患者不同中医证型的临床指标及临床特点，分析其合并症情况。方法：对急性期痛风患者进行中医辨证分型，并收集临床特征，合并高体质量、高血压、高血糖、高脂血症、高黏血症情况，及血尿酸、血肌酐、红细胞沉降率、C-反应蛋白等实验室指标，进行对比分析。结果：共纳入215例急性期痛风患者，其中湿热蕴结证115例（56.28%），痰瘀痹阻证62例（26.05%），脾虚湿阻证32例（14.88%），寒湿痹阻证6例（2.79%）。痰瘀痹阻证患者病程最长，与湿热蕴结证及脾虚湿阻证比较，差异有统计学意义（P < 0.05），且合并痛风石比例最大。脾虚湿阻证患者血尿酸水平最高，痰瘀痹阻证患者血肌酐水平最高，与其他证型比较，差异有统计学意义（P < 0.05）；各证型C-反应蛋白和红细胞沉降率比较，差异无统计学意义（P > 0.05）。痛风患者有合并症者141例（65.58%），其中合并高血压、高脂血症最多；且不同中医证型患者合并症存在差异，湿热蕴结证多合并高血压，痰瘀痹阻证多合并高脂血症，差异有统计学意义（P < 0.05）。结论：深圳地区痛风患者急性期以湿热蕴结证和痰瘀痹阻证为主；脾虚湿阻证及痰瘀痹阻证患者肾功能受损更为严重。痛风患者大多存在合并症，不同证型患者在治疗方面应有侧重。

　　【关键词】　痛风；急性期；中医证型；合并症；血尿酸；血肌酐

Clinical Characteristics of Acute Gout Patients with Different TCM Syndromes in Shenzhen

XIE Jing-jing,NING Jing,ZHANG Yan-ying,JIA Er-tao,ZHANG Jian-yong

　　【ABSTRACT】Objective:To understand the clinical indicators and characteristics of acute gout patients with different TCM syndromes in Shenzhen,and to analyze their complications.Methods:TCM syndrome differentiation and typing of acute gout patients were carried out,collecting and analyzing their clinical characteristics,complicating conditions such as high body mass,hypertension,hyperglycemia,hyperlipidemia,hyperviscosity,and laboratory indicators such as serum uric acid,serum creatinine,erythrocyte sedimentation rate and C-reactive protein.Results:Two hundred and fifteen cases were included,including 115 cases（56.28%）of damp-heat accumulation syndrome,62 cases（26.05%）of phlegm-blood stasis syndrome,32 cases（14.88%）of spleen deficiency and dampness obstruction syndrome,and 6 cases（2.79%）of cold-dampness syndrome.Compared with those with damp-heat accumulation syndrome and spleen deficiency and dampness obstruction syndrome,patients with phlegm-blood stasis obstruction syndrome had the longest course of disease,with a significant difference（P < 0.05）,and the high proportion of gout stone.The level of serum uric acid was the highest in patients with spleen deficiency and dampness obstruction syndrome,and the level of serum creatinine was the highest in those with phlegm-blood stasis syndrome,with a significant difference（P < 0.05）compared with other groups.There was no significant difference in erythrocyte sedimentation rate and C-reactive protein（P > 0.05）.There were 141 cases（65.58%）of gout patients with complications,most of which are hypertension and hyperlipidemia;and there were differences in complications among different TCM syndromes,among which those with damp-heat accumulation syndrome were mostly complicated with hypertension,and those with phlegm-blood stasis syndrome were mostly complicated with hyperlipidemia,with a statistical significance（P < 0.05）.Conclusion:Damp-heat accumulation syndrome and phlegm-blood stasis syndrome are the main symptoms in acute gout patients in Shenzhen.The kidney function of patients with spleen deficiency and dampness obstruction syndrome and phlegm-blood stasis syndrome are more seriously impaired.Gout patients mostly have complications,so patients with different syndromes should be treated differently.

　　【Keywords】 gout;acute;TCM syndromes;complications;serum uric acid;serum creatinine