化湿降浊饮对脾虚湿阻型老年痛风患者的临床观察

文章信息/Info

• Title:化湿降浊饮对脾虚湿阻型老年痛风患者的临床观察

• 卷期:2024年22卷16期

• 作者:段明亮1，王瑞鑫1，王芳1，张攀科1*，张国胜2

• 1郑州市中医院肾病风湿科，河南郑州，450007；2河南省中医院肾病科，河南郑州，450002

• Author(s):DUAN Mingliang1, WANG Ruixin1, WANG Fang1,ZHANG Panke1*,ZHANG Guosheng2

• 1 Department of Nephropathy and Rheumatology, Zhengzhou Hospital of TCM, Zhengzhou Henan 450007；2 Department of Nephrology, Henan Hospital of TCM,Zhengzhou Henan 450002

• 关键词化湿降浊饮；老年痛风；中医证候

• Keywords:HuaShiJiangZhuo Decoction; Aged patients with gout; TCM syndrome

• 摘要:目的：观察化湿降浊饮治疗脾虚湿阻型老年痛风患者的临床疗效，探讨其中医证候与临床特点的关系。方法：选取郑州市中医院肾病风湿科2020年9月－2021年06月门诊及住院老年痛风患者，纳入70例符合入组标准的受试对象。随机分为两组，观察组35例，给予化湿降浊饮口服，对照组35例，给予非布司他片口服，40mg/天。比较两组在治疗前后的血尿酸及中医体质变化。结果：（1）观察组有效率82.85%，对照组有效率88.57%，两组有效率差异无统计学意义（p＞0.05）。两组治疗后中医证候积分均低于治疗前，差异均有统计学意义（p＜0.05）。观察组治疗后血尿酸显著低于治疗前，差异有统计学意义（p＜0.05）。（2）老年痛风患者中医证候积分与血尿酸水平呈正相关（p＜0.05）。结论：1.化湿降浊饮治疗脾虚湿阻型老年痛风患者的疗效显著。2.老年痛风患者体质可能会引起血尿酸水平波动从而导致痛风的发生发展。                                                                                                                                                                                

• AbstractTo observe the clinical efficacy of HuaShiJiangZhuo Decoction in the treatment of elderly gout patients with dampness resistance of spleen deficiency, and to explore the relationship between TCM syndrome and Clinical features. Methods:A total of 70 elderly outpatients and inpatients with gout in the Department of Nephropathy and Rheumatology,Zhengzhou Hospital of TCM from September 2020 to June 2021 were selected,and 70 subjects meeting the inclusion criteria were included.The patients were randomly divided into observation group(n=35)and control group(n=35).The changes of serum uric acid and TCM constitution before and after treatment were compared between the two groups.Results:(1)The effective rate was 82.85% in the observation group and 88.57% in the control group, there was no significant difference between the two groups(p>0.05).The TCM syndrome scores of the two groups after treatment were lower than those before treatment,and the differences were statistically significant(p<0.05).The serum uric acid of the observation group after treatment was significantly lower than that before treatment,and the difference was statistically significant(p<0.05).(2)There was a positive correlation between TCM syndrome score and serum uric acid level in elderly patients with gout(p<0.05).Conclusion:1.HuaShiJiangZhuo Decoction has a significant effect on elderly gout patients with dampness resistance of spleen deficiency.2.The constitution of elderly patients with gout may cause fluctuations in blood uric acid level,leading to the occurrence and development of gout.

  痛风是一种单钠尿酸盐沉积所导致的晶体相关性关节病，与尿酸排泄减少或生成增多引起的高尿酸血症直接相关，归属代谢性风湿病范畴[1]。2020全球痛风流行病学数据显示，全球痛风发病率逐渐升高并且随着年龄的增长其患病率明显增高［2］。老年人脏器功能减退发病的综合因素较多，给治疗带来了一定的困难。因此积极有效的预防本病的发生、控制病情进展，减少疾病复发和并发症，比单纯在痛风发作时治疗意义更大。