岭南地区痛风危险因素与中医证型相关性分析
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摘要
目的:探讨痛风危险因素与中医证型的关系,总结痛风证型分布规律。方法:通过收集痛风患者年龄、病程、BMI指数、证型、合并症等资料,应用统计学方法分析各要素与中医证型的相关性。结果:(1)痛风中医证型分5型,其中湿热蕴结证比例最高(41.9%)。年龄在不同证型的差异无统计学意义(P>0.05),病程、BMI指数在不同证型的差异有统计学意义(P<0.05)。(2)高嘌呤饮食嗜好者(63.9%)、家族史(24.4%)、饮酒史(18.6%)三者在不同证型的差异无统计学意义(P>0.05)。(3)合并高脂血症50例(29.1%),合并高血压24例,高血糖9例。三高在不同证型的分布有明显差异(P<0.01)。结论:湿热蕴结证是岭南地区痛风常见证型:5种证型均离不开湿、热、瘀、虚的病机特点。同一患者随着病程增加,BMI指数改变,均可引起病机的变化,证型随之变化。临床重视痛风合并症有助于判断病机发展及证型规律,在治疗原发病同时也能对其合并症能起到很好的作用。
Objective:To explore the correlation of the gout risk factors with TCM syndrome and Conclude gout syndrome regularity.Methods:By collecting gout patients' age,course of disease,BMI,syndrome type,complication etc,the relationship of the gout risk factors and TCM syndrome were analyzed using statistical methods.Results:(1)TCM syndrome of gout includs five types,and the most is damp-heat accumulation(41.9%).Among the five syndromes,age showed no significant differences(P >0.05),while course of disease and BMI showed significant differences(P<0.05).(2)High purine diet habits(63.9%),family history(24.4%) and drinking history(18.6%) showed no significant differences among the syndromes(P>0.05).(3) There were 50 cases combined hyperlipidemia(29.1%),24 cases combined hypertension,and 9 cases combined hyperglycemia.These three complications showed significant differences among the syndromes(P<0.01).Conclusion:Damp-heat accumulation was the most common syndrome in Lingnan area.The five syndromes were inseparable from the pathogenesis characteristics of dampness,heat,blood stasis and deficiency.Syndromes could change when the course of disease or BMI changed.To attach importance to gout complications could help determine pathogenesis and syndrome type,and cure the complication while curing the primary disease.
Objective:To explore the correlation of the gout risk factors with TCM syndrome and Conclude gout syndrome regularity.Methods:By collecting gout patients' age,course of disease,BMI,syndrome type,complication etc,the relationship of the gout risk factors and TCM syndrome were analyzed using statistical methods.Results:(1)TCM syndrome of gout includs five types,and the most is damp-heat accumulation(41.9%).Among the five syndromes,age showed no significant differences(P >0.05),while course of disease and BMI showed significant differences(P<0.05).(2)High purine diet habits(63.9%),family history(24.4%) and drinking history(18.6%) showed no significant differences among the syndromes(P>0.05).(3) There were 50 cases combined hyperlipidemia(29.1%),24 cases combined hypertension,and 9 cases combined hyperglycemia.These three complications showed significant differences among the syndromes(P<0.01).Conclusion:Damp-heat accumulation was the most common syndrome in Lingnan area.The five syndromes were inseparable from the pathogenesis characteristics of dampness,heat,blood stasis and deficiency.Syndromes could change when the course of disease or BMI changed.To attach importance to gout complications could help determine pathogenesis and syndrome type,and cure the complication while curing the primary disease.
引文
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[7]邸若红,李永建,童谣.湿热证“正盛邪实”病机浅探[J].中医药学刊,2004,22(1):106-109.
[8]张琳,闫雅更,董凤丽,等.饮食饮酒及肥胖对无症状高尿酸血症发生痛风的影响[J].军医进修学院学报,2012,33(2):135-137.
[9]Yoo H G,Lee S I,Chae H J,et al.Prevalence of insulin resistance and metabolic syndrome in patients with gouty arthritis[J].Rheumatol Int,2011,31(4):485-491.
[10]赵书锋,郝贤,王世勇.朱丹溪痛风学说古今论[J].中医药学报,2008,35(1):6-7.
[11]周兆伟,李长贵.原发性高尿酸血症及痛风相关易患基因的研究进展[J].医学综述,2015(13):2305-2308.
[12]张冰清.遗传背景对痛风和/或高尿酸血症影响的初探[D].北京:北京协和医学院,2013.
[13]侯蕾蕾,赵心童,贺圣文,等.痛风遗传易感基因及相关危险因素的病例对照研究[J].中国慢性病预防与控制,2013,21(6):663-665.
[14]查旭雯,徐建华.痛风及高尿酸血症患者血清脂联素水平变化及相关因素分析[J].安徽医学,2014,35(11):1486-1489.
[15]宋丹丹,张川,杨杰,等.高血尿酸与胰岛素抵抗及血脂指标的相关性研究[J].中国实验诊断学,2014,18(2):302-304.
[2]Grassi D,Ferri L,Desideri G,et al.Chronic Hyperuricemia,Uric Acid Deposit and Cardiovascular Risk[J].Curr Pharm Des,2013,19(13):2432-2438.
[3]Fodor D,Nestorova R,Vlad V,et al.The place of musculoskeletal ultrasonography in gout diagnosis[J].Med Ultrason,2014(16):336-344.
[4]张华东,王梓淞,王振兴,等.析“高梁之变”,足生痛风[J].中国中医基础医学杂志,2012,18(10):1075-1076.
[5]安娜,任方,王效影.痛风患者对饮食控制认知行为调查及影响因素研究[J].西南国防医药,2013,41(3):263-266.
[6]常宇.朱良春匡正对痛风病机的认识[N].中国中医药报,2013,10-17(5).
[7]邸若红,李永建,童谣.湿热证“正盛邪实”病机浅探[J].中医药学刊,2004,22(1):106-109.
[8]张琳,闫雅更,董凤丽,等.饮食饮酒及肥胖对无症状高尿酸血症发生痛风的影响[J].军医进修学院学报,2012,33(2):135-137.
[9]Yoo H G,Lee S I,Chae H J,et al.Prevalence of insulin resistance and metabolic syndrome in patients with gouty arthritis[J].Rheumatol Int,2011,31(4):485-491.
[10]赵书锋,郝贤,王世勇.朱丹溪痛风学说古今论[J].中医药学报,2008,35(1):6-7.
[11]周兆伟,李长贵.原发性高尿酸血症及痛风相关易患基因的研究进展[J].医学综述,2015(13):2305-2308.
[12]张冰清.遗传背景对痛风和/或高尿酸血症影响的初探[D].北京:北京协和医学院,2013.
[13]侯蕾蕾,赵心童,贺圣文,等.痛风遗传易感基因及相关危险因素的病例对照研究[J].中国慢性病预防与控制,2013,21(6):663-665.
[14]查旭雯,徐建华.痛风及高尿酸血症患者血清脂联素水平变化及相关因素分析[J].安徽医学,2014,35(11):1486-1489.
[15]宋丹丹,张川,杨杰,等.高血尿酸与胰岛素抵抗及血脂指标的相关性研究[J].中国实验诊断学,2014,18(2):302-304.