Study On Diagnostic Criterion And Distribution Regularity Of TCM Syndrome In Acute Stage Of Gouty Arthritis

Gout is a common metabolic disease, advantages of treatment of gout in TCM has been a consensus among Chinese experts. To improve the clinical efficacy of treatment in TCM of acute gouty arthritis should first understand the TCM Syndrome Distribution, established scientific TCM diagnostic criteria. The present TCM diagnostic criteria for acute gouty arthritis period still remains in the standard of "TCM Syndrome Diagnostic efficacy standards" 1997. But with the current research of gout, we got deeper understanding in TCM Syndrome Distribution of acute gouty arthritis, there comes more unsuitable in clinical operability of this diagnostic criteria. Therefore, establish a new diagnostic criteria that based on the principle of root and excess diagnostic methods, seems necessary. With the new diagnostic criteria, we can research the TCM Syndrome Distribution of acute gouty arthritis.Objective:To discuss the distribution law of patterns of the acute gout in TCM. Preliminary establish the diagnostic criteria of the patterns of gout.Methods:Inspired by clinical practice, combining the reports of the previous researches, the research comes up the distribution law of patterns of the acute gouty arthritis in TCM by filling expert questionnaires With 2 rows of specialist questionnaire, based on Delphi, trying to suggest the main symptoms and secondary symptoms of gout, and preliminary establish the diagnostic criteria of gout in TCM. The later research prove the conclusions of the expert questionnaires to be right by inspecting clinical cases.Results:After issuing 24 expert questionnaires, the distribution law of patterns of the acute gouty arthritis in TCM came across. The distribution of root deficiency patterns are ranking as:qi deficiency pattern, yin deficiency pattern, the deficiency pattern of both qi and yin, yang deficiency pattern. The viscera relevance ranking as:spleen, kidneys, liver. The distribution of excess patterns are ranking as:damp-heat pattern, accumulated heat pattern, phlegm pattern, blood-stasis pattern.According to the results of previous expert questionnaires, comes the 2 rows specialist questionnaire, based on Delphi, trying to suggest the main symptoms and secondary symptoms of the qi deficiency pattern, yin deficiency pattern, yang deficiency pattern, damp-heat pattern, accumulated heat pattern, phlegm pattern, blood-stasis pattern. And preliminary establish the diagnostic criteria of the patterns that results from the previous expert questionnaires.After doing retrospective research from 44 clinical cases, which diagnose according to the criteria results from the previous specialist questionnaire, the distribution of root deficiency patterns are ranking as:the deficiency pattern of both qi and yin, qi deficiency pattern, yin deficiency pattern, yang deficiency pattern. The distribution of excess patterns are ranking as: damp-heat pattern, accumulated heat pattern, phlegm pattern, blood-stasis pattern.There are a small number of patients do not belong to any patterns, performance with symptoms of exterior pattern.Conclusion:The 2 rows specialist questionnaire, that based on Delphi, establish the diagnostic criteria of qi deficiency pattern, yin deficiency pattern, the deficiency pattern of both qi and yin, yang deficiency pattern, damp-heat pattern, accumulated heat pattern, phlegm pattern and blood-stasis pattern.After the statistics of specialist questionnaire and confirmed by retrospective clinical research, the root deficiency patterns of acute gout are qi deficiency pattern, yin deficiency pattern, the deficiency pattern of both qi and yin, yang deficiency pattern. The excess patterns are:damp-heat pattern, accumulated heat pattern, phlegm pattern, blood-stasis pattern.