| Objective:In this study,the clinical data and laboratory indicators of patients with primary gout were retrospectively analyzed to explore the clinical characteristics of gouty arthritis due to damp-heat accumulation and stagnation of blood stasis and heat,as well as the inflammatory and infectious indicators,in order to provide a theoretical basis for the dialectical diagnosis and prognosis evaluation of the combination of disease and syndrome of gouty arthritis.Methods:A total of 120 inpatients with gouty arthritis in the Department of Rheumatology,Affiliated Hospital of Jiangxi University of Chinese Medicine from December 2020 to October 2022 were screened out as damp-heat accumulation type(88 cases)and stasis-heat block type(32cases)according with Chinese medicine classification.The inflammation and infection indicators,blood uric acid,serum creatinine,urea nitrogen,total cholesterol,triglycerides and other relevant laboratory indicators in the serological tests of patients were recorded.A database including name,gender,age,course of disease,TCM syndrome type,WBC,%NEUT,#NEUT,CRP,ESR,SAA,PCT,TC,TG,uric acid,creatinine,urea,IL-1β,IL-6,IL-17,TNF-α,and IFN-γ was constructed,and the relationships among the items in the database were analyzed from different angles.Results:1.Comparison of general data between the two groups: There were significant differences in age between the two types of gout(P <0.05),the type of stasis and heat retardation >the type of damp-heat accumulation;There was no significant difference in the course of disease between the two gout syndromes(P >0.05).The difference in attack sites between the two gout syndromes was statistically significant(P <0.01).The difference in the presence of tophi in two types of gout was statistically significant(P <0.01),but not statistically significant from the location of tophi(P >0.05).2.Comparison of the inflammatory and infection indexes between the two groups: The differences of IL-1β,IL-6,and TNF-α in gout were statistically significant(P <0.05),while the differences of CRP,ESR,IL-17,and IFN-γ were not statistically significant(P >0.05).The differences of PCT between the two gout syndromes were statistically significant(P <0.01),while the differences of WBC,%NEUT,#NEUT,and SAA were not statistically significant(P >0.05).3.The comparison of other related indicators between the two groups showed that the differences in serum uric acid and creatinine of the two gout syndrome types were not statistically significant(P >0.05),and the difference in urea nitrogen was statistically significant(P <0.05).The difference of TG between the two gout syndromes was not statistically significant(P >0.05),but the difference of TC was statistically significant(P <0.05).4.Comparison between inflammatory and infection indexes: IL-1βpositively correlated with IL-6(r=0.813,P <0.01),positively correlated with TNF-α(r=0.831,P <0.01),and positively correlated with IL-17(r=0.186,P <0.05);IL-6 positively correlated with TNF-α(r=0.938,P <0.01);IL-17 positively correlated with IFN-γγ(r=0.209,P <0.05);WBC was positively correlated with #NEUT(r=0.428,P <0.01),positively correlated with %NEUT(r=0.331,P <0.01),and positively correlated with CRP(r=0.243,P <0.01).%NEUT positively correlated with #NEUT(r=0.422,P <0.01).5.Comparison of other indicators with those of inflammation and infection: Uric acid was positively correlated with IL-1β,IL-6,and TNF-α(P <0.01);Creatinine positively correlated with SAA(r =0.224.P <0.05).Urea nitrogen positively correlated with SAA(r=0.235.P <0.01),and positively correlated with IL-1β(r =0.002.P <0.05).TC had a negative correlation with SAA(r =-0.189,P <0.05)and a positive correlation with TG(r=0.216,P <0.05).TG had a negative correlation with CRP(r =-0.185,P <0.05),SAA(r =-0.155,P <0.05),and UA(r=0.241,P <0.01).6.Comparison of general conditions with other indicators: The course of disease was positively correlated with creatinine(r=0.042,P <0.05),and negatively correlated with TG(r =-0.212,P <0.05);Age positively correlated with creatinine(r=0.256,P <0.01),urea nitrogen(r=0.252,P <0.01).Conclusion:The combination of inflammatory and infectious indicators with symptoms,signs and other laboratory indicators can optimize the differentiation of TCM syndromes and the judgment of prognosis and outcome to a certain extent for early prevention.1.GA traditional Chinese medicine syndrome is related to the attack site and the existence of gout stone.The damp-heat accumulation syndrome is more likely to cause swelling and pain in the first metatarsophalangeal joint during the attack,and the stasis-heat stagnation syndrome is more likely to form scattered gout stone.2.The positive expression rates of IL-1,IL-6 and TNF-in serum of patients with two GA syndromes were high,and the three interacted and correlated with the syndromes.The stasis and heat syndrome was more likely to cause the increase of IL-6 and TNF-in serum.3.The positive expression rates of WBC,PCT and neutrophils in patients with two GA syndromes were low.PCT was related to the syndrome,and the stasis and heat syndrome was more likely to cause the increase of PCT,but the increase level was not high.4.Two syndromes of GA are related to urea nitrogen and total cholesterol level,while the syndrome of stasis and heat retardation is more likely to cause the increase of urea nitrogen and cholesterol level.5.There was a positive correlation between uric acid level and inflammatory factors,and uric acid should be actively controlled. |
PDF Full Text Request