The Research Of Gout TCM Syndrome Distributy And Differentiation Factor

Objective:Discussion on the distribution of TCM syndromes and characteristics of gout,establish the main syndromes and syndrome differentiation factors, to explore the correlation between the check indexes with various syndrome types, so as to provide the basis for clinical diagnosis and treatment of gout standardization.Methods:By designing of the clinical questionnaire, collected the information of gout clinical cases, which include of the patient’s sex, age, course of disease, blood uric acid,creatinine, urea nitrogen, TC, TG, blood routine and other relevant laboratory datas.Besides, the TCM tongue and pulse and other diagnostic information was included.Using "The Standard of TCM syndrome diagnosis and curative effect " to discriminate the syndrome differentiation;using SPSS19.0 statistical analysis software, to count enumeration data by frequency analysis and Logistic two classification analysis, to cout measurement data by comparison among groups.Then analyzed the correlation between TCM Syndrome Distribution and laboratory analysis of gout.Result:1 The oncoming characteristics: The incidence rate of women is far lower than the male,the male is 19 times that of women. The age of onset is between 30-69 years old. The course of disease between 1-5 years accounted for the largest proportion(34%),which including 34 cases.The main inducement of gout attack were high Purine diet, drinking and fatigue. The main complicating diseases of gout were hyperlipidemia, hypertension,fatty liver and diabetes.2 Characteristics of symptoms: The main pain position of gout patients is the first metatarsophalangeal joint, and joint swelling, heat, pain, red skin were the first symptom. On the physical examination, there were 27 cases who were found to have uratoma, accounting for 27%, and 9 cases occurred in the metatarsophalangeal joint,accounting for the highest Percentage(33.3%).3 The characteristics of syndromes :3.1 One hundred cases of gout patientsthe were discriminated into 4 types, Damp and hot accumulated knot syndromes, Phlegm turbidity block syndromes, Stasis hot block syndromes and Liver-kidney yin deficiency syndrome.The order of the types’ proportion was as follows: Damp and hot accumulated knot syndromes,Phlegm turbidity block syndromes, Liver-kidney yin deficiency syndrome, Stasis hot block syndromes.3.2 Four syndromes of course compared significant differences(P<0.05), in which the patients’ course of Liver-kidney yin deficiency syndrome was longer than other types(P<0.05), that of Damp and hot accumulated knot syndromes was shorter(P<0.05); the age of onset of various syndromes had differences, the age of onset of Liver-kidney yin deficiency syndrome was older than that of Damp and hot accumulated knot syndromes(P<0.05).3.3The UA of 4 kinds of syndromes were higher than the normal, and the UA of Damp and hot accumulated knot syndromes was higher than that of other syndromes(P <0.05); the Cr of Liver-kidney yin deficiency syndrome was significantly higher than that of other types, the comparation was statistically significant(P < 0.05), the BUN of Liver-kidney yin deficiency syndrome was significantly different with other types(P<0.05); the TG and TC of various syndromes were in the abnormal range, but there was no difference(P>0.05); the h-CRB and ESR of 4 types had no difference(P >0.05);in the blood routine examination, blood Platelet values of Damp and hot accumulated knot syndromes was significantly different with Phlegm turbidity block syndromes and Stasis hot block syndromes(P<0.05), there was no difference in the other index(P>0.05).4 The main dialectical elements of syndromes of Damp and hot accumulated knot syndromes: using frequency analysis to analyze of the symptoms, tongue and pulse of Damp and hot accumulated knot syndromes.Joint pain, swelling, skin color red fever,thirsty, upset, red tongue and yellow greasy moss symptoms were the whose the frequency was not less than 50%. Two classification by Logistic analysis showed,according to the symptoms that coefficient,joint swelling, joint, joint glowing skin colorred,upset and yellow greasy moss were the main syndrome differentiation factors for Damp and hot accumulated knot syndromes.5 The treatment principle of gout: According to TCM theory, aiming at the main syndromes,treat the syndromes by clearing heat and resolving dampness,treat essence by benefiting liver,kidney and spleen.Conclusions:1 Getting the pathogenesis by the syndromes, damp turbidity was the main pathogenesis of gout,and liver,kidney and spleen deficiency was the essence of gout.2 Syndrome distribution of gout was Damp and hot accumulated knot syndromes >Phlegm turbidity block syndromes>Liver-kidney yin deficiency syndrome>Stasis hot block syndromes, and most gouty arthritis patients’ syndrome was Damp and hot accumulated knot syndromes.3 The main symptoms of gout is Damp and hot accumulated knot syndromes, the main syndrome differentiation factors were joint swelling, joint, joint glowing skin color red,upset and yellow greasy moss.4 Characteristics of the Pathogenesis of gout is deficiency in origin and excess in superficiality. Treating the syndromes of gout by clearing heat and resolving dampness,treat the essence by benefiting liver,kidney and spleen,and change the medicine when the syndrome change.5 Cr and BUN were expected to become the objective standard indicators of Liver-kidney yin deficiency syndrome, and abnormal blood fat was a major risk factor for gout.