The Clinical Study Of Gout Traditional Chinese Medicine Syndromes And Patient Factors With Clinical Characteristics

ObjectiveThrough a TCM Syndrome typing of 160 cases of gout patients collected by the Shenzhen Clinical Medical College Affiliated to Guangzhou University of Traditional Chinese Medicine, this study has explored the correlation between TCM Syndrome of gout and Patients influence factors along with the clinical characteristics and regularity of TCM Syndrome of gout, establishing a unified specification of TCM Syndrome of gout to play a guiding role in the etiology and clinical prevention, so as to effectively reduce the incidence and recurrence rate of gout.MethodsThis study uses epidemiological cross-sectional survey research methods to design clinical questionnaire and collect primary gout patients meet the diagnostic criteria of Chinese and Western medicine. Two or more attending doctor or above are needed to do the syndromes typification of distribution, typification unanimously ones are put in a group, general information of patients with the syndrome (gender, age, BMI, episode age, course of disease, predisposing factors, etc.), the symptom index (starting position, tophi, joint deformities, etc.), complication, (hyperlipidemia, hypertension, high blood sugar or type 2 diabetes, fatty liver, gall bladder and ureteral stone) and laboratory parameters (serum uric acid, creatinine, total cholesterol, triglycerides, HDL, LDL, fasting plasma glucose, erythrocyte sedimentation rate, C-reactive protein) are investigated respectively. Establish a database with EpiData3.0, by SPSS19.0 software for statistical analysis. Do descriptive analysis, frequency analysis and chi-square test in the database count data, measurement data using analysis of variance shows P＜O.05, which indicate it has statistical significance.Results1. Clinical characters:The prevalence of gout is male:female=52.3:1, predilection age is 31-40 years, mean episode age is 38.17±11.89 years, overweight and obese patients have 112 cases (70%), the number of people who engaged in intellectual occupations is up to 102 cases (63.8%), people with education of high school and higher have 133 cases (83.1%).2. History and clinical symptoms:The shortest course of disease is two weeks, and the longest is 30 years, the average duration is 6.65±5 79 years, which 1-5 years and 5-10 years are most common, the proportion is 31.3% and 30%, relationship between course of disease and TCM Syndrome analysis shows P＜0.01, which has statistically significant, the longest course of disease is phlegm and blood blockage type, followed are spleen dampness>heat Accumulation>liver and kidney; 39 patients have a family history (24.4%); predisposing factors are high-purine diet>drinking>exertion>chill>trauma; starting positions are unilateral plantar toe joint> unilateral ankle> unilateral dorsal> knee joint) unilateral heel> bilateral plantar toe joint, bilateral dorsal, double knee> bilateral ankle>unilateral wrist; associated with fatty liver 61 cases (38.13%), hyperlipidemia 49 cases (30.63%), gall bladder and ureteral stone 36 cases (22.5%), hypertension 29 cases (18.13%), high blood sugar or diabetes 14 cases (8.75%), the patient’s comorbidities and TCM syndromes chi-square test shows P＞0.05, which has no statistically significant; 40 patients in this survey has tophi (25%),22 patients with joint deformities (13.75%), relationship among tophi, joint deformity and TCM syndromes chi-square test shows P＜0.05, which has statistically significant, phlegm blockage type is most easily to form tophi, joint deformity.3. Laboratory indicators:Blood uric acid abnormal has 128 cases (80%), minimum 228umol/L, maximum 939umol/L, mean 5.92±175.86umol/L, relationship of serum uric acid level and TCM Syndromes by mono-ANOVA analysis shows P＜0.05, which has statistically significant, heat accumulation syndromes has the maximum blood uric acid mean, followed by Blockage of phlegm and blood type, spleen dampness type, liver and kidney; abnormal serum creatinine have 37 cases (23.13%), minimum 45umol/L, maximum 274umol/L, mean 98.48±29.44umol/L, Tamhane’s T2 test shows P＜O.05, which has statistically significant, mean serum creatinine liver-kidney> Blockage of Phlegm>heat Accumulation>spleen dampness; Triglyceride (TG) abnormal has 108 cases (67.5%), total cholesterol (TC) abnormal has 112 cases (70%), high density lipoprotein (HDL) abnormalities has 43 cases (26.9%), low density lipoprotein (LDL) abnormalities has 58 cases (36.3%), fasting blood glucose (FBG) abnormal has 59 cases (36.88%), erythrocyte sedimentation rate (ESR) abnormal has 122 cases (76.25%) and C- reactive protein (CRP) abnormal has 116 cases (72.5%), the relationship among blood lipids 4, FBG, ESR, CRP and TCM Syndrome gout by ANOVA shows P>0.05, which has no significant significance.Conelusions1. Primary gout of syndromes have certain regularity, study about 160 cases of primary gout TCM type heat Accumulation is most common, liver and kidney yin deficiency type is most rare, Blockage of phlegm and blood type more than spleen dampness type.2. The present study shows that blockage Phlegm type course is the longest, and most likely to the form tophi and joint deformities. 3. The present study suggests that uric acid, serum creatinine values can be used as dialectical objective indicator of heat Accumulation Type gout and liver and kidney.4. The study also shows that patients with gout have high probability of lipid 4 (TG, TC, HDL, LDL) and asting glucose abnormal.