| Hyperuricemia has become a high incidence of purine metabolic disease worldwide.It is an independent risk factor for many metabolic diseases,chronic kidney diseases,cardiovascular diseases and stroke,which has gradually attracted people's attention.With regard to its treatment,modern medicine mainly uses drugs that inhibit uric acid source and increase uric acid excretion,but its toxicity and adverse reaction are obvious.Long term use causes toxic and side effects of liver and kidney function,gastrointestinal reaction and bone marrow suppression.What is more,it can rebound easily after stopping using it,and the long-term effect is poor.Traditional Chinese medicine has its unique advantages in the treatment of hyperuricemia,which not only reduces the level of blood uric acid,but also relieves or disappears many discomfort symptoms.However it lacks a unified understanding of its syndrome differentiation and treatment.Therefore,it is necessary and important to study the regularity of TCM syndrome and the treatment of traditional Chinese medicine.Objectives:On one hand,through the investigation of patients with hyperuricemia,we preliminarily discuss the factors of TCM syndrome and the distribution of syndromes of hyperuricemia,so as to provide a clinical basis for the treatment of syndrome differentiation.On the other hand,under the guidance of TCM syndrome differentiation and treatment theory and with the combination of disease and syndrome as the breakthrough point,the clinical efficacy and safety of "Bai Fu Qing Li San" in the treatment of hyperuricemia with damp heat and stasis type of hyperuricemia is observed.Object:A total of 100 patients with hyperuricemia diagnosed at our hospital from April to December in 2017 were selected as subjects for the syndrome study.Among them,30 patients diagnosed as having damp-heat obstructive hyperuricemia were treated with the traditional Chinese medicine "Bai Fu Qing Li San" to conduct their own pre-and post-contrast controlled clinical studies.Methods:1.Syndrome Research:Taking the form of questionnaire to record patients' general demographic data,disease history,physical and chemical examination indicators,and four diagnostic information of TCM.Statistical method:using SPSS24.0 to analyze the data built by the collected data,two kinds of statistical methods were used to excavate the TCM syndrome of hyperuricemia by using factor analysis and cluster analysis.2.Clinical Research:On the basis of the routine treatment of low purine diet,weight control and necessary alkaline urine,30 cases of eligible patients were given the Chinese medicine "Bai Fu Qing Li San"(Zhimu 10g,Huangbai 10g,Cangzhu 10g,Jixueteng 20g,Danshen 20g,Yimucao 15g,Shiwei 15g,Tufuling 30g,Yiyiren 30g,Chuanniuxi 10g,etc)and 4 weeks as a treatment.After two courses of treatment,the efficacy indexes were measured in the 4 and 8 weeks respectively:blood uric acid,blood lipid,fasting blood glucose,homocysteine,safety index:liver and kidney function,urine routine,and record the four diagnosis information of Chinese medicine.Statistical methods were used to analyze the difference of indicators before and after treatment.Result:1.Patients with hyperuricemia were significantly higher than women(male 70%,female 30%);the age of onset was mainly under 60 years of age,mainly in middle and young people;the majority of BMI were not standard,which were overweight and obese.2.Through cluster analysis,the possible syndrome types of hyperuricemia were:damp heat stasis,spleen qi deficiency,phlegm dampness and spleen,kidney yin deficiency,kidney yang deficiency,qi and yin deficiency,qi stagnation and blood stasis.3.Through factor analysis,the main syndromes of hyperuricemia were damp heat,blood stasis,and dampness.The secondary factors were yang deficiency,yin deficiency,and qi stagnation.The elements of the sandwich were qi deficiency and blood deficiency;the main disease location was the spleen.,liver,kidney,and related to the stomach,lungs,and heart.Speculated that the main syndromes of hyperuricemia are:dampness and heat phlegm,dampness and spleen,qi stagnation and blood stasis,liver and kidney yin deficiency,spleen and kidney yang deficiency,and qi and blood deficiency.4.The total effective rate of reducing uric acid by Chinese medicine "Bai Fu Qing Li San" was 83.3%,among which 30%were markedly effective,16%were effective,and 5%were ineffective.The total effective rate of symptom improvement rate in traditional Chinese medicine was 90%,among which clinical recovery accounted for 10%,markedly effective 33.3%,effective 46.7%,invalid 10%.The blood uric acid and total cholesterol were significantly lower than those before treatment in the 2 months after treatment(P<0.01).Triglycerides were significantly lower in the treatment of 1 month and 2 months before treatment than before treatment.The differences were statistically significant(P<0.05).Conclusions:1.Hyperuricemia is frequent in men,young adults,overweight or obese people.2.Hyperuricemia in TCM syndrome type is mostly damp heat and stasis type.3.The factor analysis and cluster analysis are common,the essence of which is to sum up and analyze the syndrome factors of disease mining.This study combined with these two statistical methods,the results of mining are verified,and the pattern of syndrome distribution has high consistency.The common clinical syndrome of hyperuricemia may be:Damp heat stagnation.Phlegm dampness sleepy,qi stagnation and blood stasis,liver and kidney yin deficiency,spleen and kidney yang deficiency.4.The Chinese medicine "Bai Fu Qing Li San" has certain curative effect in the treatment of hyperuricemia due to dampness heat and blood stasis,and has no obvious adverse reactions,and can improve symptoms and reduce blood lipids. |
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