Clinical Study On Treating Patients With Intermittent Gout Combined With Impaired Glucose Regulation By Clearing Heat And Relieving Dampness

Objective:To observe the clinical effect of gout prescription on patients with intermittent gout combined with impaired glucose regulation and observe the effect of this prescription on the improvement of symptoms of patients with intermittent gout combined with impaired glucose regulation and on uric acid,blood glucose,insulin and blood lipid.Methods:All the observed cases were 66 patients who met the inclusion criteria in the outpatient and inpatient department of endocrinology department of jiangsu provincial hospital of traditional Chinese medicine from March 2017 to January 2019.According to the random number method,they were divided into 33 cases in the control group and 33 cases in the experimental group.Under the basic treatment,the control group was given febuxostat orally,20mg/time,once a day;In the experimental group,the gout prescription was added on the basis of the control group,1 dose per day,divided into 2 oral administration,and observed for 12 weeks.To evaluate whether the clinical symptoms of the two groups were improved before and after treatment,and to observe the changes of blood uric acid,glucose and lipid metabolism,islet function and other indicators.To evaluate the clinical efficacy and safety of gout protocol.Results:? Among the 66 patients included in the study,a total of 5 patients fell off during the observation period,including 2 in the control group and 3 in the treatment group.Finally,61 patients were included in the study.?overall curative effect of the disease,the control group significantly 2 cases(6.45%),11 cases(35.48%),18 cases(58.06%),the total effective rate of 41.94%%;In the experimental group,there were 6 cases(20%)with significant effect,19 cases(63.33%)with effective effect,and 5 cases(16.67%)with ineffective effect.The total effective rate was up to 83.33%.The total effective rate of the test group was significantly higher than that of the control group(P<0.05).?The total score of TCM symptoms in the control group decreased compared with that before treatment,but there was no statistically significant difference(P>0.05).The score of TCM symptoms in the test group decreased more than that before treatment(P<0.05),After treatment,the improvement of TCM symptoms in the experimental group was better than that in the control group(P<0.05).?Uric acid metabolism,SUA level in the two groups after treatment was significantly lower than before treatment(P<0.05);The SUA level of the experimental group decreased more than that of the control group(P<0.05).?Glucose metabolism:the levels of FBG,PBG and HbAlc in the control group decreased after treatment,but there was no statistical significance(P>0.05).The levels of FBG,PBG and HbAlc in the test group decreased significantly after treatment(P<0.05).After treatment,the levels of FBG,PBG and HbAlc in the experimental group were significantly lower than those in the control group(P<0.05).?Islet function:the control group Fins,HOMA-IR,ISI,HOMA-? levels were slightly improved after treatment,no statistical significance compared to before treatment(P>0.05),the experimental group Fins,HOMA-IR,ISI,HOMA-?levels were significantly improved after treatment(P<0.05).Compared with the control group after treatment,the results of Fins,HOMA-IR,ISI and HOMA-? levels of the experimental group were statistically significant(P<0.05).?After treatment,TC,TG,HDL and LDL levels in the control group showed no statistical significance(P>0.05);after treatment,TC,TG,HDL and LDL levels in the test group were significantly improved(P<0.05);After treatment,TC,TG,HDL and LDL levels in the experimental group were statistically significant compared with those in the control group(P<0.05).?Gout acute attack,in the control group,there were 2 cases of recurrence,including 1 case of 1 attack,involving 1 joint of the metatarsophalangeal joint of the left foot;Another case had 2 attacks,involving 3 joints of both knees and right metatarsophalangeal joints at the same position.In the experimental group,1 patient had a seizure involving 1 joint of the lateral malleolus of the left foot.There was no significant difference between the two groups(P>0.05).?In terms of safety,blood,urine and stool routine examination and liver and kidney function before and after treatment in the two groups showed no abnormality.In the control group,1 patient had sexual dysfunction and 1 patient had fatigue.In the treatment group,3 patients presented increased abdominal distension and exhaust,and 2 patients presented diarrhea,which relieved spontaneously after 4 days of medication.There was no significant difference between the two groups(P>0.05)Conclusion:From the point of clinical preliminary study,on the basis of clear heat lishi method proposed gout agreement party can not only on the basis of the cloth division him,can effectively reduce the patients' blood uric acid level,and can regulate lipid metabolism,effectively control blood sugar,an important role in the prevention of diabetes,treatment is provided for the clinical treatment of gout with sugar regulation damaged the basis,and no obvious adverse reactions.