Clinical Observation Of Self-made Tongfeng Decoction In Treating Intermittent Gout

Research purposes:Analyze the distribution of TCM syndromes of gout in intermittent period;observe the effect of gout decoction guided by the method of regulating the spleen and kidney to relieve turbidity and removing blood stasis on the symptom improvement of patients with intermittent gout and its influence on blood uric acid,blood lipids,renal function and other indicators.Research methods:1.search for the period 1999-2019,China Zhiwang,Wanfang database,Weipu Chinese Journal of Science and Technology database of three Chinese databases,related to the combination of disease and syndrome in the treatment of intermittent gout clinical research literature;search the theme words : " gout "," intermittent " or " remission period "," Chinese medicine "," clinical observation ".By establishing Excel database of intermittent gout syndrome type,the frequency and frequency of TCM syndromes involved in the literature were counted.2.60 patients with intermittent gout,spleen and kidney deficiency and stasis syndrome,divided into treatment group and control group of 30 cases each.On the basis of gout health education,For the first time,the control group was given non-bustar tablets,10 mg/,Once a day,Three days,If there is no joint pain,adjust the dose to 20 mg/,Once a day.Treatment group on the basis of the control group Tongfeng decoction(Tu Fuling 30 g?Mian Bixian 30g?Cu Yanhusuo 20 g?Baihe 20 g?Chen Pi 10 g?Tusizi 15 g?Jixueteng 15 g?Zhihuangqi15g)treatment,One dose per day,About 300 ml,Warm clothes after meals in the morning and evening.During the treatment of the two groups,if there were symptoms of joint swelling and pain,Both of them were given diclofenac sodium sustained-release tablets.Both groups were treated for 4 weeks,To observe and record the score of TCM syndromes before and after treatment and the indexes of serum uric acid,blood lipid and renal function.statistical analysis of the data using SPSS21.0 software.Results:1.According to the results of literature search,there are 10 TCM syndromes involving intermittent gout,the percentage of which is more than 10% is spleen and kidney deficiency syndrome,dampness and heat accumulation syndrome,phlegm turbid block syndrome,spleen deficiency dampness trap syndrome,phlegm dampness internal Sheng syndrome,liver and kidney yin deficiency syndrome.The syndrome type was divided into syndrome elements,and finally 8 kinds of syndrome elements were extracted,including 5 kinds of real syndrome elements and 3 kinds of deficiency syndrome elements.Among the syndrome elements of disease type,the factors that account for more than 10% are dampness evil,qi deficiency and phlegm turbid.Spleen is the key factor of intermittent gout disease(46.9%),kidney(37.5%),followed by the liver(15.6%).2.General situation of : the analysis of the cases in this study showed that gout occurred mostly in young and middle-aged male patients,with a family history of 25% of the total number of cases,the course of disease is longer.Gout associated diseases,hypertension is the most frequent,followed by hyperlipidemia,diabetes,fatty liver and so on.TCM syndrome improvement: the two groups of treatment in improving TCM syndrome score are significant(P<0.05),the treatment group is better than the control group(P<0.05).serum uric acid level:the average serum uric acid decreased after treatment in the two groups(P<0.05),and the effect of reducing uric acid in the treatment group was better than that in the control group(P<0.05).creatinine index: both groups could reduce creatinine(P <0.05),but there was no significant difference in the effect of reducing creatinine(P >0.05).urinary microalbumin: the treatment group was effective in reducing urinary microalbumin(P <0.05),and the control group was not effective in reducing urinary microalbumin(P >0.05).There were four items of blood lipids: both groups had curative effect in reducing TC?LDL-C(P <0.05),but there was no statistical significance between the two groups(P >0.05);both groups could reduce TG(P<0.05),but no statistical significance;neither group had significant effect on regulating HDL-C(P >0.05).Conclusion:1.TCM syndromes of intermittent gout are mainly spleen and kidney deficiency syndrome,dampness and heat accumulation syndrome,phlegm turbid block syndrome,spleendeficiency and dampness trap syndrome,phlegm dampness internal Sheng syndrome and liver and kidney yin deficiency syndrome;pathogenic factors include qi deficiency,phlegm turbid,blood stasis,dampness evil,heat evil,yin deficiency,cold evil,yang deficiency and so on;disease position often involves spleen,kidney,followed by liver,etc.2.Gout decoction guided the method of regulating spleen and kidney and removing turbid and removing blood stasis is effective in reducing uric acid and improving symptoms of patients with intermittent gout.