| Objective: 1.To examine the Chinese version of the gout impact scale(GIS)in gout patients in China.2.To investigate the HRQOL of gout patients and analyze influencing factors such as age,sex,lifestyle,complications,family history and disease-specific clinical manifestations.3.To study the impact of Chinese medicine intervention on patients' short-term prognosis through a 90-day cohort research,which may provide theoretical basis for prevention and control measures in enhancing the HRQOL of gout patients in the future.Methods: Cross-sectional study and cohort study were used in this research.A Chinese version of the gout impact scale was introduced and translated.In cross-sectional study,applicating this scale with SF-12,HAQ-DI,PHQ-9 and GAD-7 to the 202 patients who met the criteria at Yueyang Hospital during Jan.2018 and Dec.2018 in order to receive data.A 90-day cohort study was conducted on 81 patients who were treated for the first time.Patients were naturally divided into exposed group and non-exposed group according to the risk factors of intervention in Chinese medicine.At the last time of the follow-up,the questionnaire was conducted again to obtain data on the quality of life of gout patient.SPSS 22.0 was used to carry out a statistical analysis of the social demographic data,living habits,medical history and disease-specific clinical manifestations of patients,and to verify the reliability and validity of the Chinese version of the GIS by cronbach alpha coefficient and factor analysis.The influencing factors of patients' quality of life were analyzed by using the methods of Variance analysis,ChiSquare Inspection,rank inspection and multivariate linear regression analysis.To compare the quality of life and gout attack frequency of two groups of patients before and after treatment through stratification and matching in order to analyze the effect of traditional Chinese medicine intervention on short-term prognosis of gout patients.Results: 1.Cronbach alpha coefficient in all dimensions was more than 0.6 in the Chinese version of GIS,and the remeasurement correlation coefficient was more than 0.8.The result shows that the scale has a good reliability.The result of factor analysis extracted five main components,which can explain 69.01% variation.The corresponding entries of five components fited the dimensions and entries of the original scale design which showed a good structure.The total score of GIS was(56.88±15.83).Comparing to American gout patients,the difference in the dimension of "Gout medication side effects" was statistically significant(P < 0.01).But there were no differences in the three dimensions of "Gout concern overall","Gout concern during attack","Well being during anack"(P>0.05).2.The cross-sectional study included 202 patients.All patients had a physiological score of(38.93±11.78)and a mental score of(44.26±11.28)in SF-12,which showed a significant statistical difference(P<0.01)in comparison with the normal population.The average score of HAQ-DI was(0.7 ± 0.5),70.3% of the patients had no significant disability or only had mild dysfunction.The average score of PHQ-9 was(4.05±3.85),and the GAD-7 average score was(2.83±3.16).There were the largest number of patients without depression and anxiety,accounting for 63.9% and 79.2%.Single factor analysis shows:Age,sex,occupation,smoking history,alcohol history,low purine diet in gout remission period,complications and disease-specific clinical manifestations have a statistical difference in the quality of life of gout patients(P<0.05).However,BMI,monthly income levels,forms of medical payment,family history,and low purine diet in gout attack period showed no diferences(P>0.05).Multivariate linear regression analysis showed:(1)Increasing of age and disease course are negatively related to the quality of life;(2)Men are more prone to anxiety than women;(3)Patients with no smoking and alchol history are in better psychological condition,while the patients with longer average pain duration had worse psychological condition;(4)Patients with gout attack and tophus in joints are positively related to the physiological disfuntion;(5)Over the past 12 months,the more gout attacks,the worse quality of life and the greater the degree of concern for the disease;(6)Containing regular treatment in gout remission period can improve the patients' quality of life at all levels which is better than that of containing regular treatment in gout attack period.3.The results of cohort study showed that there were no significant statistical differences in the social demographic characteristics,lifestyle and related medical history,frequency of gout attacks,and HRQOL before treatment in two groups(P>0.05).Gout stages and the average pain duration showed differences in both groups(P<0.05).Compared with the same group of patients,the gout attack and the quality of life in both groups were much better than those before treatment.The frequency of gout attack,the score of Chinese version of GIS and PHQ-9 were lower in the comprehensive treatment group of TCM than in the western medicine treatment group,while the score of SF-12 was higher which indicated significantlly difference(P<0.05).However,the study result showed no differences in HAQ-DI and GAD-7 scores after different treatment(P>0.05).Conclusion: 1.The Chinese version of GIS is a good tool for evaluating the overall condition of gout in China.2.The overall quality of life of gout patients in this research was poor,mainly with the decrease of physiological function,but most patients had no obvious disability or only mild dysfunction,and there was no obvious depression and anxiety.3.The main factors affecting the quality of life of gout patients are age,sex,smoking and alchol history,course of illness,gout stage,frequency of gout attack,average pain duration,tophus and regular treatment.Among all,regular treatment is the most important factor to improve the quality of life,especially when it in gout remission period.4.The intervention of traditional Chinese medicine is more advantageous than simple western medicine in reducing the frequency of gout attack,reducing the influence of disease on patients ' life,improving physiological function and relieving depression.However,there was no obvious diferences in reducing the degree of disability and relieving anxiety in these two groups. |
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