Literature Study On The Law Of Syndromes And Treatment Of Acute Gouty Arthritis And The Application Of The Method Of Clearing Away Heat, Removing Dampness And Dredging Collaterals

Purpose:To summarize the syndrome types of acute gouty arthritis and the rules of medication,and to discuss Professor Ma Baodong's therapeutic approach of "clearing heat,removing dampness and dredging the passages of body" for clinical treatment of this disease.Material and methods:The Chinese literature on the treatment of acute gouty arthritis in CNKI from 2010-2019 was retrieved,and EXCEL and SPSS 22.0 were used to analyze the symptoms and treatment of acute gouty arthritis and the medication rules,and to summarize the clinical experience of Professor Ma Baodong's "clearing heat,removing dampness,and dredging the passages of body ".Results:1.In general:(1)Inclusion:From 2010 to 2019,the number of articles included in each year was 7,6,12,8,9,9,14,18,14,12 respectively,with a total number of 109.(2)Sample size range: The samples were mainly concentrated between 60-120 cases,with the largest number of papers in the sample size range of 60-80 cases,accounting for 61.47%,and fewer papers above 120 cases,accounting for only 9.17%.(3)Gender distribution: A total of 9512 cases of AGA patients were included,of which 7910 were men and 1602 were women,with more men than women.The number of patients was increasing,but the gender ratio tended to decrease.(4)Duration of treatment: The treatment was concentrated in the range of 7 or 14 days and was mainly 7 days.2.Syndrome types: There were 15 syndromes involved.The top 5 syndromes were damp-heat accumulation syndrome(56.88%),damp-heat stasis syndrome(14.68%),damp-turbidity internal resistance syndrome(4.59%),damp-heat accumulation syndrome,turbidity-toxin internal resistance syndrome(4.59%)and rheumatic-heat syndrome(4.59%),which were the main syndromes of AGA.Damp-heat accumulation syndrome and damp-heat stasis syndrome were the most common syndromes of AGA.3.Traditional Chinese medicine:178 types of traditional Chinese medicine were recorded,witha total frequency of 1209 times.The top 5 Chinese medicines were Coix seed,Atractylodes atractylodes,Poria cocos,Achyranthes bidentata and Cortex Phellodendri,with frequencies greater than 60 times,which were the core traditional Chinese medicine for the treatment of AGA.4.Classification of traditional Chinese medicine: The medicines were divided into 16 categories,including heat-clearing drugs(28.87%),diuresis and dampness-promoting drugs(19.52%),blood-activating and stasis-removing drugs(13.48%)and rheumatism-removing drugs(12.57%)as the main therapeutics for AGA,among which heat-clearing drugs occupied the first place.5.Principles of treatment:There were 34 treatment principles involved,520 times in total.Dehumidification and heat-clearing were the core principles of AGA.Analgesia,dredging passages of bodies,detoxification,removing stasis,turbidity,activating blood circulation,dispelling numbness,dispelling rheumatism,detumescence,invigorating kidney and invigorating spleen were the important principles of AGA.6.Formulas: Of the 20 formulas included,the most frequently used formulas were self-drafted,followed by Simiaowan,and the frequency of each of the remaining 18 formulas was ? 3times.7.Clustering results:(1)Traditional Chinese medicine: divided into five categories:(1)licorice;(2)coix seed,corydalis,atractylodes rhizome,achyranthes bidentata,tuckahoe cocos;(3)plantain seed,alisma rhizome,lonicera vine;(4)wilfordish,razor;(5)Radix Paeoniae lactiflori,tetrandrine,Salvia miltiorrhiza,cigus mushroom,rhubarb,Anemarrhena rhizome,Atractylodes macrocephala,Angelica sinensis.(2)Classification of traditional Chinese medicine: divided into four categories:(1)heat-clearing drugs;(2)diuresis and dampness-permeating drugs;(3)deficiency-tonifying drugs,blood-activating and stasis-removing drugs,rheumatism-dispelling drugs;(4)dampness-removing drugs,surface-relieving drugs,diarrhea drugs,liver-calming and rheumatism-relieving drugs.8.Factor analysis results: A total of 8 common factors were extracted,F1: achyranthesbidentata,atractylodes macrocephala,cortex phellodendri,coix seed;F2: rhubarb,cichen mushroom;F3: ramulus vulgaris,radix willingii,poria glabra;F4: alismatis,plantago seed;F5: anemarrhenae rhizoma,licorice;F6: atractylodes macrocephala,angelica sinensis;F7:radix tetrandrae,aonicera;F8: salvia miltiorrhiza,radix paeoniae root.Conclusion:This study showed that damp-heat accumulation syndrome and damp-heat stasis obstruction syndrome were the most common clinical symptoms of acute gouty arthritis.The core treatment principle was clearing heat and removing dampness.Clearing heat,diuresis and dampness,activating blood circulation and removing blood stasis and removing rheumatism drugs were often used in the treatment of acute gouty arthritis by various physicians.The self-prepared prescriptions and Simiaowan were widely used with clearing heat drugs as the first choice.Based on the literature studies,it was suggested that the treatment of AGA by "clearing heat,removing dampness and dredging passages of body" was worthy of affirmation.