针刺联合药物治疗痛风的临床观察

目的针刺联合药物治疗痛风的临床观察。方法采用随机对照的方法,将99例痛风患者随机分为针刺组、药物组、针刺联合药物组。结果3组治疗7d观察,疗效差异亦有统计学意义。针刺组与针刺加药物组（χ^2=15.28,P〈0.01）,药物组与针刺加药物组（χ^2=12.28,P〈0.01）,针刺加药物组明显优于针刺组和药物组。结论针刺联合药物组在治疗痛风的过程中,症状缓解快且不良反应少,效果显著。     

Gout Assessment Questionnaire: Initial results of reliability, validity and responsiveness

We evaluated the psychometric properties of a new gout-specific patient reported outcomes questionnaire. The Gout Assessment Questionnaire (GAQ) and the SF-36 were administered to 126 subjects in a multicenter Phase II program of febuxostat, an investigational treatment for hyperuricemia (serum uric acid >8.0 mg/dl) in patients with chronic gout. The questionnaire was administered at baseline and 1, 6 and 12 months later. The majority of subjects, mean age 54 years, were male, Caucasian and had experienced a gout flare within the last year. Seven domains were identified, all met criteria for reliability and validity. Cronbach's alpha ranged from 0.78 to 0.97. Pearson correlations between GAQ and SF-36 scales were generally low to moderate, with the highest correlation between Gout Pain and Severity and SF-36 Bodily Pain, r = 0.45. Guyatt's statistic (measure of responsiveness) ranged from 0.24 to 1.00 at 12 months. Minimal clinically important differences ranged from 2 (Gout Concern) to 10 points (Productivity). The GAQ has acceptable psychometric properties. Further research is required to confirm results, which may provide more information to improve the GAQ for use in clinical trials.     

针灸配合中药苦蝶子治疗急性痛风性关节炎

目的观察中医治疗痛风的有效治疗方法.方法中医认为痛风是痰湿内聚,瘀久化热,闭阻经脉,气血运行不畅而发病.临床上经过抽血化验尿酸增高,结合症状表现进行诊断.本文将46例痛风患者随机分为两组,中药治疗组(针刺和静点苦蝶子)和西药对照组(急性期给醋氯芬酸片,缓解期给别嘌呤醇口服).结果 治疗组总有效率95.65%,对照组总有效率82.60%,两组疗效有显著差异,治疗组疗效优于对照组.结论 针药并举安全有效,是治疗痛风的一个比较理想的方法.     

原发性痛风患者326例血尿酸、胱抑素C和脂代谢特点分析及其临床意义

目的 了解原发性痛风患者血尿酸（sUA）、血脂及血浆胱抑素C（CysC）的代谢特点,探讨痛风患者易并发心脑血管疾病的可能机制.方法 检测326例原发性痛风性关节炎（GA）患者和210例健康体检者sUA、CysC、胆固醇（TC）、甘油三酯（TG）、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）、极低密度脂蛋白（VLDL）、载脂蛋白A1（apoA1）、载脂蛋白B100 （apoB100）、超敏C反应蛋白（hsCRP）浓度并完善血细胞计数,详细收集痛风患者临床资料;比较两组上述指标的差异并分析sUA、CysC与各指标的相关性.结果 痛风组sUA、CysC、hsCRP、WBC、中性粒细胞（GR）、体重指数、TG、TC、VLDL、apoB100、血糖、肌酐和尿素均显著高于正常对照组（P均＜0.01）,而淋巴细胞、HDL则显著低于对照组（P均＜0.01）.痛风组sUA与年龄、WBC、TG、VLDL、肌酐及CysC呈显著正相关（r=0.24、0.27、0.27、0.33、0.25、0.21,P均＜0.05）,与HDL-C呈显著负相关（r=-0.16,P＜0.01）;痛风组CysC与WBC、GR、单核细胞计数、apoA1、血糖、肌酐、尿素、hsCRP呈显著正相关（r=0.26、0.20、0.31、0.22、0.46、0.67、0.63、0.33,P均＜0.05）,与TC、LDL-C呈显著负相关（r=-0.25、-0.27,P均＜0.01）.结论 痛风患者血脂异常特点符合致动脉粥样硬化血脂谱的典型特征.痛风患者易出现脂代谢紊乱、易合并心脑血管疾病,可能与高尿酸血症致血管内皮损伤、平滑肌细胞增殖等血管长期慢性炎症反应有关.CysC可能可作为痛风早期肾功能损害及慢性炎症的判定指标.     

64例别嘌醇引起皮肤系统损害分析

目的:探讨别嘌醇引起皮肤系统不良反应的表现及发生规律,为临床安全用药提供参考。方法:我院不良反应监测系统2005年1月～2012年3月使用别嘌醇引起的皮肤系统不良反应病例进行统计分析。结果:共检索到ADR 64例,以中老年居多(51例,79.7%),其常用日剂量为50～100 mg(51例,79.7%),潜伏期2 d～4个月不等;皮肤系统ADR的临床表现以一般型、剥脱性皮炎型及多形红斑型的药疹为主,占73.4%,60%患者有伴随症状。结论:临床应重视别嘌醇皮肤系统不良反应的危害性。对老年患者更应注意密切观察用药后反应,确保用药安全。     

清热解毒利湿法治疗原发性痛风急性发作的临床研究

目的观察清热解毒利湿法治疗原发性痛风急性发作的临床疗效。方法60例原发性痛风急性发作患者随机分为2组。中药组30例运用清热解毒利湿法治疗,外敷金黄膏。西药组30例用秋水仙碱治疗。2组均用药1周后观察临床疗效及副反应情况。结果2组临床疗效比较无显著性差异（P〉0．05）;中药组未出现副反应,西药组有不同的副反应出现（P〈0.01）。结论清热解毒利湿法治疗原发性痛风急性发作的疗效良好,安全性高。     

羟氯喹对痛风患者血尿酸及血脂的影响

目的探讨羟氯喹治疗对痛风患者血尿酸(UA)和血脂的影响及其安全性。方法将2009年1月—2010年4月治疗的原发性痛风患者43例随机均分为治疗组和对照组,治疗组25例采用一般治疗+控制尿酸药+羟氯喹治疗,对照组18例采用一般治疗+控制尿酸药+小剂量秋水仙碱治疗,观察期6个月,比较2组血清尿酸和血脂的变化。结果 (1)血UA:2组治疗后3、6个月末较治疗前比较差异有统计学意义(P<0.05或P<0.01),且治疗组尿UA降低较对照组同时点明显(P<0.05或P<0.01)。(2)血脂:治疗组治疗后3、6个月末TC、LDL-C、HDL-C水平较治疗前比较差异有统计学意义(P<0.05或P<0.01),而对照组治疗前后变化不明显(P>0.05);治疗组治疗后3、6个月末TC、LDL-C、HDL-C水平较对照组同时点有显著差异(P<0.05或P<0.01)。急性痛风性关节炎复发次数减少,差异无统计学意义(P>0.05)。结论羟氯喹可减少痛风关节炎的发作次数及降低血尿酸、血脂,具有较好耐受性和安全性。     

高尿酸血症防治中应关注的几个关键问题

随着人们生活水平的提高和饮食结构的改变,高尿酸血症及其相关疾病的发病率急剧上升.由于多数患者处于无症状高尿酸血症状态,故尚未引起患者和医务工作者的重视.本文就高尿酸血症与痛风、肾损害、糖代谢紊乱、动脉粥样硬化性疾病的关系及其预防进行评论,以期提高广大临床医师对高尿酸血症的认识及对该病防治的重视.

Abstract：

The incidence of hyperuricemia and relevant diseases has been increasing recently since the living improvement and dietary changing. Both patients and doctors do not pay enough attention to this disease, due to the lack of obvious clinical presentations in early stage. This paper comments on the relationship between hyperuricemia and gout, gouty nephropathy, impaired glucose metabolism,and atherosclerotic diseases in order to arouse enough attention to this disease.     

山东沿海居民高尿酸血症及痛风五年随访研究

目的 与2004年结果相比较,明确目前山东沿海地区20岁以上居民高尿酸血症(HUA)与痛风的患病情况及其影响因素.方法 采用随机(随机数字表法)、分层、整群抽样的方法,入户调查青岛、烟台、威海、日照、东营5 191名长住居民HUA与痛风的患病情况.结果 (1)与2004年相比,2009年无论男性还是女性,人群整体血尿酸水平均有增高趋势.(2)按照统一人口标化后,2009年HUA患病标化率为16.99%,比2004年增加3.72%;其中男性增加4.57%、女性增加3.33%.(3)痛风患病标化率为1.36%,比2004年增加0.26%;其中男性降低0.45%,女性增加0.85%.(4)与2004年比较,目前30岁以下男性人群的HUA患病率最高,50~岁年龄组为最低.同样30岁以下女性人群中HUA患病率也较2004年明显增高,70~岁患病率最高.(5)与2004年相比,男性痛风患病率40~岁年龄组为最高.女性30岁以下年龄组较2004年明显增加,70~岁患病率最高.(6)logistic回归分析显示每日海产品摄入量、肉类产品摄入量、啤酒和烈酒摄入量均为HUA和痛风独立危险因素.结论 与2004年相比,人群整体血尿酸水平、HUA和痛风患病率均有增高趋势,且呈明显年轻化,以女性增加显著;膳食因素对HUA和痛风发病有明显影响,海产品、肉类产品、啤酒和白酒每日摄入量为HUA独立危险因素.

Abstract：

Objective To determine the prevalence and risk factors of hyperuricemia (HUA) and gout among residents aged≥20 years in Shandong coastal areas compared with the results of 2004. Methods A randomized stratified cluster sampling was conducted, and 5 191 inhabitants were investigated for prevalences of HUA and gout in Qingdao, Yantai, Weihai, Rizhao, and Dongying. Results (1)The level of serum uric acid had the tendency to increase in both males and females in 2009 compared with that in 2004. (2)According to the uniform population standardization, the standardized prevalence of HUA was 16.99%in 2009. The standardized rate increased by 3.72%compared to 2004, being 4.57%in males and 3.33%in females. (3) The standardized prevalence of gout was 1.36%. Compared with that in 2004, the standardized rate increased by 0.26%, decreased by 0.45%in males while increased by 0.85%in females. (4) Compared to 2004, the prevalence of HUA among males aged≤30 years was the highest, whereas aged between 50 years and 60 years was the lowest at present. (5) Currently, the prevalence of HUA among females aged≤30 years was significantly higher than that of 2004, and aged≥70 years was the highest. (6) Logistic regression analysis showed that the amount of daily intake of seafood, meat, beer, and liquor were independent risk factors of HUA and gout. Conclusions Compared to 2004, the level of serum uric acid and the prevalence of HUA and gout show a tendency to increase among younger in the population surveyed in 2009, significant in female. Dietary factors exert significant effects on the development of HUA and gout. The amount of daily intake of seafood, meat, beer, and liquor are independent risk factors of HUA and gout.     

北川羌族人群高尿酸血症及痛风流行病学调查

目的调查5.12地震后,绵阳市北川羌族人群高尿酸血症及痛风的患病率情况。方法采用随机、分层、整群抽样的方法,调查安置在板房居住的北川羌族人群2275人的高尿酸血症与痛风的患病率情况。结果①血尿酸水平及高尿酸血症情况：总体血尿酸水平为（341.4±89.4）μmol/L,其中男性为（375.4±85.5）μmmol/L,女性为（318.7±7l.9）μmmol/L;两者之间差异有统计学意义（P〈0.01）;高尿酸血症患病率为14.2%,男性患病率为9.67%,女性为4.57%,两者比较差异有统计学意义,②痛风患病率：患痛风例数为21人,痛风患病率为0.92%,其中男18人（1.37%）,女3人（0.40%）,两者之间差异有统计学意义（x2=30,38,P〈0.01）。男性高尿酸人群中痛风患病率为7.8%（18/230）,女性高尿酸人群中痛风患病率为2.9%（3/104）;③血尿酸存在性别差异：男性血尿酸水平随年龄增长变化不明显,而女性血尿酸随年龄增长逐渐升高,尤以48岁后增速加快,68岁后与男性的血尿酸水平接近。④与血尿酸正常组比较,高尿酸血症组及痛风组年龄较大,同时合并高血压、糖尿病的患者多,BMI、TG、TC、LDL-C值更高,HDL-C值更低,饮酒者较多。结论绵阳北川羌族人群高尿酸血症及痛风患病率较其它地区低,男性高尿酸血症及痛风的患病率高于女性,且趋于年轻化。高尿酸血症及痛风患者合并高血压、脂代谢紊乱、糖尿病、肥胖者较血尿酸正常组明显增高。