痛风患者个体化营养治疗的临床观察

Individualized nutrition therapy for patients with gout

目的观察"痛风患者个体化营养治疗食谱"在痛风患者临床治疗中的作用。方法营养干预组痛风患者18例采用控制患者每日摄入食物总嘌呤量与总能量相结合的个体化营养治疗方法治疗痛风。另选10例不进行营养干预的痛风患者作为对照组。测定关节肿痛总分数、体重,观察食谱对临床症状的改善程度。检测血尿酸,观察控制食物中嘌呤含量对患者血尿酸的影响。结果与治疗前比较,治疗后营养干预组关节肿痛总分数由7.78±1.26下降到3.94±1.16,体重由(81.44±9.74)kg降至(78.58±8.79)kg,血尿酸由(572.33±78.07)μmol/L降为(416.61±50.87)μmol/L,差异均有统计学意义(P<0.05);对照组患者关节肿痛总分数由7.70±1.16下降到5.15±1.38,血尿酸由(580.29±67.33)μmol/L降为(496.72±70.48)μmol/L,差异有统计学意义(P<0.05),体重由(80.73±9.08)kg降至(80.05±9.36)kg,差异无统计学意义。治疗后营养干预组与对照组关节肿痛总分数、体重、血尿酸比较,差异均有统计学意义。结论"痛风患者个体化营养治疗食谱"可控制痛风患者的体重、血尿酸水平,明显改善患者临床症状,易掌握,操作性强。

Objective To explore the effect of individualized nutrition recipe in the clinical treatment of patients with gout. Methods The individualized nutrition therapy combined with control of the total daily intake of food energy and total purine was used for patients with gout in nutrition group（ n = 18 ）. Ten patients with gout were not given nutrition therapy as control group. The joint swelling and pain score,weight and the level of serum uric acid were recorded and compared before and after treatment in 2 groups. The serum uric acid was observed under the control of food puriue. Results The joint swelling and pain score decreased from 7.70± 1.16 to 5.15 ±1.38 after treatment in control group （ P 〈 0.05 ）, the serum uric acid decreased from （580.29 ±67.33 ）μmol/L to （496.72±70.48 ）μ mol/L（ P 〈 0. 05 ）, and the body weight decreased from （ 80.73 ± 9.08 ） kg to （ 80.05± 9.36 ） kg, but there was no significant difference （ P 〉 0.05 ）. The joint swelling and pain score decreased from 7.78 ± 1.26 to 3.94± 1.16 after nutrition therapy in nutrition group （ P 〈 0.05 ）, body weight decreased from （ 81.44 ± 9.74） kg to （ 78.58 ± 8.79 ） kg （ P 〈 0.05 ）, and the level of uric acid decreased from（ 572.33± 78.07 ） μmol./L to（416.61± 50.87 ） μmol/L（ P 〈 0.05 ）. The joint swelling and pain score, body weight, and the level of serum uric acid showed significant difference after treatment between 2 groups （ P 〈 0.05 ）. Conclusion Individualized nutrition recipe can decrease the serum uric acid levels,control the body weight in patients with gout, and improve the clinical symptoms, and also it is easy and feasible to perform.