运脾化浊法治疗脾虚型高尿酸血症回顾性研究

A Retrospective Study of Spleen-activating and Turbid Pathogen-eliminating Therapy in Treatment of Hyperuricemia with Spleen Deficiency

目的评价运脾化浊法治疗脾虚型高尿酸血症患者的临床疗效。方法使用回顾性研究的方法,检索天津市中医药研究院附属医院的电子病历系统,收集近5年住院的脾虚型高尿酸血症患者,选择接受运脾化浊法治疗的45例患者为运脾化浊组,采用倾向性评分匹配法匹配以接受常规西医治疗的45例患者为常规治疗组,疗程均为2周。比较两组患者治疗前后血尿酸水平、脾虚证症状评分。结果治疗后两组患者血尿酸水平均较治疗前降低(P<0.05),两组患者降尿酸达标率(运脾化浊组40%、常规治疗组55.56%)以及降尿酸疗效相近(P>0.05)。治疗后运脾化浊组脾虚证症状评分较治疗前降低(P<0.05),且降低幅度较常规治疗组更大(P<0.05);两组中医症状疗效比较,差异有统计学意义(P<0.05)。结论采用运脾化浊法治疗脾虚型高尿酸血症,可降低患者的血尿酸水平且明显改善其脾虚证症状。

Objective To investigate the clinical effect of spleen-activating and turbid pathogen-eliminating therapy in the treatment of hyperuricemia with spleen deficiency.Methods A retrospective study was conducted,and the electronic medical record system of Affiliated Hospital of Tianjin Academy of Traditional Chinese Medicine was searched to collect the clinical data of patients with hyperuricemia with spleen deficiency who were hospitalized in the recent 5 years.A total of 45 patients who received the spleen-activating and turbid pathogen-eliminating therapy were enrolled as spleen-activating and turbid pathogen-eliminating group,and the propensity score matching method was used to select 45 patients who received conventional Western medicine treatment as conventional treatment group;the course of treatment was 2 weeks for both groups.The two groups were compared in terms of serum uric acid and symptom score of spleen deficiency before and after treatment.Results After treatment,both groups had a significant reduction in serum uric acid(P<0.05),and the two groups had a similar rate of reaching the standard uric acid level(40%for the spleen-activating and turbid pathogen-eliminating group and 55.56%for the conventional treatment group)and a similar response rate of uric acid-lowering treatment(P>0.05).Both groups had a significant reduction in the symptom score of spleen deficiency after treatment(P<0.05),and the spleen-activating and turbid pathogen-eliminating group had a significantly greater reduction than the conventional treatment group(P<0.05);there was also a significant difference in the treatment outcome of traditional Chinese medicine symptoms between the two groups(P<0.05).Conclusion In the treatment of hyperuricemia with spleen deficiency,spleen-activating and turbid pathogen-eliminating therapy can effectively reduce serum uric acid level and improve the symptoms of spleen deficiency.