中医慢病管理模式对痛风患者血尿酸达标率及炎症因子IL-18、IL-1β水平的影响

Effect of Traditional Chinese Medicine Chronic Disease Management Mode on Standard-reaching Rate of Blood Uric Acid and Levels of Inflammatory Factors IL-18 and IL-1β in Patients with Gout

【目的】探索中医慢病管理模式对痛风患者血尿酸达标率及炎症因子白细胞介素18(IL-18)、白细胞介素1β(IL-1β)的影响。【方法】将100例痛风患者随机分为管理组和对照组,每组各50例。对照组给予常规降尿酸药物治疗,管理组在对照组的基础上实施中医慢病管理模式,疗程为6个月。观察2组患者治疗前后血尿酸水平和血清IL-18、IL-1β水平以及血尿酸达标率的变化情况,以评价中医慢病管理模式的治疗效果。【结果】(1)治疗后,2组患者的血尿酸水平均较治疗前降低(P<0.05),且管理组的血尿酸水平明显低于对照组(P<0.05)。(2)治疗后,2组患者血清IL-18、IL-1β水平均较治疗前降低(P<0.05),且管理组的血清IL-18、IL-1β水平均明显低于对照组(P<0.05)。(3)治疗前,管理组和对照组患者的血尿酸达标率分别为58.00%(29/50)、64.00%(29/50),组间比较,差异无统计学意义(P>0.05)。治疗后,管理组和对照组患者的血尿酸达标率分别为88.00%(44/50)、72.00%(36/50),均较治疗前提高(P<0.05),且管理组的血尿酸达标率明显高于对照组(P<0.05)。【结论】中医慢病管理模式对降低痛风患者血尿酸水平疗效显著,可有效提高患者达标率,降低血清IL-18、IL-1β表达水平,减少痛风复发。

Objective To explore the effect of traditional Chinese medicine(TCM)chronic disease management mode on the standard-reaching rate of blood uric acid and on the levels of inflammatory factors interleukin 18(IL-18)and interleukin 1β(IL-1β)in gout patients. Methods One hundred cases of gout patients were randomly divided into the management group and the control group,with 50 cases in each group. The control group was given conventional medicines for lowering uric acid levels,while the management group implemented the TCM chronic disease management mode on the basis of treatment for the control group. The course of treatment for both groups covered 6 months. The changes in blood uric acid levels and serum IL-18 and IL-1β levels as well as the standard-reaching rate of blood uric acid in the two groups were observed before and after treatment,and then the therapeutic effect of the TCM chronic disease management mode was evaluated. Results(1)After treatment,the blood uric acid level in both groups was decreased compared with that before treatment(P<0.05),and the level in the management group was significantly lower than that in the control group(P<0.05).(2)After treatment,the serum IL-18 and IL-1β levels of patients in both groups were decreased compared with those before treatment(P<0.05),and the serum IL-18 and IL-1β levels in the management group were significantly lower than those in the control group(P<0.05).(3)Before treatment,the standard-reaching rate of blood uric acid in the management group and control group was 58.00%(29/50)and 64.00%(29/50)respectively,and the intergroup comparison showed that the difference was not statistically significant(P>0.05). After treatment,the standard-reaching rate of blood uric acid in the management group and control group was 88.00%(44/50) and 72.00%(36/50)respectively,which was higher than that before treatment(P<0.05),and the standard-reaching rate of blood uric acid in the management group was significantly higher than that in the control group(P<0.05). Conclusion The TCM chronic disease management mode is effective on lowering blood uric acid level in gout patients,increasing the standard-reaching rate,decreasing serum IL-18 and IL-1β expression levels,and reducing gout recurrence.