舌象与原发性痛风炎症活动度关系的临床研究The Clinical Research on the Relationship between Tongue Image and Inflammatory Activity of Primary Gout
何梦吟,祝韵薇,鲁盈
摘要(Abstract):
目的探讨舌象与痛风炎症活动度的关系,为中医药防治痛风提供新思路。方法采用前瞻性研究方法,共纳入原发性痛风患者120例,其中急性期80例,缓解期40例。对舌象资料量化积分,对比急性期与缓解期舌象特征,并探讨舌象积分与炎症指标的相关性。结果急性期组红舌、黄苔、腻苔和滑苔的出现率高于缓解期组,缓解期组淡白舌、白苔的出现率高于急性期组(P <0.05)。Logistic回归模型提示黄苔、腐腻苔、胖舌均是痛风急性发作的正相关影响因素,黄苔时痛风急性发作的概率是白苔时的117.047倍。急性期的舌象特征如红舌、黄苔、腻苔积分与血沉、超敏C反应蛋白、NLRP3炎症体、白细胞介素-1β呈正相关。结论舌诊在判断痛风的炎症活动度,及预测痛风急性发作方面有一定的诊断价值和规律性。
关键词(KeyWords): 原发性痛风;中医诊断;舌诊;炎症;NLRP3;IL-1β
基金项目(Foundation): 浙江省医药卫生科技项目(2017200207)
作者(Author): 何梦吟,祝韵薇,鲁盈
参考文献(References):
- [1]中华医学会风湿病学分会.2016中国痛风诊疗指南[J].中华内科杂志,2016,55(11):892-899.
- [2]中国医师协会心血管内科医师分会.无症状高尿酸血症合并心血管疾病诊治建议中国专家共识[J].中国临床医生,2011,39(2):73-77.
- [3]Chen YZ,Tang ZZ,Huang ZY,et al.The prevalence of gout in mainland China from 2000 to 2016:a systematic review and meta-analysis[J].J Public Health-Heidelberg,2017,25(5):521-529.
- [4]Zhu Y,Pandya BJ,Choi HK.Prevalence of gout and hyperuricemia in the US general population:the National Health and Nutrition Examination Survey 2007-2008[J].Arthritis Rheum,2011,63(10):3136-3141.
- [5]路杰,崔凌凌,李长贵.原发性痛风流行病学研究进展[J].中华内科杂志,2015,54(3):244-247.
- [6]刘湘源,郑晓娟.尿酸持续达标是难治性痛风治疗的关键[J].北京大学学报:医学版,2012,44(2):168-170.
- [7]Dalbeth N,Merriman TR,Stamp LK.Gout[J].Lancet,2016,388(10055):2039-2052.
- [8]刘芬芬,羊维,李海昌,等.基于“内湿致痹”理论探讨湿与痛风的关系[J].中国中医急症,2015,24(1):96-98.
- [9]Neogi T,Jansen TL,Dalbeth N,et al.2015 Gout classification criteria:an American College of Rheumatology/European League Against Rheumatism collaborative initiative[J].Ann Rheum Dis,2015,74(10):1789-1798.
- [10]朱文锋.中医诊断学[M].北京:中国中医药出版社,2002:72.
- [11]徐迪华,徐剑秋.中医量化诊断[M].江苏:江苏科学技术出版社,1997:42-44.
- [12]Vijay-Kumar M,Aitken JD,Carvalho FA,et al.Metabolic syndrome and altered gut microbiota in mice lacking TollLike receptor 5[J].Science,2010,328(5975):228-231.
- [13]Rosenbaum JT,Asquith MJ.The microbiome:a revolution in treatment for rheumatic diseases[J].Current Rheumatology Reports,2016,18(10):62-69.
- [14]Breban M.Gut microbiota and inflammatory joint diseases[J].Joint,bone,spine,83(6):645-649.
- [15]Shao TJ,Shao L,Li HC,et al.Combined signature of the fecal microbiome and metabolome in patients with gout[J].Frontiers in Microbiology,2017,8(268):1-9.
- [16]Guo Z,Zhang JC,Wang ZL,et al.Intestinal microbiota distinguish gout patients from healthy humans[J].Scientific Reports,2016,6(1):1-10.