世界中医药

目的：观察清热利湿法治疗湿热型原发性高尿酸血症的临床疗效。方法：选取112例湿热体质类型原发性高尿酸血症患者，随机分成治疗组（58例）和对照组（54例），对2组患者进行健康教育，调整生活方式和饮食结构，在此基础上，对照组给予别嘌醇片口服，100 mg，2次/d。治疗组加用中药四妙丸加减治疗。评估2组治疗的安全性，检测2组患者治疗前及治疗第2周、第4周的血尿酸（SUA）水平和24 h尿尿酸（UUA）水平，并统计治疗过程中2组患者痛风发作情况。结果：1）治疗组胃肠不良反应发生率低于对照组。2）在治疗第2周对照组的男性患者和女性患者的血尿酸水平均显著低于治疗前，在治疗第4周，2组患者的血尿酸水平均显著低于治疗前。组间比较，2组患者血尿酸水平无统计学意义。3）对照组24 h尿尿酸水平在治疗的第2周和第4周均较治疗前无统计学意义，在治疗的第2周和第4周，治疗组的尿尿酸水平均显著高于治疗前。组间比较，治疗组的尿尿酸水平在治疗第2周和第4周均显著高于对照组。4）在治疗过程中，对照组患者的痛风发作率高于治疗组。结论：通过中医体质辨识指导治疗原发性高尿酸血症临床疗效显著，且具有较好的安全性，值得临床推广。

English Summary:

To observe the clinical effects of clearing heat and removing dampness in treating primary hyperuricemia of damp-heat type. Methods： One hundred and twelve patients with primary hyperuricemia of damp-heat type were randomized into treatment group（n=58）and control group(n=54).Both groups gave patients intervention of lifestyle， including guidance of diet and physical exercise. Patients in the control group were treated with oral administration of 100 mg allopurinol two times a day. Patients in the treatment group were treated with Simiao Pellet， in addition to conventional treatment. The therapeutic effects were compared after treatment. Results： 1)The occurrence rate of adverse reaction of treatment group was lower than the control group.2)After two weeks of treatment， the level of serum uric acid of control group were lower than that before treatment； after 4weeks of treatment， the level of serum uric acid of both groups were lower than those before treatment. 3)The 24 hours urine uric acid level of treatment group was higher than that of the control group on the 2nd week and the 4th week.4)During the treatment， the occurrence rate of gout was higher in control group than in treatment group. Conclusion： Chinese medicine treatment based on constitution determination and syndrome differentiation can improve the clinical effect of primary hyperuricemia.

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