Research On The Characteristics Of Dual-source CT Imaging Of Gout And Its Correlation With TCM Syndrome Types

Objective: The purpose of this study is to explore the distribution characteristics of uric acid crystals in ankle and foot based on dual-energy CT,and to analyze the relationship between the distribution of TCM syndromes of gout and the imaging characteristics of dual-energy CT,so as to promote the basic and clinical research of gout,and to integrate modern diagnostic methods into the diagnosis and treatment of TCM for the differentiation of TCM.Syndrome-based treatment provides certain objective basis and reference.Materials and Methods: Study 1 retrospectively collected 138 patients diagnosed as gout with dual-energy CT(double-foot and ankle)in Dongzhimen Hospital as the research object,collected basic information and dual-energy CT reports,and analyzed the distribution characteristics of uric acid crystals in the ankle and foot.Study two retrospectively collected54 inpatients who were diagnosed as gout and underwent dual-energy CT(double-foot and ankle)examination as the research object,collected basic information and dual-energy CT reports,and consulted ’medical records of patients and laboratory examination results according to the medical record number,recorded patients’ basic information,history of gout and the results of four TCM diagnoses and related laboratory examinations.The patients were divided into damp-heat obstruction,damp-heat obstruction and gout.The characteristics of uric acid deposition among the three TCM syndromes of stasis-heat obstruction and deficiency of liver and kidney were compared.All data in this study were analyzed by SPSS20.0 statistical software.Results: The most common sites of uric acid deposition were the tissues near the first toe bone(108,78.3%)and the first metatarsophalangeal joint(49,35.5%).There was no significant difference in the positive rate of uric acid deposition between left and right ankle and foot(P > 0.05).Among the three syndromes,damp-heat obstruction syndrome was the most common,followed by stasis-heat obstruction syndrome,and liver and kidney deficiency syndrome was the least.There was no difference in the positive rate of urate crystallization deposition among the three syndromes(P > 0.05),indicating that the distribution of urate deposition was not related to the type of syndromes.There were statistical differences in the number of uric acid crystalline deposits among the three groups(P=0.02,less than 0.05).There were statistical differences between the damp-heat obstruction group and the stasis-heat obstruction group(P=0.01,less than 0.05),but there were no statistical differences between the other two groups.The average ranks of damp-heat obstruction group,stasis-heat obstruction group and liver-kidney deficiency syndrome were 21.29,37.64,27.14 respectively.It shows that the number of deposits of uric acid crystals in stasis-heat obstruction group is higher than that in damp-heat obstruction group.The other two comparisons were not statistically significant because the sample size of liver and kidney deficiency group was too small.Conclusion and significance: In the foot and ankle,the most common part of uric acid crystallization deposition is the forefoot,followed by the ankle,middle foot and hind foot;in the more detailed anatomical distribution,the most common area is the first toe bone,followed by the first metatarsophalangeal joint;there is no difference in the distribution characteristics of uric acid crystallization between the left and right foots and ankles;it reveals the distribution characteristics of uric acid crystallization in the foot and ankle,which is conducive to promoting the pathogenesis of gout.The distribution of uric acid deposit is not related to TCM syndromes.There is no difference in the distribution of different syndromes.There is no need to regard the location of uric acid deposit as a reference factor in TCM syndrome differentiation.The number of deposition sites of uric acid crystals in patients with stasis-heat obstruction syndrome is more than that in patients with Damp-heat obstruction syndrome,suggesting that the number of deposition sites of uric acid crystals can be used to assist in judging TCM syndromes to a certain extent,but this study is limited to the foot and ankle,not to the wrist and knee,and for retrospective study,the sample size is small,so only a trend result can be put forward.That is to say,when the number of deposits of uric acid crystals is small,the syndrome of damp-heat obstruction is more likely to be considered,while the syndrome of stasis-heat obstruction is more likely to be considered.In conclusion,this study attempts to incorporate the results of imaging into the judgment of TCM syndromes,in order to promote the diagnosis and treatment of diseases by integrated traditional Chinese and Western medicine,and promote the modernization of TCM.