| Objective: To summarize the clinical characteristics of young gout patients and the distribution law of TCM syndromes,and further deepen the understanding of young gout;To explore the risk factors of adverse outcome,so as to guide early clinical intervention and improve prognosis;To analyze their knowledge and compliance of gout,so as to carry out targeted education and standardize management.Methods: The clinical data of 119 gout patients were collected,and the database was created by Microsoft Excel,and the statistical analysis was made by SPSS 22.0.Patients were divided into young group and middle-aged group according to their age.The general situation,clinical characteristics,laboratory examination results and TCM syndrome distribution of the two groups were compared and analyzed,and the relationship between the general situation,clinical characteristics,laboratory examination results,understanding of gout and compliance of young patients with TCM syndrome types was analyzed,so as to explore the risk factors of poor outcome of young patients with gout.Results:1.General situation of young patients with gout: most of them are male(98.8%),and their BMI is mainly overweight or obese(89.3% in total).65.5% of them have a history of smoking,44.0% have a history of drinking,and 63.1% have no habit of drinking a lot.2.Clinical characteristics of young patients with gout: The course of gout and the incidence of gouty nephropathy in young patients are lower than those in middle-aged and elderly patients(P < 0.05).3.Laboratory examination of young gout patients: The levels of SUA and GFR in young gout patients are higher than those in middle-aged and elderly patients,and the levels of ESR and CRP are lower than those in middle-aged and elderly patients(P < 0.05).4.TCM syndrome types distribution of young gout patients: damp-heat accumulation(40.5%)> phlegm stagnation(28.6%)> stasis-heat stagnation(21.4%)> liver-kidney yin deficiency(9.5%),and the course of disease of patients with liver-kidney yin deficiency is longer than that of patients with damp-heat accumulation(P < 0.05).5.GKQ and CCQR scores of young gout patients: GKQ score ≥7(knowing gout related knowledge)accounted for 28.6%;CCQR score ≥ 60(good treatment compliance)accounted for 70.2%;The GKQ scores of patients aged 25～34 were higher than those of patients aged 35～44(P < 0.05).6.Risk factors of adverse outcome(gout stone and/or gouty nephropathy)in young patients with gout: hypertension complicated with disease and deficiency of liver and kidney yin syndrome in TCM may be the influencing factors of adverse outcome(P < 0.05).Conclusion:1.Most young gout patients are overweight or obese;Most of them have no habit of drinking a lot of water;The main inducement is drinking;The course of disease is short,mostly within 5 years;The incidence of gouty nephropathy is low;The levels of SUA and GFR are higher,but the levels of ESR and CRP are lower.2.The most common TCM syndrome of young gout patients is damp-heat accumulation syndrome,and the course of disease of patients with liver-kidney yin deficiency syndrome is longer than that of patients with damp-heat accumulation syndrome.3.Young gout patients have poor knowledge about gout,but good compliance with treatment.The awareness rate of gout related knowledge among young gout patients aged 25～34 is higher than that of patients aged 35～44.For young gout patients,especially those aged 35～44,it is necessary to strengthen health education to improve patients’ disease knowledge and compliance with uric acid treatment.4.Complicating hypertension and TCM syndrome of deficiency of liver and kidney yin may increase the risk of adverse outcome(gout stone and/or gouty nephropathy)in young gout patients.In clinic,we should pay more attention to these two kinds of young patients,standardize the diagnosis and treatment process,urge them to take uric acidlowering drugs in time,change their diet and lifestyle,and check them regularly to reduce the occurrence of adverse outcomes. |
