2025 年第 5 期 第 20 卷

益气温阳利水治法对慢性心力衰竭合并高尿酸血症患者血尿酸水平的影响

Effect of Yiqi Wenyang Lishui therapy on serum uric acid level in patients with chronic heart failure complicated with hyperuricemia

作者：杨远银1袁王菲1郑涛2

英文作者：Yang Yuanyin1， Yuan Wangfei1， Zheng Tao2

单位：1贵州中医药大学，贵阳550002；2贵州中医药大学第一附属医院心内科，贵阳550001

英文单位：1Guizhou University of Traditional Chinese Medicine Guiyang 550002 China; 2Department of Cardiology the First Affiliated Hospital of Guizhou University of Traditional Chinese Medicine Guiyang 550001 China

关键词：慢性心力衰竭；高尿酸血症；益气温阳利水治法；血尿酸

英文关键词：Chronicheartfailure;Hyperuricaemia;YiqiWenyangLishuitherapy;Blooduricacid

• 摘要：

• 目的 探讨中医益气温阳利水治法对慢性心力衰竭（CHF）合并高尿酸血症(HUA)患者血尿酸水平的影响。方法 选取2021年5月至2023年4月就诊于贵州中医药大学第一附属医院心内科的阳气亏虚兼痰饮证CHF合并HUA患者54例，以是否应用益气温阳利水治法分为对照组（24例，予常规西药治疗）和观察组（30例，常规西药基础上加益气温阳利水法治疗）。对比治疗后2组患者血尿酸水平，并分析患者血尿酸水平与年龄、性别、左心室射血分数（LVEF）、纽约心脏病协会（NYHA）心功能分级、体重指数、是否合并高血压病、是否合并糖尿病、是否有缺血性疾病病史、是否服用抗心力衰竭药物、是否服用中药等因素的关系。结果 2组基线血尿酸水平比较，差异无统计学意义（P＞0.05）。治疗后，2组血尿酸水平均低于基线，且观察组下降幅度大于对照组，差异均有统计学意义（均P＜0.05）。治疗后，观察组患者血尿酸水平比对照组患者多下降27.102 μmol/L（β值为-27.102，95%置信区间：-38.000～-16.203，P＜0.001）。CHF合并HUA患者的血尿酸水平与年龄、LVEF、NYHA心功能分级、体重指数、是否服用益气温阳利水治法中药均呈显著正相关（均P＜0.05）；与性别、是否合并高血压病、是否合并糖尿病、是否有缺血性疾病病史、是否服用抗心力衰竭药物均无显著相关性（均P＞0.05）。结论 中医益气温阳利水治法对改善CHF合并HUA患者的血尿酸水平具有积极影响。

• Objective To investigate the effect of traditional Chinese medicine therapy of Yiqi Wenyang Lishui on serum uric acid level in patients with chronic heart failure (CHF) complicated with hyperuricemia (HUA). Methods Totally 54 patients with CHF combined with HUA and Yang qi deficiency syndrome were selected from the Department of Cardiology, the First Affiliated Hospital of Guizhou University of Traditional Chinese Medicine from May 2021 to April 2023. The patients were divided into the control group (24 cases, treated with conventional western medicine) and the observation group (30 cases, treated with Yiqi Wenyang Lishui on the basis of conventional western medicine) according to whether they took traditional Chinese medicine. The serum uric acid levels of the two groups were compared after treatment. The relationship between serum uric acid level and age, gender, left ventricular ejection fraction (LVEF), New York Heart Association (NYHA) cardiac function classification, body mass index, whether complicated with hypertension, whether complicated with diabetes, whether with ischemic diseases history, whether taking anti-heart failure drugs, whether taking traditional Chinese medicine and other factors were analyzed. Results There was no significant difference in the level of uric acid between the two groups at baseline (P>0.05). After treatment, the uric acid levels of the two groups were lower than those at baseline, and the decrease in the observation group was greater than that in the control group (all P<0.05). After treatment, the serum uric acid level of the observation group decreased by 27.102 μmol/L more than that of the control group (β value was -27.102, 95% confidence interval: -38.000--16.203, P＜0.001). The serum uric acid level of CHF patients with HUA was significantly positively correlated with age, LVEF, NYHA cardiac function classification, body mass index, and whether to take Yiqi Wenyang Lishui treatment traditional Chinese medicine (all P＜0.05). There was no significant correlation with gender, hypertension, diabetes, ischemic history, and use of anti-heart failure drugs (all P＞0.05). Conclusion Traditional Chinese medicine therapy of Yiqi Wenyang Lishui has a positive effect on improving serum uric acid level in CHF patients with HUA.