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针刺治疗无症状高尿酸血症患者血清尿酸水平的随机双盲安慰剂对照试验

Acupuncture for serum uric acid in patients with asymptomatic hyperuricemia: A randomized, double-blind, placebo-controlled trial.

作者信息

Huang Yingjuan, Meng Jun, Sun Baoguo, Xiang Ting, Zhou Xin, Xu Biyu, Wu Yingzi, Chen Zexiong, Zhang Shijun

机构信息

Department of Traditional Chinese Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, PR China.

出版信息

Int J Cardiol. 2017 Apr 1;232:227-232. doi: 10.1016/j.ijcard.2017.01.016. Epub 2017 Jan 6.

Abstract

BACKGROUND

Hyperuricemia (HUA) is the most common disease associated with cardiovascular disease, metabolic syndrome, hypertension, and kidney disease. The objective of the current study was to evaluate the preliminary efficacy, mechanism, and safety of acupuncture on serum uric acid in patients with asymptomatic HUA.

METHODS

A randomized, placebo-controlled trial among 123 patients with asymptomatic HUA was conducted. The acupoints used in the acupuncture group were bilateral Five Shu in Spleen Meridian. Each participant received the intervention once daily for 10 consecutive days. The sham group received the same treatment duration on the same acupoints by the Park Sham Device. All patients underwent measurements of serum or urine creatinine, uric acid, serum lipid profiles, fasting plasma glucose, HbA1c, xanthine oxidase (XOD) and urate-anion exchanger (URAT-1).

RESULTS

At the end of the intervention, the individuals in the acupuncture group were found to have significantly less levels of serum uric acid than those in the sham group [(453±65 vs. 528±81) μmol/L, p<0.01]. Acupuncture was effective on increasing the urine uric acid level, urine pH value and 24-hour urine volume than the sham treatment (p<0.05 for all). Interestingly, acupuncture significantly decreased the level of URAT-1 (p<0.01) but not XOD than that of the sham intervention. The adverse events were that 3 patients experienced severe pain.

CONCLUSIONS

Acupuncture on Five Shu in Spleen Meridian appeared to be safe and efficacious for decreasing serum uric acid in a Chinese HUA patient population. The mechanism might be associated with the decrease level of enzyme URAT-1.

CHINESE CLINICAL TRIAL REGISTRATION

ChiCTR-TRC-13004122.

摘要

背景

高尿酸血症(HUA)是与心血管疾病、代谢综合征、高血压和肾脏疾病相关的最常见疾病。本研究的目的是评估针刺对无症状HUA患者血清尿酸的初步疗效、作用机制和安全性。

方法

对123例无症状HUA患者进行了一项随机、安慰剂对照试验。针刺组使用的穴位为双侧脾经五输穴。每位参与者每天接受一次干预,连续10天。假针刺组通过Park假针刺装置在相同穴位接受相同的治疗持续时间。所有患者均接受血清或尿肌酐、尿酸、血脂谱、空腹血糖、糖化血红蛋白、黄嘌呤氧化酶(XOD)和尿酸盐阴离子交换体(URAT-1)的测量。

结果

干预结束时,发现针刺组个体的血清尿酸水平明显低于假针刺组[(453±65 vs. 528±81)μmol/L,p<0.01]。与假针刺治疗相比,针刺在增加尿酸排泄量、尿液pH值和24小时尿量方面更有效(均p<0.05)。有趣的是,与假针刺干预相比,针刺显著降低了URAT-1水平(p<0.01),但未降低XOD水平。不良事件为3例患者出现剧痛。

结论

针刺脾经五输穴对降低中国HUA患者人群的血清尿酸似乎安全有效。其机制可能与URAT-1酶水平降低有关。

中国临床试验注册

ChiCTR-TRC-13004122。

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