目的 探讨整合医学模式下高原特勤人员高尿酸血症的防治效果。方法 选取2020-01至2021-12武警烟台特勤疗养中心收治129例高尿酸血症的高原特勤人员为研究对象,按照2∶1的比例,随机分为试验组86例,对照组43例。试验组采用基于整合医学理论的多学科联合开展健康评估、健康教育、健康促进和健康监测的个性化管理,对照组采用常规健康管理手段干预。干预时间均为12个月,比较两组干预后的血尿酸、血脂,肾功能、痛风发作等相关指标变化。结果 干预12个月后,试验组失访8例,对照组失访11例。试验组和对照组干预方案执行率分别为83.33%(78例)和81.25%(32例)。干预后两组血尿酸水平较前均明显下降(P<0.01),且试验组血尿酸水平低于对照组[(425.07±14.21) μmol/L vs. (474.26±25.56) μmol/L,t=-12.86,P=0.000]。干预后试验组18例(23.08%)和对照组6例(18.75%)彻底停用降尿酸药物。试验组干预后关节痛风石数量,痛风发作例数(15.38% vs. 34.38%,χ²=4.948 )、频次和程度、脂肪肝检出率(17.95% vs. 56.25%,χ²=14.088),均低于对照组,差异具有统计学意义(P<0.05)。结论 基于整合医学的健康管理模式显著降低高原特勤人员的血尿酸水平,降低痛风发生频次和程度,明显提升健康知识及健康行为水平。

Objective To explore the effect of prevention and treatment of hyperuricemia in high altitude special service personnel under integrated medical model. Methods A total of 129 high altitude special service personnel with hyperuricemia admitted to Yantai Special Service Recuperation Center of Chinese People’s Armed Police Force from January 2020 to December 2021 were selected as the study objects, and were randomly divided into the experimental group (86 cases) and control group (43 cases) according to the ratio of 2∶1. The experimental group adopted a multidisciplinary approach under integrated medicine to carry out individualized management of health assessment, health education, health promotion and health monitoring, while the control group received routine health management. The intervention period was 12 months, and the changes of blood uric acid, blood lipid, kidney function, gout attack and other related indexes were compared between the two groups after intervention. Results After 12-month intervention, 8 patients in the experimental group and 11 patients in the control group were lost to follow-up. The implementation rates of the intervention program in the experimental group and the control group were 83.33% (78 cases) and 81.25% (32 cases), respectively. After intervention, the serum uric acid level of both groups significantly decreased (P<0.01), and the serum uric acid level of the experimental group was lower than that of the control group (425.07±14.21μmol/L vs. 474.26±25.56 μmol/L, t=-12.86, P=0.000). After intervention, 18 cases (23.08%) in the experimental group and 6 cases (18.75%) in the control group stopped using urico-lowering drugs completely. After intervention, the number of arthritic turgout, the number of gout attacks (15.38% vs. 34.38%, χ²=4.948), the frequency and severity, and the detection rate of fatty liver(17.95% vs. 56.25%,χ²=14.088), in the experimental group were lower than those in the control group, and the difference was statistically significant (P<0.05). Conclusions The health management model under integrated medicine can significantly reduce the blood uric acid level and the frequency and degree of gout attacks, and significantly improve the level of health knowledge and health behavior.