摘要：痛风性关节炎(GA)是以嘌呤代谢紊乱导致尿酸盐沉积于关节滑膜及其他组织中，引起关节及局部组织炎症，更甚者导致关节畸形及损伤，且常并发高脂血症、脂肪肝、高血压、肾脏病变的一种代谢性疾病。此外，GA并发症若控制不佳，会加速GA的病程进展，甚至累及泌尿及心血管系统，西药治疗GA并发高脂血症(HLP)多以服用阿托伐他汀钙、非诺贝特类药物为主，但长期服用会引起肝功能的损害。相对而言，中医药可通过含有的有效成分，多途径、多靶点的作用于本疾病，而且安全性高、不良反应小。基于此，本文通过查阅相关文献，对健脾类方药在改善胰岛素抵抗、调节肠道菌群、抗氧化应激、降低炎症因子等方面的研究进展进行论述，并进一步阐明GA并发HLP的发病机制，为中医药防治GA并发HLP的临床应用提供理论参考及科学依据。

    关键词：痛风性关节炎；高脂血症；发病机制；从脾论治

    中图分类号：R684.3" " " " " " " " " " " " " " " " "文献标识码：A" " " " " " " " " " " " " " " " "DOI：10.3969/j.issn.1006-1959.2024.14.040

    文章编号：1006-1959(2024)14-0188-05

    Pathogenesis of Gouty Arthritis Complicated with Hyperlipidemia

    and the Research Status of Treatment from the Spleen

    LIANG De-feng，JIANH Chao-yu，QIN Yin-yin，XU Jia-xin，PANG Xue-feng

    (Department of Rheumatology and Immunology，Ruikang Hospital Affiliated to Guangxi University of Traditional Chinese Medicine，Nanning" 530000，Guangxi，China)

    Abstract：Gouty arthritis (GA) is a metabolic disease in which purine metabolic disorders lead to urate deposition in joint synovium and other tissues， causing inflammation of joints and local tissues ......