成人高尿酸血症与痛风食养指南（2024年版）目录一、前言·································································1二、疾病特点与分型···················································2（一）高尿酸血症与痛风定义与分期························2（二）中医对高尿酸血症与痛风的认识与分型············3三、食养原则和建议···················································4（一）食物多样，限制嘌呤····································4（二）蔬奶充足，限制果糖····································5（三）足量饮水，限制饮酒····································6（四）科学烹饪，少食生冷····································7（五）吃动平衡，健康体重····································7（六）辨证辨体，因人施膳····································8（七）因地因时，择膳相宜····································9附录1常见食物嘌呤含量···········································11附录2成人高尿酸血症与痛风人群的食物选择················18附录3不同阶段不同地区不同季节食谱示例··················20一、无症状高尿酸血症期与痛风间歇期····················20二、急性痛风性关节炎期及慢性痛风性关节炎期········42附录4常见食物交换表·············································61附录5高尿酸血症与痛风食养方举例···························671成人高尿酸血症与痛风食养指南一、前言尿酸是人体代谢产物之一，主要由膳食摄入和体内分解的嘌呤化合物经肝脏代谢产生，通过肾脏和消化道排泄。正常情况下，体内尿酸产生和排泄保持平衡状态。当嘌呤代谢障碍时，就会出现高尿酸血症。高尿酸血症是痛风发生的病理基础。2018-2019年中国慢性病及危险因素监测数据表明，我国成人居民高尿酸血症患病率为14%，痛风患病率为0.86%～2.20%，男性高于女性，城市高于农村，沿海高于内陆。痛风患病率呈逐年上升趋势，发病年龄趋于年轻化。高尿酸血症与痛风的发生与膳食及生活方式密切相关，尤其是长期摄入高能量食品、大量酒精和（或）高果糖的饮料。肥胖是高尿酸血症与痛风发生的独立危险因素。合理搭配膳食，减少高嘌呤膳食摄入，保持健康体重，有助于控制血尿酸水平，减少痛风发作，改善生活质量。中医食养是在中医辨证施膳指导下的非药物调养方法，强调根据病因、证候、体质等给予不同食养方案，达到逐步改善体质，辅助控制疾病发生发展的目的。为预防和控制我国人群高尿酸血症与痛风的发生，指导高尿酸血症与痛风人群日常膳食，提高居民健康水平，发展传统食养服务，根据《健康中国行动（2019—2030年）》和《国民营养计划（2017—2030年）》相关要求，制定本指南。本指南以食养理念为基础，依据现代营养学理论和相关证据，2以及我国传统中医理论和调养方案，提出多学科优势互补的成人高尿酸血症与痛风人群食养基本原则和食谱示例。本指南主要面向未合并肾功能不全等相关合并症的成人高尿酸血症、痛风人群以及基层卫生工作者（包括营养指导人员），为高尿酸血症与痛风的预防与改善提供食养指导，不可代替药物治疗。有其他合并症的高尿酸血症与痛风人群，可参考本指南制定食养方案，同时应在医生或营养指导人员等专业人员的指导下，根据患者具体情况设计个性...
