清热利湿益气活血法联合结肠透析治疗慢性高尿酸血症的临床研究

Clinical study on clearing away heat and dampness(清热利湿) and promoting circulation of Qi and blood(益气活血) method combined with colon dialysis in treating patients with chronic hyperurecemia

目的:观察清热利湿益气活血法联合结肠透析对慢性高尿酸血症患者尿酸水平的影响。方法98例慢性高尿酸血症患者,根据血尿酸水平分为轻、中、重度组,分别进行结肠透析治疗后,以清热利湿、益气活血法为原则,以大黄为主药组方,进行保留灌肠。采用尿酸酶过氧化酶法测定治疗前后血尿酸水平,同时检测血清K+、Na+、Cl-、Ca2+、胰岛素水平、24h尿蛋白、血压及体重等指标变化。结果:98例患者中,各组血尿酸水平均显著下降(P<0.05或P<0.01);血清胰岛素水平、24h尿蛋白、血压均较治疗前明显下降(P<0.05或P<0.01);血K+、Na+、Cl-、Ca2+水平及体重等指标无明显改变(P均>0.05)。结论:清热利湿益气活血法联合结肠透析可有效降低慢性高尿酸血症患者血尿酸水平,减少并发症的发生。

Objective： To observe the effect of clearing away heat and dampness （清热利湿） andpromoting circulation of Qi and blood （益气活血） method combined with colon dialysis on uric acid （UA） level in patients with chronic hyperurecemia. Methods： Ninety -eight patients with chronic hyperurecemia were divided into mild, middle and severe degree groups according to the serum level of UA. All the patients were treated with colon dialysis combined with continuous enema of agents with clearing away heat and dampness and promoting circulation of Qi and blood, the main ingredient being rhubarb. Before and after treatment, the serum level of UA, K^＋ , Na^＋ , Cl^-, Ca^2＋ , insulin as well as 24 -hour uric protein, diastolic and systolic blood pressure ,body weight were also measured. Results： Traditional Chinese medicine of clearing away heat and dampness and promoting circulation of Qi and blood combined with colon dialysis could lower the serum level of UA （P〈0.05 or P〈0.01）, 24 -hour uric protein, diastolic and systolic blood pressure and the serum level of insulin （P〈0. 05 or P〈0. 01）, but there were no significant changes on the level of K^＋, Na^＋ , Cl^-, Ca^2＋ and body weight （all P〉0. 05）. Conclusion： Traditional Chinese medicine of clearing away heat and dampness and promoting circulation of Qi and blood combined with colon dialysis could decrease the serum level of UA and lower the complication morbidity in patients with chronic hyperurecemia.