除湿化瘀方对痛风患者肾功能影响的临床研究

Therapeutic Effect of Chushi Huayu Prescription on Renal Function of Gout Patients

目的:观察除湿化瘀方对痛风患者早期肾损害的临床疗效。方法:选择小样本开放性自身对照疗效观察的研究方法,对22例肾小球滤过功能无明显损害、间歇期1月以上的痛风患者单独连续服用除湿化瘀方(药物组成:土茯苓、草(艹解)、薏苡仁、益母草、金钱草、车前草、丹参、黄芪、大黄、甘草)1月,比较治疗前后血尿酸(BUA)、血尿素氮(BUN)、血肌酐(Cr)的变化,以及早期肾小管损伤指标尿N-乙酰-β-D-氨基葡萄糖苷酶(NAG)、溶菌酶(LYZ)的变化。另征集15例健康成人作为尿NAG和LYZ测定的正常参照。结果:患者服药前尿液NAG和LYZ显著高于正常对照组;治疗后患者BUA、BUN、Cr与治疗前比较,差异无显著性意义(P>0.05),但尿NAG和LYZ显著降低,与治疗前比较,差异均有显著性意义(P<0.05)。结论:除湿化瘀方对痛风患者的高血尿酸水平无明显效果,但对其引发的肾小管损害可能具有保护作用。

Objective:To observe the therapeutic effect of Chushi Huayu Pre- scription (CLIP) on early renal impairment in gout patients.Methods:A small- sample self-control open trial was carried out in 22 gout patients without obvious damage of glomerular filtrating function after an intermission over one month.The gout patients were given CHP (mainly composed of Rhizomu Smilacis Glabrae,Rhizoma Dioscoreue Hypoglaueae,Semen Coieis,Herba Lysimachiae,Herba Plataginis, Radix Selviae Miltiorrhizae,Radix Astragali,Radix et Rhizoma Rhei,Radix Gly- cyrrhizac) for one continuously month.The changes of blood uric acid (BUA),blood urea nitrogen (BUN) and creatinine (Cr) as well as the parameters of early renal tubular injury such as urinary N-acetyl-β-D-glucosaminidase(NAG) and lysozyme (LYZ) were observed before and after treatment.The levels of urinary NAG and LYZ in 15 healthy volunteers served for the normal reference.Results:The uri- nary levels of NAG and LYZ in the gout patients before treatment were higher than those in the normal control.The levels of BUA,BUN and Cr after treatment did not differ from those before treutment but the urinary levels of NAG and LYZ differed from those before treatment (P<0.05).Conclusion:CHP has no effect on the high blood uric acid level in gout patients but has protective effect on renal tubular injury induced by high blood uric acid level.