益肾降浊化瘀汤联合别嘌醇、碳酸氢钠与支持治疗尿酸性肾病随机平行对照研究

Yishen Jiangzhuo Decoction combined with Allopurinol, Sodium Bicarbonate and Western Medicine Treatment Support Uric Acid Nephropathy Study Random Parallel Control

[目的]观察益肾降浊化瘀汤联合别嘌醇、碳酸氢钠与支持治疗尿酸性肾病疗效。[方法]使用随机平行对照方法,将60例住院及门诊患者按就诊顺序编号简单随机分为两组。对照组30例别嘌醇片0.1g/次,2次/d;碳酸氢钠片1g/次,3次/d;积极控制血压、感染,及时纠正水、电解质及酸碱失衡。治疗组30例益肾降浊化瘀汤,黄芪30g,熟地黄20g,大黄酒、党参、土茯苓、秦皮各10g,川牛膝15g,苍术、萆薢、红花各10g,川芎20g,地龙12g;关节剧痛,加全虫、蜈蚣、威灵仙、延胡索;夹湿热,加黄柏、银花藤、水牛角;夹寒湿,加鹿角霜、炮姜、桂枝;夹水湿,加车前子、大腹皮、猪苓、茯苓;合并肾结石,加鸡内金、石韦、金钱草;1剂/d,水煎400m L,早晚温服;别嘌醇片、碳酸氢钠片与西医支持治疗同对照组。连续治疗8周为1疗程。观测临床症状、血生化指标(尿酸、尿素氮、肌酐)、尿生化指标(血、尿β2-M、24h尿蛋白定量)、不良反应。连续治疗2疗程,判定疗效。[结果]治疗组显效12例,有效14例,无效4例,总有效率86.67%。对照组显效5例,有效13例,无效12例,总有效率60.00%。治疗组疗效优于对照组(P<0.05)。血生化指标、尿生化指标改善治疗组治疗组优于对照组(P<0.05,P<0.01)。[结论]益肾降浊化瘀汤联合别嘌醇片、碳酸氢钠片与支持治疗尿酸性肾病,疗效满意,无严重不良反应,值得推广。

[Objective] To observe the effect of Yishenjiangzhuo decoction combined with allopurinol, sodium bicarbonate and Western medicine to support the efficacy of the treatment of uric acid nephropathy. [Method] Using random parallel control method, 60 cases of inpatient and outpatient number simple according to the visiting sequence were randomly divided into two groups. 30 cases of the control group Allopurinol Tablets 0.1g/ times, 2 times /d; Sodium Bicarbonate Tablets 1g/ times, 3 times /d; positive control of blood pressure, infection, timelycorrect water, electrolyte and acid-base imbalance. The treatment group of 30 cases of Yishen Jiangzhuodecoction, 30 g of Radix Astragali, Radix Rehmanniae Preparata 20 g, large Yellow Wine, Codonopsis, Poria cocos,Achyranthes bidentata cortex Fraxini each 10 g, 15 g, Atractylodes rhizome, Rhizoma Dioscoreae hypoglaueae,safflower each 10 g, Chuanxiong 20 g, Lumbric us 12g; joint pain, and scorpion, centipede, clematis root, Corydalis yanhusuo; clip damp heat, and Cortex Phello dendri, honeysuckle rattan, water buffalo horn; dampness, withantlers cream, fresh ginger, cassia twig; clip water wet, plantain seed, areca peel, Poria, Polyporus umbellatus;renal stones, Gachi Hei Kim, Shi Wei, Christina Loosestrife herb; 1 agent /d, Decoction 400 m L, morning and evening clothes; treatment with the control group in support of allopurinol tablet, sodium bicarbonate tablets with Western medicine. Continuous treatment for 8 weeks for 1 courses of treatment. Observation of clinical symptoms,blood biochemical indexes（uric acid, urea nitrogen, creatinine） and urine biochemical indexes（blood and urine beta 2-M, 24 h urinary protein quantitative）, adverse reaction. 2 course of treatment, continuous treatment to determine efficacy. 12 cases of the treatment group produce. [Results] Effective 14 cases, invalid 4 cases, the total efficiency of 86.67%. The control group 5 cases, effective 13 cases, invalid 12 cases, the total efficiency of 60%.The efficacy of the treatment group was better than that of the control group（P〈0.05）. Biochemical index of blood, urine and biochemical indexes of treatment group improved in treatment group than in control group（P〈0.05, P〈0.01）. [Conclusion] The Yishen Jiangzhuo decoction combined with Allopurinol Tablets, Sodium Bicarbonate Tablets support with western medicine in treatment of uric acid nephropathy, curative effect satisfaction, no serious adverse reaction, is worth promoting.