加味四妙方治疗湿热浊瘀型慢性尿酸性肾病的临床观察

Clinical observation on dampness-heat stagnancy type of chronic uric acid nephropathy treated by Jia Wei Si Miao decoction

目的评价加味四妙汤治疗湿热内蕴型慢性尿酸性肾病的临床疗效。方法 70例慢性尿酸性肾病患者,随机分为2组。两组疗程均为3个月。观察肾功能[肌酐(Scr)、尿素氮(BUN)、尿酸(UA)]、C反应蛋白(CRP)、血清雌二醇(E2)、睾酮(T)、尿微量白蛋白/尿肌酐(U-MA/U-Cr)、尿β2微球蛋白(Uβ2-MG)、尿沉渣红细胞计数的变化以及中医临床征候表现。结果与对照组比较,加味四妙方组总有效率提高,组间差异显著(P<0.05)。在改善血Scr、UA、BUN、CRP、T、E2以及降低U-MA、Uβ2-MG和尿沉渣红细胞计数方面,加味四妙方组均优于对照组(P<0.05或P<0.01)。结论加味四妙汤联合基础治疗湿热浊瘀型慢性尿酸性肾病疗效显著。

Objective To observe the clinical therapeutic effect of Jia Wei Si Miao decoction on chronic uric acid nephropathy. Methods Seventy cases of dampness-heat stagnancy type of chronic uric acid nephropathy were randomly divided into the control group （35 cases）used standard treatment and the treatment group （35 cases） used standard treatment plus Jia Wei Si Miao decoction for 3 months. The total therapeutic effect, renal function （Scr, BUN, UA）, CRP, serum estradiol（E2）, testosterone （T）, urinary microalbumin/creatinine （U-MA/U-Cr）, urine β2 microglobulin （Uβ2- MG）, the changes of urinary sediment red blood cell count and clinical symptom of TCM were evaluated. Results A remarkable difference in the effect rate （P 〈 0.05） between the treatment group and the control group was found. In aspects of improving the Scr, BUN, UA, CRP, E2, T, and reducing U-MA,Uβ2- MG, and uric red blood cell numbers, the treatment group were better than the control group （P 〈 0.05 or P 〈 0.01）. Conclusion Standard treatment plus Jia Wei Si Miao decoction can enhance the clinical curative effect in the treatment of dampness-heat stagnancy type of chronic urate nephropathy.