健脾补肾化湿解毒方联合西药治疗痛风性肾病临床研究

Clinical Study of Jianpi Bushen Huashi Jiedu Prescription Combined with Western Medicine in Treating Gouty Nephropathy

目的:观察健脾补肾化湿解毒方联合常规西药治疗痛风性肾病的临床疗效。方法:选取86例痛风性肾病脾肾气虚兼湿浊证患者,按随机数字表法分为对照组和观察组各43例,所有患者给予低嘌呤饮食并禁酒,服用别嘌呤醇片、碳酸氢钠片、控压降脂等基础药物治疗,观察组联合健脾补肾化湿解毒方治疗。2组均以4周为1疗程,3疗程后对比2组患者治疗前后的尿蛋白定量、尿红细胞计数、尿β_2微量球蛋白(β_2-MG)、血肌酐(SCr)、血尿素氮(BUN)、血尿酸(UA)水平,治疗后的临床疗效及不良反应情况。结果:观察组治疗总有效率为88.4%,显著高于对照组的67.4%,差异有统计学意义(P<0.05)。治疗后,对照组血UA较治疗前降低(P<0.05),而血SCr、血BUN、尿蛋白定量、尿红细胞计数及尿β_2-MG虽较治疗前降低,但差异均无统计学意义(P>0.05);观察组血UA、血SCr、血BUN、尿蛋白定量、尿红细胞计数及尿β_2-MG与治疗前相比均降低(P<0.05),6项指标值均低于对照组(P<0.05)。观察组不良反应发生率为9.3%,低于对照组的14.0%,但差异无统计学意义(P>0.05)。结论:健脾补肾化湿解毒方联合常规西药治疗痛风性肾病疗效确切,能显著改善患者的肾功能,安全性好。

Objective：To observe the clinical effect of Jianpi Bushen Huashi Jiedu prescription combined with routine western medicine in treating gouty nephropathy.Methods：Selected 86 patients with gouty nephropathy,divided them into the observation group and the control group randomly,43 cases in each.All patients were low purine diet and prohibited drinking alcohol,oral ingestion with allopurinol,gentamycin,and basic drug treatment for blood pressure control and lipid lowing.The observation group was given Jianpi Bushen Huashi Jiedu prescription additionally.One course of treatment for the two groups last 4 weeks.After the 3rd courses,compared levels of urinary protein,urinary erythrocyte count andβ_2-microglobulin（β_2-MG）,serum creatinine（SCr）,blood urea nitrogen（BUN）,blood uric acid（UA）,clinical effect and adverse reaction after treatment.Results：The total effective rate in the observation group was 88.4%,being obviously higher than the 67.4%in the control group（P〈0.05）.After treatment,blood UA was decreased in the control group,while blood SCr,blood BUN,urinary protein,urinary erythrocyte count and urinary β_2-MG were not decreased in the control group（P〈0.05）.Blood UA,SCr,BUN,urinary protein,urinary erythrocyte count and urinary β_2-MG were decreased in the observation group（P〈0.05）,scores of the 6 indexes were lower than those in the control group（P〈0.05）.Adverse reaction rate in the observation group was 9.3%,being lower than the 14.0%in the control group（P〈0.05）.Conclusion：Jianpi Bushen Huashi Jiedu prescription combined with routine western medicine in treating gouty nephropathy has obvious curative effect and high safety,can improve renal function of patients significantly.