半夏泻心汤加味联合非布司他治疗高尿酸血症的临床观察

Clinical Observation on Modified Banxia Xiexin Decoction Combined with Febuostat in the Treatment of Hyperuricemia

目的观察半夏泻心汤加味联合非布司他对高尿酸血症的临床疗效。方法将60例高尿酸血症患者随机分为观察组和对照组,各30例,对照组予非布司他治疗,观察组在对照组的基础上予中药汤剂半夏泻心汤加味治疗,持续治疗8周。观察两组患者治疗前后的中医证候积分、体质量指数(BMI)、血尿酸(UA)、血肌酐(Scr)、估算肾小球滤过率(eGFR)、甘油三酯(TG)、总胆固醇(TC)、白介素-1β(IL-1β)、肿瘤坏死因子-α(TNF-α)、可溶性细胞间黏附因子-1(sICAM-1)、门冬氨酸鸟氨酸蛋白酶-1(Caspase-1)的变化情况及不良反应情况。结果观察组的总有效率为96.67%,对照组为86.67%,观察组的总有效率高于对照组(P<0.05);治疗后,两组患者的中医证候积分评分均较治疗前下降(P<0.05),且观察组优于对照组(P<0.05);观察组患者的BMI、Scr、TG、TC均较治疗前降低,eGFR较治疗前升高(P<0.05),对照组患者的BMI、Scr均较治疗前降低(P<0.05),且观察组Scr、eGFR、TG、TC较对照组改善(P<0.05);治疗后,两组患者IL-1β、TNF-α、sICAM-1、Caspase-1均较治疗前下降(P<0.05),且观察组优于对照组(P<0.05)。结论半夏泻心汤加味联合非布司他治疗高尿酸血症具有良好的临床疗效,在降低尿酸、血脂,减轻机体炎症水平,改善患者肾功能及临床症状方面优于单用非布司他,且无严重不良反应,值得临床推广。

Objective To observe the clinical effects of Banxia Xiexin Decoction combined with febuxostat on hyperuricemia.Methods A total of 60 patients with hyperuricemia were randomly divided into an observation group and a control group,with 30 cases in each group.The control group was treated with febuxostat.The observation group was treated with Banxia Xiexin Decoction on the basis of the control group.The treatment lasted for 8 weeks.The scores of TCM syndromes,body mass index(BMI),blood uric acid(UA),serum creatinine(Scr),estimated glomerular filtration rate(eGFR),triglyceride(TG),total cholesterol(TC),Interleukin-1β(IL-1β),tumor necrosis factor-α(TNF-α),soluble intercellular adhesion factor-1(sICAM-1),ornithine aspartate protease-1(Caspase-1),as well as the adverse reactions were observed before and after treatment.Results The total effective rate of the observation group was 96.67%,and that of the control group was 86.67%.The total effective rate of the observation group was higher than that of the control group(P<0.05);after treatment,the scores of TCM syndromes of the 2 groups were decreased than those before treatment(P<0.05),and the observation group was better than the control group(P<0.05);BMI,Scr,TG and TC in the observation group were decreased than those before treatment,and eGFR was increased than those before treatment(P<0.05).BMI and Scr in the control group were decreased than those before treatment(P<0.05),and Scr,eGFR,TG and TC in the observation group were better than those in the control group(P<0.05);after treatment,the levels of IL-1β,TNF-α,sICAM-1 and Caspase-1 in the 2 groups were lower than those before treatment(P<0.05),and the observation group was better than the control group(P<0.05).Conclusion Banxia Xiexin Decoction combined with febuxostat has good clinical efficacy in the treatment of hyperuricemia.It is superior to febuxostat alone in reducing uric acid and blood lipid,alleviating bodily inflammation level,improving renal function and clinical symptoms,and has no serious adverse reactions,which is worthy of clinical promotion.