健脾益肾祛瘀汤联合非布司他治疗尿酸性肾病临床研究

Clinical Study on Jianpi Yishen Quyu Tang Combined with Febuxostat for Uric Acid Nephropathy

目的:观察健脾益肾祛瘀汤联合非布司他治疗尿酸性肾病(UAN)的临床疗效。方法:选取UAN患者74例,按随机数字表法分为对照组和观察组各37例。2组均予以多饮水、低嘌呤饮食、适当运动和碱化尿液等治疗,对照组予非布司他片口服,观察组在对照组基础上加健脾益肾祛瘀汤,2组均治疗12周。评价2组临床疗效,比较2组治疗前后血尿酸(SUA)、血肌酐(SCr)、肾小球滤过率(eGFR)、尿微量白蛋白排泄率(UAER)和24 h尿蛋白定量(24 h-UP)的变化。结果:观察组总有效率为94.59%,高于对照组78.38%,差异有统计学意义(P<0.0)。治疗前,2组SUA、SCr及eGFR水平比较,差异无统计学意义(P>0.05)。治疗后,2组SUA、SCr水平较治疗前下降,且观察组SUA、SCr水平低于对照组(P<0.05);2组eGFR水平较治疗前升高,且观察组eGFR水平高于对照组(P<0.05)。治疗前,2组UAER、24 h-UP水平比较,差异无统计学意义(P>0.05)。治疗后,2组UAER、24 h-UP水平较治疗前降低,且观察组UAER、24 h-UP水平低于对照组,差异有统计学意义(P<0.05)。结论:健脾益肾祛瘀汤联合非布司他治疗UAN疗效确切,能有效保护肾功能,降低血尿酸水平,减少尿蛋白的排泄。

Objective:To observe the clinical effect of the therapy of Jianpi Yishen Quyu tang combined with febuxostat on uric acid nephropathy(UAN).Methods:A total of 74 patients with UAN were selected and randomly divided into the control group and the observation group according to the random number table method,with 37 cases in each group.Both groups were treated with drinking water,low purine diet,appropriate exercise,alkaline urine and so on.The control group was treated with oral administration of febuxostat tablets,and the observation group was additionally treated with Jianpi Yishen Quyu tang based on the treatment of the control group.Both groups were treated for 12 weeks.The clinical effects in the two groups were evaluated.Before and after treatment the changes of serum uric acid(SUA),serum creatinine(SCr),estimated glomerular filtration rate(eGFR),urinary albumin excretion rate(UAER)and 24-hour urinary protein(24 h-UP)in the two groups were compared.Results:The total effective rate was 94.59%in the observation group,higher than that of 78.38%in the control group,the difference being significant(P<0.05).Before treatment,there was no significant difference being found in the comparison of levels of SUA,SCr and eGFR between the two groups(P>0.05).After treatment,the levels of SUA and SCr in the two groups were decreased when compared with those before treatment,and the above two levels in the observation group were lower than those in the control group(P<0.05);the eGFR level in the two groups was increased when compared with that before treatment,and the eGFR level in the observation group was higher than that in the control group(P<0.05).Before treatment,there was no significant difference being found in the comparison of levels of UAER and 24 h-UP between the two groups(P>0.05).After treatment,the levels of UAER and 24 h-UP in the two groups were decreased when compared with those before treatment,and the above two levels in the observation group were lower than those in the control group(P<0.05).Conclusion:The therapy of Jianpi Yishen Quyu tang combined with febuxostat has a definite curative effect on patients with UAN,which can effectively protect the kidney function,reduce the level of serum uric acid,and decrease the urinary protein excretion.