祛痹消癥益肾方治疗高尿酸血症肾病的疗效观察及对IL-1β、IL-18、TNF-α表达的影响

Curative Effect of Qubi Xiaozheng Yishen Decoction(祛痹消癥益肾方)in Treatment of Hyperuricemia Nephropathy and the Influence on IL-1β,IL-18,TNF-α

目的:探讨祛痹消癥益肾方治疗高尿酸血症肾病的疗效及对IL-1β(白介素-1β)、IL-18(白介素-18)、TNF-α(肿瘤坏死因子-α)表达的影响。方法:选取100例高尿酸血症肾病患者,随机分成西医组和中西结合组各50例,西医组行常规西医治疗,中西结合组在西医组基础上加用祛痹消癥益肾方,治疗2个月后评估临床疗效,并比较两组患者肾功能相关指标(UA、SCr、BUN、β_(2)-MG、24 h UP)、血清IL-1β、IL-18及TNF-α的变化。结果:中西结合组临床总有效率(90.0%)较西医组(74.0%)明显升高,差异有统计学意义(P<0.05)。与本组治疗前比较,治疗2个月后两组UA、SCr、BUN、β_(2)-MG、24 hUP下降(P均<0.05);治疗后组间比较,中西结合组上述各指标明显低于西医组,差异均有统计学意义(P均<0.05)。治疗后两组患者血清IL-1β、IL-18及TNF-α水平均较治疗前降低(P均<0.05),且治疗后中西结合组上述各指标明显低于西医组,差异有统计学意义(P均<0.05)。结论:祛痹消癥益肾方治疗高尿酸血症肾病可控制尿酸水平,改善肾功能,并能下调炎性因子表达,减轻肾脏炎症损伤,其疗效优于单纯西医治疗。

Objective:To investigate the efficacy of Qubi Xiaozheng Yishen Decoction in the treatment of hyperuricemia nephropathy and the effect on serum IL-1β,IL-18,TNF-αexpressions.Methods:100 patients with hyperuricemia nephropathy were randomly divided into Western medicine group and integrated Chinese and Western medicine group,with 50 cases in each.Western medicine group was treated with Western medicine routine treatment,integrated Chinese and Western medicine group was given Qubi Xiaozheng Yishen Decoction on the basis of Western medicine routine treatment,after^(2) months of treatment,evaluated the curative effect and compare the changes in renal function related indicators(UA,SCr,BUN,β_(2)-MG,24 hUP)and serum IL-1β,IL-18,TNF-αchanges between the two groups.Results:The total clinical effective rate of the integrated Chinese and Western medicine group was 90.0%,which was significantly higher than that of the Western medicine group that was 74.0%,the difference was statistically significant(P<0.05).Compared with before treatment,UA,SCr,BUN,β_(2)-MG,24 hUP levels were decreased in the two groups after^(2) months of treatment(P<0.05);the levels of the above indicators in the integrated Chinese and Western medicine group were significantly lower than those in the Western medicine group,and the differences were all statistically significant(P<0.05).The levels of IL-lβ,IL-18,TNF-αwere lower in the two groups after two months treatment than before treatment(P<0.05),and the levels of IL-lβ,IL-18,TNF-αin the integrated Chinese and Western medicine group were significantly lower than those in the Western medicine group after treatment,the difference was statistically significant(P<0.05).Conclusion:Qubi Xiaozheng Yishen Decoction can control uric acid levels,improve renal function,and down-regulate the inflammasomes expressions and reduce kidney inflammation damage in patients with hyperuricemia nephropathy,Its curative effect is better than that of Western medicine alone.