散结通络益肾泄浊法联合别嘌醇缓释胶囊治疗早期痛风肾病效果及对患者症状改善、生化指标的影响

Sanjie Tongluo Yishen Xiezhuo Method Combined with Allopurinol Sustained Release Capsule in the Treatment of Early Gouty Nephropathy and Its Effect on Symptom Improvement and Biochemical Indexes

目的探讨散结通络益肾泄浊法联合别嘌醇缓释胶囊治疗早期痛风肾病(GN)效果及对患者症状改善、生化指标的影响。方法选取2020年10月—2022年5月收治的早期GN 60例,根据治疗方法不同将其分为观察组和对照组2组各30例。观察组采用散结通络益肾泄浊法联合别嘌醇缓释胶囊治疗,对照组采用别嘌醇缓释胶囊治疗。比较2组治疗8周后临床效果及治疗前、治疗4周后、治疗8周后中医证候积分、肾功能指标、血清炎性因子、T淋巴细胞亚群,以及治疗期间不良反应。结果治疗8周后,观察组总有效率[90.00%(27/30)]高于对照组[66.67%(20/30)](P<0.05)。与治疗前比较,治疗4周和8周后2组中医证候主症积分、次症积分、总积分,肾功能指标,血清炎性因子及CD3+/CD8+、CD4+/CD8+均降低,CD3+和CD3+/CD4+均升高(P<0.05);与治疗4周后比较,治疗8周后2组中医证候主症积分、次症积分、总积分,肾功能指标,血清炎性因子及CD3+/CD8+、CD4+/CD8+亦均降低,CD3+和CD3+/CD4+亦均升高(P<0.05)。治疗4周和8周后,观察组中医证候主症积分、次症积分、总积分,肾功能指标,血清炎性因子及CD3+/CD8+、CD4+/CD8+低于对照组,CD3+和CD3+/CD4+高于对照组(P<0.05)。治疗期间,2组不良反应总发生率比较差异无统计学意义(P>0.05)。结论散结通络益肾泄浊法联合别嘌醇缓释胶囊治疗早期GN患者效果可靠,可减轻炎性损伤,提高机体免疫功能,从而改善临床症状,促进肾功能好转,且安全性较好。

Objective To investigate the effect of Sanjie Tongluo Yishen Xiezhuo method combined with Allopurinol sustained release capsule in the treatment of early gouty nephropathy(GN)and its effect on the improvement of symptoms and biochemical indexes of patients.Methods Sixty patients with early GN treated from October 2020 to May 2022 were selected and divided into observation group(n=30)and control group(n=30)according to different treatment methods.The observation group was treated with Sanjie Tongluo Yishen Xiezhuo method combined with Allopurinol sustained release capsules,and the control group was treated with Allopurinol sustained release capsules.The clinical effects at 8 weeks after treatment,TCM syndrome scores,renal function indexes,serum inflammatory factors,and T lymphocyte subsets at 4 weeks and 8 weeks after treatment as well as adverse reactions during treatment were compared between the two groups.Results At 8 weeks after treatment,the total effective rate of observation group[90.00%(27/30)]was higher than that of control group[66.67%(20/30)](P<0.05).Compared with those before treatment,the main TCM syndrome score,secondary syndrome score,total score,renal function index,serum inflammatory factors,CD3+/CD8+,and CD4+/CD8+were decreased at 4 and 8 weeks after treatment,while both CD3+and CD3+/CD4+were increased(P<0.05).Compared with those at 4 weeks after treatment,the main TCM symptom score,secondary symptom score,total score,renal function index,serum inflammatory factors,CD3+/CD8+,and CD4+/CD8+were also decreased at 8 weeks after treatment in the two groups,while CD3+and CD3+/CD4+were also increased(P<0.05).At 4 and 8 weeks after treatment,the main TCM syndrome score,secondary syndrome score,total score,renal function index,serum inflammatory factors,CD3+/CD8+,and CD4+/CD8+in the observation group were lower than those in the control group,while CD3+and CD3+/CD4+were higher than those in the control group(P<0.05).During treatment,there was no significant difference in the total incidence of adverse reactions between the two groups(P>0.05).Conclusion Sanjie Tongluo Yishen Xiezhuo method combined with Allopurinol sustained release capsule has a reliable effect in the treatment of early GN patients,which can reduce inflammatory damage,improve immune function,improve clinical symptoms and promote renal function,with good safety.