辨证分型治疗痛风性肾病随机平行对照研究  

Syndromes Gouty Nephropathy Randomized Controlled Study

作　　者：丁颖迪[1] 

机构地区：[1]吉林省长春市中医院血液净化科,长春130031

出　　处：《实用中医内科杂志》2015年第8期23-25,共3页Journal of Practical Traditional Chinese Internal Medicine

摘　　要：[目的]观察辨证分型治疗痛风性肾病疗效。[方法]使用随机平行对照方法,将40例门诊及住院患者按抛硬币法简单随机分为两组。控制尿酸合成,提高尿酸排泄度,控制尿液p H值,嘱咐大量饮水,指导饮食,多吃低嘌呤食物。对照组20例别嘌醇,0.2g/次,3次/d;碳酸氢钠,1g/次,3次/d。治疗组20例脾肾虚衰、湿毒内滞:扶正解毒汤(大黄、干姜各10g,山药20g,土茯苓30g,续断炒20g,仙灵脾30g,甘草5g,附子制10g,太子参20g,黄芪30g,苍术炒20g,砂仁15g,丹参30g);气阴两虚、水湿内停:金匮肾气丸(附子炮6g,山茱萸、丹皮各15g,茯苓20g,砂仁12g,川芎、熟地黄各15g,肉桂10g,山药炒20g,黄芪30g,党参20g,知母12g);湿热痹阻、瘀血内停:四妙勇安汤合四物汤(苍术炒30g,牛膝10g,当归、赤芍各15g,萹蓄10g,滑石15g,甘草5g,黄柏、川芎、生地各15g,萆薜30g,车前子15g,白茅根20g);均1剂/d,水煎200m L,早晚口服。连续治疗56d为1疗程。观测临床症状、血尿酸、血肌酐、尿素氮、不良反应。治疗1疗程,判定疗效。[结果]治疗组显效11例,有效7例,无效2例,总有效率90.00%。对照组显效7例,有效5例,无效8例,总有效率60.00%。治疗组疗效优于对照组(P<0.05)。[结论]辨证分型治疗痛风性肾病疗效满意,无严重不良反应,值得推广。[Objective]To observe Syndromes gouty nephropathy.[Methods]Randomized parallel controlled method,40 cases of outpatient and inpatient simply by flipping a coin law randomly divided into two groups.Control uric acid synthesis,increase the excretion of uric acid,urine p H control,asked a lot of water,guiding diet,eat low-purine foods.The control group 20 cases allopurinol,0.2g/time,3 times/d;with sodium bicarbonate,1g/time,3 times/d.The treatment group 20 cases Syndromes.Spleen virtual failure,internal poisoning caused by stagnation：FJD（Dahaung,Ganjiang 10 g,Shaoyao 20 g,Tufuling 30 g,Xuduan 20 g,Xianlingpi 30 g,Gancao 5g,Zhifuzi 10 g,Taizishen 20 g,Huangqi 30 g,Cangzhu 20 g,Sharen 15 g,Danshen 30g）;Qi,moisture inside the stop type：Jingguishenqi pill（Fuzi 6g,Shanzhuyu,Danpi 15 g,Fuling 20 g,Sharen 12 g,Chuanxiong,Shudihaung 15 g,Rougui 10 g,Sahnyao 20 g,Huangqi 30 g,Dangshen 20 g,Zhimu 12g）;heat blockage,bleeding within the stop type：Simiao decoction and Siwutang（Cangzhu 30 g,Niuxi 10 g,Danggui,Chishao 15 g,Bianxu 10 g,Huashi 15 g,Gancao 5g,Huangbai,Chuanxiong,Shengdi 15 g,Bibi 30 g,Cheqianzi 15 g,Baimaogen 20g）;both a/d,decoction 200 m L,sooner or later orally.56 d for a course of continuous treatment.Observation of clinical symptoms,uric acid,creatinine,urea nitrogen,adverse reactions.A course of treatment,to determine efficacy.[Results]In treatment group,11 cases markedly effective in 7 cases,2 cases,the total efficiency of 90.00%.Group 7 cases markedly effective in 5 cases,8 cases,the total efficiency of 60.00%.Treatment group than the control group（P〈0.05）.[Conclusion]Syndromes gouty nephropathy treatment satisfaction,no side effects,worthy of promotion.

关 键 词：痛风性肾病 辨证分型 别嘌醇 碳酸氢钠片 血尿酸 血肌酐 尿素氮 中医药治疗 随机平行对照研究 

分 类 号：R276.144.3[医药卫生—中医五官科学]