降尿酸方联合别嘌醇治疗尿酸性肾病的临床研究  

Clinical study on Uric acid-reducing Decoction combined with allopurinol in treating uric acid nephropathy

作　　者：王毅兴[1] 王维谆[1] 高建东[2] 张春燕[1] WANG Yixing;WANG Weizhun;GAO Jiandong;ZHANG Chunyan(Department of Traditional Chinese Medicine,East Hospital Affiliated to Tongfi University,Shanghai 200120,China;Department of Nephrology,Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine;Nephrology Institute of Traditional Chinese Medicine,Shanghai University of Traditional Chinese Medicin;Key Laboratory for Liver and Kidney Diseases of Education Ministr;Shanghai Clinical Key Laboratory of Traditional Chinese Medicine,Shanghai 201203,China)

机构地区：[1]同济大学附属东方医院中医科,上海200120 [2]上海中医药大学附属曙光医院肾病科上海中医药大学中医肾病研究所肝肾疾病病证教育部重点实验室上海市中医临床重点实验室,上海201203

出　　处：《上海中医药杂志》2018年第8期44-46,57,共4页Shanghai Journal of Traditional Chinese Medicine

基　　金：国家自然科学基金面上项目(81373613);上海市浦东新区卫计委名中医继承人培养建设项目(PDZYXK-6-2014024);上海市浦东新区卫计委名中医及名中医工作室项目(PDZYXK-3-2014014)

摘　　要：目的探讨降尿酸方联合别嘌醇治疗脾肾气虚兼湿热内蕴型尿酸性肾病的临床疗效。方法将60例脾肾气虚兼湿热内蕴型尿酸性肾病患者随机分为治疗组和对照组,每组30例。两组均予别嘌醇片口服,治疗组在此基础上加服降尿酸方。两组疗程均为28天,观察临床疗效,比较血尿酸、血肌酐、血尿素氮、肾小球滤过率、尿β2微球蛋白、N-乙酰基-β-D氨基葡糖苷酶、24 h尿蛋白定量的变化情况。结果 (1)治疗组、对照组总有效率分别为80.0%、50.0%;组间临床疗效比较,治疗组明显优于对照组(P<0.05)。(2)与本组治疗前比较,治疗组血尿酸、血肌酐、尿β2微球蛋白、N-乙酰基-β-D氨基葡糖苷酶、24 h尿蛋白定量水平下降(P<0.05),肾小球滤过率明显提高(P<0.05),对照组仅血尿酸水平下降(P<0.05);组间治疗后比较,上述各指标差异均有统计学意义(P<0.05)。结论降尿酸方联合别嘌醇治疗脾肾气虚兼湿热内蕴型尿酸性肾病,不仅能明显降低血尿酸水平,还可改善肾小球滤过功能、肾小管修复功能,降低尿蛋白水平。Objective To discuss the clinical efficacy of Uric acid-reducing Decoction combined with allopurinol in the treatment of uric acid nephropathy with syndrome of qi deficiency of spleen and kidney and dampness-heat accumulated in interior. Methods Sixty patients of uric acid nephropathy with syndrome of qi deficiency of spleen and kidney and dampness-heat accumulated in interior were randomly divided into the treatment group and control group,30 cases in each group. Both groups were orally treated with allopurinol tablets,and the treatment group was additionally treated with Uric acid-reducing Decoction,with a course of28 days. The clinical efficacy was observed. The changes on uric acid,creatinine and urea nitrogen levels in serum,glomerular filtration rate,urinary β2 microglobulin,N-acetyl-β-D glucosaminidase and 24 h urine protein quantity were compared. Results（1）The total effective rates were 80.0% in the treatment group and 50.0% in the control group,the clinical efficacy of the treatment group was better than that of the control group（P〈0.05）.（2）Compared with treatment before,the levels of serum uric acid,serum creatinine,urinary β2 microglobulin,N-acetyl-β-D glucosaminidase and 24 h urine protein quantity were decreased（P〈0.05） and the glomerular filtration rate was obviously increased（P〈0.05） in the treatment group,while only the serum level of uric acid was decreased in the control group（P〈0.05） after treatment. There were statistically significant differences on above indexes between the two groups after treatment（P〈0.05）.Conclusion Uric acid-reducing Decoction combined with allopurinol in the treatment of uric acid nephropathy with syndrome of qi deficiency of spleen and kidney and dampness-heat accumulated in interior can not only significantly decrease the serum level of uric acid,but also improve the glomerular filtration function and renal tubule repair function,and reduce the proteinuria level.

关 键 词：尿酸性肾病 中西医结合疗法 降尿酸方 别嘌醇 血尿酸 

分 类 号：R692[医药卫生—泌尿科学]