滋阴养血通络法联合常规西药治疗痛风性肾病临床研究  

Clinical Study on Method of Nourishing Yin,Tonifying Blood and Unblocking the Collaterals Combined with Routine Western Medicine for Gouty Nephropathy

作　　者：陈惠霞 王伟伟 宋艳艳 CHEN Huixia;WANG Weiwei;SONG Yanyan(Department of Renal Rheumatology and Immunology,Central Hospital,Jiaozuo He'nan 454100,China)

机构地区：[1]焦煤中央医院肾脏风湿免疫科,河南焦作454100

出　　处：《新中医》2023年第15期79-84,共6页New Chinese Medicine

基　　金：河南省医学科技攻关计划联合共建项目(LHGJ20191168)。

摘　　要：目的:滋阴养血通络法联合常规西药治疗痛风性肾病的临床疗效。方法:选择痛风性肾病患者106例,按随机数字表法分为研究组和对照组各53例。对照组给予常规西药治疗,研究组在对照组基础上给予滋阴养血通络法治疗。比较2组治疗前后血清可溶性血管细胞黏附分子-1(sVCAM-1)、单核细胞趋化蛋白-1(MCP-1)、核因子-κB(NF-κB)、NACHT-LRR-PYD结构域蛋白3(NALP3)、血友病因子(vWF)、血管内皮生长因子(VEGF)、活性氧(ROS)、超氧化物歧化酶(SOD)、总抗氧化能力(TAOC)、尿酸(UA)水平,检测尿α1-微球蛋白(α1-MG)、β-D半乳糖苷酶(GAL)、N-乙酰-β-D氨基葡萄糖苷酶(NAG)、丙氨酸氨基肽酶(AAP)水平,检测2组肾主动脉中段舒张末期最低流速(Vdmin)、收缩期峰值流速(Vsmax)、阻力指数(RI),评价2组临床疗效。结果:治疗后,2组血清NF-κB、NALP3、MCP-1、UA、ROS、vWF、sICAM-1水平较治疗前降低(P<0.05),且研究组血清NF-κB、NALP3、MCP-1、UA、ROS、vWF、sICAM-1水平低于对照组(P<0.05)。治疗后,2组血清SOD、TAOC、VEGF水平较治疗前升高(P<0.05),研究组血清SOD、TAOC、VEGF水平高于对照组(P<0.05)。治疗后,2组尿α1-MG、GAL、NAG、AAP水平较治疗前降低(P<0.05),研究组尿α1-MG、GAL、NAG、AAP水平低于对照组(P<0.05)。治疗后,2组肾主动脉中段Vdmin、Vsmax较治疗前升高(P<0.05),研究组肾主动脉中段Vdmin、Vsmax高于对照组(P<0.05);2组肾主动脉中段RI较治疗前降低(P<0.05),研究组肾主动脉中段RI低于对照组(P<0.05)。研究组总有效率为96.23%,高于对照组84.91%(P<0.05)。结论:滋阴养血通络法联合常规西药治疗痛风性肾病患者,可抑制机体微炎症状态,降低氧化应激反应,提升血管内皮功能,减少肾小管损伤,改善肾血流动力学,提升临床疗效。Objective:To observe the clinical effect of method of nourishing yin,tonifying blood and unblocking the collaterals combined with routine western medicine on gouty nephropathy.Methods:A total of 106 patients with gouty nephropathy were selected and divided into the study group and the control group according to the random number table method,with 53 cases in each group.The control group was given routine western medicine for treatment,and the study group was additionally treated with method of nourishing yin,tonifying blood and unblocking the collaterals based on the treatment of the control group.Before and after treatment,the levels of serum soluble intracellular adhesion molecule-1(sVCAM-1),monocyte chemoattractant protein-1(MCP-1),nuclear factorκB(NF-κB),NACHT-LRR-PYD domain protein 3(NALP3),von Willebrand Factor(vWF),vascular endothelial growth factor(VEGF),reactive oxygen species(ROS),superoxide dismutase(SOD),total antioxidant capacity(TAOC)and urine acid(UA)were compared between the two groups;the levels ofα1-microglobulin(α1-MG),β-D galactosidases(GAL),N-acetyl-β-D-glucosidase(NAG)and alanine aminopeptidase(AAP)in urine in the two groups were detected;the minimum end-diastolic velocity(Vdmin),maximum systolic velocity(Vsmax),and resistance index(RI)of the middle renal aorta in both groups were detected,and the clinical effects were evaluated.Results:After treatment,the levels of serum NF-κB,NALP3,MCP-1,UA,ROS,vWF and sICAM-1 in the two groups were decreased when compared with those before treatment(P<0.05),and the above seven levels in the study group were lower than those in the control group(P<0.05).After treatment,the levels of serum SOD,TAOC and VEGF in both groups were increased when compared with those before treatment(P<0.05),and the above three levels in the study group were higher than those in the control group(P<0.05).After treatment,the levels ofα1-MG,GAL,NAG and AAP in urine in the two groups were decreased when compared with those before treatment(P<0.05),and the above four levels i

关 键 词：痛风性肾病 滋阴养血通络法 微炎症 抗氧化指标 血管内皮功能 肾小管损伤 

分 类 号：R589.7[医药卫生—内分泌]