加味三仁汤治疗湿热内蕴型痛风性肾病临床观察  

Efficacy observation of modified Sanren decoction on gouty nephropathy with syndrome of heat-damp retention in the interior

作　　者：焦璐璐 王体敬 JIAO Lu-lu;WANG Ti-jing(Shandong University of Traditional Chinese Medicine,Jinan250014,China;不详)

机构地区：[1]山东中医药大学,济南250014 [2]山东省菏泽市中医医院

出　　处：《山西中医》2024年第6期19-22,共4页Shanxi Journal of Traditional Chinese Medicine

基　　金：山东省中医药科技项目(编号:2020Q134)。

摘　　要：目的:观察加味三仁汤治疗湿热内蕴型痛风性肾病的临床疗效。方法:选取62例湿热内蕴型痛风性肾病患者,随机分为两组各31例。对照组予非布司他片治疗,治疗组在对照组基础上予加味三仁汤治疗。2周为1个疗程,治疗4个疗程。比较两组患者治疗前后肾功能指标[24小时尿蛋白总量(24 h-UTP)、肾小球滤过率(eGFR)、血尿酸(UA)、肌酐(Scr)、尿素氮(BUN)、β_(2)微球蛋白(β_(2)-MG)、胱抑素C(Cys-C)、同型半胱氨酸(Hcy)、视黄醇结合蛋白(RBP)、尿N-乙酰-β-D-氨基葡萄糖苷酶(NAG)]水平、炎症指标[白介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、C反应蛋白(CRP)]水平及中医证候积分变化情况,评估加味三仁汤的临床疗效和安全性。结果:治疗组总有效率为87.10%,对照组为70.97%,治疗组优于对照组,差异具有统计学意义(P﹤0.05);治疗后,两组患者24 h-UTP、eGFR、UA、Scr、BUN、β_(2)-MG、Cys-C、Hcy、RBP、NAG、IL-6、TNF-α、CRP水平及中医证候积分均优于治疗前(P﹤0.05),且治疗组改善程度优于对照组(P﹤0.05)。结论:加味三仁汤可以改善患者肾功能、减轻炎症反应、缓解临床症状,疗效优于单纯西医治疗。Objective:To observe the clinical efficacy of modified Sanren decoction on gouty nephropathy with syndrome of damp-heat retention in the interior.Methods:62 cases of patients with gout nephropathy with syndrome of damp-heat retention in the interior were selected and randomly divided into two groups,31 cases in each group.The control group was treated with febuxostat tablets,while the treatment group was treated plus with modified Sanren decoction on the basis of control group.2 weeks as 1 course of treatment,in total 4 courses of treatment.The changes of renal function indexes[including 24-hour urinary total protein(24 h-UTP),estimated glomerular filtration rate(eGFR),serum uric acid(UA),creatinine(Scr),urea nitrogen(BUN),β_(2)-microglobulin(β_(2)-MG),cystatin C(Cys-C),homocysteine(Hcy),retinol binding protein(RBP),urinary N-acetyl-β-D-glucosaminidase(NAG)],inflammato ry indexes[including interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),C-reactive protein(CRP)]and TCM syndrome score of patients were compared between two groups before and after treatment.The clinical efficacy and safety of modified Sanren decoction were evaluated.Results:The total effective rate was 87.10%in the treatment group and 70.97%in the control group,the treatment group was better than control group,and the difference was statistically significant(P﹤0.05).After treatment in both groups,the levels of 24 h-UTP,eGFR,UA,Scr,BUN,β_(2)-MG,Cys-C,Hcy,RBP,NAG,IL-6,TNF-αand CRP as well as TCM syndrome scores of patients were better than those before treatment(P﹤0.05),and the improvement degree of treatment group was better than that of control group(P﹤0.05).Conclusion:Modified Sanren decoction can improve renal function of patients,reduce inflammatory reaction and relieve clinical symptoms.Its curative effect is better than that of simple western medicine.

关 键 词：痛风性肾病 湿热内蕴 加味三仁汤 中西医结合疗法 

分 类 号：R277.5[医药卫生—中医学]