黄葵胶囊联合苯溴马隆治疗尿酸性肾病临床研究

目的：评价黄葵胶囊联合苯溴马隆治疗尿酸性肾病(chronic uric acid nephropathy, CUAN)的疗效。方法将符合入选标准的CUAN患者60例采用随机数字表法分为2组，每组30例。均给予低嘌呤、低蛋白饮食，戒烟戒酒，多饮水等常规治疗，对照组在此基础上口服苯溴马隆，中西医结合组在对照组基础上口服黄葵胶囊。2组均治疗8周。采用全自动生化分析仪检测患者血尿酸(blood uric acid, BUA)、血肌酐(serum creatinine, SCr)、血尿素氮(blood urea nitrogen, BUN)、血清胱抑素C(cystatin C, Cys-C)、SOD、24 h尿蛋白定量、尿沉渣红细胞计数，采用类风湿关节炎生活质量量表评价患者生活质量。结果中西医结合组总有效率为86.64%(26/30)、对照组为63.33%(19/30)，2组比较差异有统计学意义(χ2＝7.264， P＝0.001)。治疗后，中西医结合组 BUA(273.52±110.37)μmol/L 比(331.28±126.54)μmol/L，Z＝-2.543]、BUN(6.24±1.23)mol/L比(8.16±2.35)mol/L，Z＝-2.680]、SCr(90.37±20.16)μmol/L比(110.38±16.72)μmol/L，Z＝-2.534]、Cys C(0.86±0.51)比(1.03±0.10)，Z＝-2.372]水平低于对照组(P＜0.01)，SOD(156.37±32.04)μmol/L 比(143.36±31.52)μmol/L，Z＝-2.041]高于对照组(P＜0.01)；24 h尿蛋白定量(439.86±250.41)mg/24 h比(897.69±213.37)mg/24 h，Z＝-2.853]、尿沉渣红细胞计数(50.31±14.06)个/μl 比(213.47±38.46)个/μl，Z＝-2.106]低于对照组(P＜0.01)；中西医结合组生理功能(43.14±2.06)分比(36.48±3.21)分，Z＝10.362]、心理功能(40.76±3.28)分比(16.54±3.71)分，Z＝9.547]、社会功能(40.74±3.58)分比(33.04±5.48)分，Z＝6.034]、健康自我认识(24.57±1.97)分比(22.63±3.43)分，Z＝4.236]评分与总评分(127.38±6.43)分比(107.69±13.57)分，Z＝6.754]均高于对照组(P＜0.01)。结论黄葵胶囊联合苯溴马隆可降低CUAN患者SCr水平，保护肾功能，提高生活质量。

Clinical study ofHuangkui capsule combined with benzbromarone on the treatment of the patients with chronic uric acid nephropathy

Objective To observe the clinical effect ofHuangkui capsule combined with benzbromarone on the treatment of the patients with chronic uric acid nephropathy (CUAN).Methods A total of 60 patients were recruited and divided into the treatment group and the control group by using the random number table method, each group 30 patients. Two groups were treated with conventional treatment, such as low purine, low protein diet, quit smoking and drinking extra water. The control group was added with oral benzbromarone, and the treatment group was added with oralHuangkui capsule. All the treatments last 8 weeks. Theblood uric acid (BUA), serum creatinine (SCr), blood urea nitrogen (BUN), cystatin C (Cys-C), SOD, 24-hour urinary protein quantity and Urinary sediment red blood cell count were detected by the automatic biochemical analyser.The clinical effect was evaluated by the Rheumatoid arthritis (RA) quality of life questionnaire.Results Compared with the control group, the total effective rate in the treatment group was 86.64% (26/30), which was significantly higher than that of 63.33% (19/30) in the control group (χ2=7.264, P=0.001). After treatment, the BUA (273.52 ± 110.37μmol/Lvs. 331.28 ± 126.54μmol/L,Z=-2.543), BUN (6.24 ± 1.23 mol/Lvs. 8.16 ± 2.35 mol/L,Z=-2.680), SCr (90.37 ± 20.16μmol/Lvs. 110.38 ± 16.72μmol/L,Z=-2.534), Cys C (0.86 ± 0.51 vs. 1.03 ± 0.10,Z=-2.372) in the treatment group were lower than those of the control group (P<0.01); SOD (156.37 ± 32.04μmol/Lvs. 43.36 ± 31.52μmol/L,Z=-2.041) in the treatment group was higher than that in the control group (P<0.01); the 24 hours urinary protein (439.86 ± 250.41 mg/24hvs.897.69 ± 213.37 mg/24h,Z=-2.853), urine sediment RBC counts (50.31 ± 14.06 points/μlvs.213.47 ± 38.46 points/μl, Z=-2.106) in the treatment group were lower than those in the control group (P<0.01); the physiological function(43.14 ± 2.06 pointsvs.36.48 ± 3.21 points,Z=10.362), the psychological function (40.76 ± 3.28 points vs. 16.54 ± 3.71 points,Z=9.547), social function (40.74 ± 3.58 points vs. 33.04 ± 5.48 points,Z=6.034), healthy self-awareness (24.57 ± 1.97 points vs. 22.63 ± 3.43 points,Z=4.236) and total score (127.38 ± 6.43 points vs. 107.69 ± 13.57 points,Z=6.754) in the treatment group were higher than those in the control group (P<0.01) . Conclusions TheHuangkui capsule combined with benzbromarone could reduce CUAN patient's blood uric acid levels, protect renal function, and improve the quality of life.