加味三妙散治疗慢性尿酸性肾病的临床研究

目的 探讨加味三妙散治疗慢性尿酸性肾病的临床疗效。方法 94例慢性尿酸性肾病患者按随机数字表分为两组，每组47例。对照组采用常规西药治疗。治疗组加服加味三妙散，疗程12周。观察临床疗效及治疗前后尿蛋白（Pro）定量、尿沉渣红细胞计数（尿RBC）；尿β2 微球蛋白（β2-M）、尿N-乙酰β-D氨基葡萄糖苷酶（NAG）；血肌酐（SCr）、血尿素氮（BUN）、血尿酸（SUA）水平的变化。 结果 （1）治疗组总有效率为87.2%（41/47），对照组为61.7%（21/47），治疗组疗效优于对照组（P＜0.01）。（2）治疗后治疗组尿Pro、尿RBC排泄率、尿β2-M、尿NAG均明显改善，且优于对照组（P＜0.05，P＜0.01）；而对照组仅尿RBC较治疗前明显减少（P＜0.05），其他指标变化无统计学意义（P>0.05）。（3）治疗后两组SUA均显著降低（P＜0.01），且治疗组优于对照组（P＜0.05）；治疗组SCr、BUN亦明显改善（P＜0.01）。 结论 加味三妙散结合常规西药治疗慢性尿酸性肾病，不仅能明显降低SUA，而且能减轻蛋白尿、血尿，降低尿β2-M、尿NAG，改善肾功能。

Clinical Study on Modified Sanmiao Powder in Treating Chronic Uric Acid Nephropathy

Objective To investigate the clinical efficacy of modified Sanmiao Powder （SMP） in treating chronic uric acid nephropathy （CUAN）. Methods Ninety-four patients with CUAN were equally randomized to the treated group and the control group. Vonventiona treatment was given to all patients and the treated group was administered with SMP additionally for 12 weeks. Changes of symptoms were observed, and laboratory indexes, as urinary protein quantity （UPro）, urinary RBC count （URBC）, urinary β2 mJcroglobulin （β2-M）, urina- ry β-N-acetyglucosamidase （ NAG）, blood urea nitrogen （ BUN）, serum creatine （SCr） and serum uric acid （SUA）, were detected before and after treatment. Results The total effective rate in the treated group was 87.2% （41/47）, and in the control group was 61.7% （21/47）, showing significant difference between groups （P〈0.01） ; significant improvement of UPro, URBC, β2-M, NAG, BUN, SCr and SUA were shown in the treated group （P 〈0.05, P 〈0.01 ） ; but in the control group, only URBC count was significantly decreased （P 〈 0.05）, no statisticaly significant change of other indexes was found （ P 〉 0.05）. SUA decreased in both groups （ P 〈 0.01 ）, which was markedly lower in the treated group than in the control group （ P 〈 0.05） ; SCr and BUN were also decreased in the treated group （P 〈0.01 ）. Conclusions Combined therapy of SMP and conventional Western medicine shows a favorable effect in treating CUAN. It could not only reduce SUA, but also alleviate the albuminuria and hematouria, lower the urinary levels of IB2-M and NAG to improve renal function.