降尿酸方治疗慢性肾脏病伴高尿酸血症的疗效观察

目的:观察降尿酸方治疗慢性肾脏病伴高尿酸血症(HUA)的疗效,以及血尿酸改变对肾功能的影响。方法:64例患者,治疗组与对照组各32例,治疗组在西药治疗基础上予降尿酸方结合辨证治疗,对照组单纯西药治疗,疗程8周。观察治疗后血尿酸(SUA)、肾功能(Bun、Scr、eGFR)、血浆白蛋白(Alb)、总胆固醇(TC)、甘油三脂(TG)、24h尿蛋白定量(U-TP)等的变化。结果:(1)高尿酸血症(HUA)的疗效,治疗组总有效率优于对照组(59.37%vs 28.13%,P<0.05);(2)肾功能的疗效,治疗组总有效率优于对照组(84.37%vs 53.12%,P<0.05)。(3)治疗组治疗后SUA下降幅度优于对照组(P<0.05)。(4)治疗组治疗后Scr下降、eGFR上升,与对照组比较有统计学意义(P<0.05)。(5)治疗组治疗后UTP组内与组间差别有统计学意义(P<0.05),其它实验室指标无统计学意义(P>0.05)。(6)HUA有效病例Scr下降幅度优于对照组(P<0.05)。结论:(1)降尿酸方能降低慢性肾脏病伴高尿酸血症的SUA水平;(2)SUA下降有助于改善患者的肾功能。

Clinical Observation on Uric Acid-decreasing Formula Treating Chronic Kidney Disease with Hyperuricemia

Objective:To observe the effect of uric acid-decreasing formula treating chronic kidney disease with hyperuricemia and the influence of changes of uric acid in serum on kidney functions.Methods:64 cases were divided into treatment and control groups with 32 cases in each group.The treatment group was given treatment based on syndrome differentiation based on western medicine treatment.The control group was only given western medicine.Both were treated for 8 weeks.SUA,Bun,Scr,eGFR,Alb,TC,TG and U-TP were observed.Results:For treating hyperuricemia,the effective rate in treatment group was superior to that in control group(59.37% vs 28.13%,P<0.05);For treating kidney function,the total effective rate in treatment group was superior to that in control group(84.37% vs 53.12%,P<0.05).The decrease of SUA in treatment group was superior to that in control group(P<0.05).mAfter treatment,Scr level was decreased and eGFR level was increased in treatment group,which had significance compared with control group(P<0.05).nAfter treatment,U-TP in treatment group had significance both in intragroup and intergroup comparisons(P<0.05),other indexes had no significance(P>0.05).The decrease of Scr in effective cases was superior to that in control group(P<0.05).Conclusion:Uric acid-decreasing formula can decrease the SUA level in patients with chronic kidney disease combined with hyperuricemia.The decrease of SUA can help to improve the kidney functions.