中医治疗慢性肾脏病3期合并高尿酸血症137例疗效观察

目的观察合并高尿酸血症慢性肾脏病3期患者中医药治疗临床疗效。方法对137例合并高尿酸血症慢性肾脏病3期患者进行回顾性研究，其中联合治疗组47例、中药组48例、氯沙坦组42例，比较蛋白尿、肾功能的临床疗效以及血尿酸、收缩压、舒张压、胆固醇、三酰甘油、低密度脂蛋白的变化。结果在137例合并高尿酸血症慢性肾脏病3期患者中，中药组治疗蛋白尿的疗效显著优于氯沙坦组和联合治疗组，有统计学差异（P〈0．05）。保护肾功能方面联合治疗组和中药组显示出优势，各组的血尿酸、收缩压、舒张压、胆固醇、三酰甘油、低密度脂蛋白变化无统计学差异。结论中医药治疗合并高尿酸血症慢性肾脏病3期有显著的临床疗效，其疗效不仅仅依赖于血尿酸、血压、血脂的改善，与血管紧张素受体拮抗剂协同作用在保护肾功能方面具有更优的效果。

Clinical efficacy of 137 cases of chronic kidney disease in the third stage complicated with hyperuricemia

Objective To observe the clinical efficacy of traditional Chinese medicine（TCM） treatment for chronic kidney disease in the third stage with hyperuricemia. Methods 137 cases of chronic kidney disease in the third stage with hyperuricemia were retrospectively studied and divided into the combined treatment group（47 cases）, the TCM treatment group（48 cases）, and the losartan treatment group（42 cases）. The proteinuria, renal function, as well as the blood uric acid, systolic blood pressure,diastolic blood pressure, cholesterol, triglycerides, low-density lipoprotein changes were analyzed. Results The TCM treatment group had more significantly satisfactory efficacy than in the losartan treatment group and the combined treatment group in lowing proteinuria. There are significant differences （P〈0. 05）. The renal function was improved more significantly in the combined treatment group than the rest two groups. Combined treatment group decreased serum creatinine and glomerular filtration rate was significantly higher than the other two groups, reaching statistial significance （P~ 0. 05）. There were no significant differences in changes of serum uric acid, systolic blood pressure, di- astolic blood pressure, cholesterol, triglycerides, low-density lipoprotein changes, in each group. Conclusions Clinical efficacy of TCM treatment for chronic kidney disease complicated with hyperuricemia is satisfactory. The efficacy of TCM does not depend on the improvement of blood uric acid, blood pressure and blood lipids. TCM treatment protects renal function in coordination with ARB.