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目的:观察健脾补肾化湿解毒方联合常规西药治疗痛风性肾病的临床疗效。方法:选取86例痛风性肾病脾肾气虚兼湿浊证患者,按随机数字表法分为对照组和观察组各43例,所有患者给予低嘌呤饮食并禁酒,服用别嘌呤醇片、碳酸氢钠片、控压降脂等基础药物治疗,观察组联合健脾补肾化湿解毒方治疗。2组均以4周为1疗程,3疗程后对比2组患者治疗前后的尿蛋白定量、尿红细胞计数、尿β_2微量球蛋白(β_2-MG)、血肌酐(SCr)、血尿素氮(BUN)、血尿酸(UA)水平,治疗后的临床疗效及不良反应情况。结果:观察组治疗总有效率为88.4%,显著高于对照组的67.4%,差异有统计学意义(P<0.05)。治疗后,对照组血UA较治疗前降低(P<0.05),而血SCr、血BUN、尿蛋白定量、尿红细胞计数及尿β_2-MG虽较治疗前降低,但差异均无统计学意义(P>0.05);观察组血UA、血SCr、血BUN、尿蛋白定量、尿红细胞计数及尿β_2-MG与治疗前相比均降低(P<0.05),6项指标值均低于对照组(P<0.05)。观察组不良反应发生率为9.3%,低于对照组的14.0%,但差异无统计学意义(P>0.05)。结论:健脾补肾化湿解毒方联合常规西药治疗痛风性肾病疗效确切,能显著改善患者的肾功能,安全性好。
Objective: To observe the clinical effects of invigorating the spleen and invigorating the kidney, dampness and detoxification combined with conventional western medicine on gouty nephropathy. Methods: A total of 86 patients with gouty nephropathy with deficiency of both qi and blood of the spleen and kidney syndrome were randomly divided into control group and observation group according to random number table method. All patients were given low purine diet and were given no alcohol. Allopurinol tablets and bicarbonate Sodium tablets, such as the control of lipid-lowering drugs and other basic treatment, the observation group combined with the spleen and kidney Huashi detoxification side treatment. The levels of urinary protein, urinary erythrocyte count, β_2-MG, SCr and BUN before and after treatment were compared between the two groups before and after treatment for 3 weeks. ), Serum uric acid (UA), clinical efficacy and adverse reactions after treatment. Results: The total effective rate of observation group was 88.4%, which was significantly higher than that of control group (67.4%), the difference was statistically significant (P <0.05). After treatment, blood UA in control group decreased (P <0.05), while SCr, BUN, urinary protein, urinary erythrocyte count and urinary β_2-MG were lower than before treatment, but the difference was not statistically significant P <0.05). The UA, SCr, BUN, urinary protein, urinary erythrocyte count and urinary β_2-MG in the observation group were lower than those before treatment (P <0.05) (P <0.05). The incidence of adverse reactions in the observation group was 9.3%, which was lower than that in the control group (14.0%), but the difference was not statistically significant (P> 0.05). Conclusion: Jianpi Bushen Huashi Detoxification combined with conventional western medicine is effective in treating gouty nephropathy and can significantly improve renal function and safety of patients.