健脾化湿祛瘀方治疗青年高尿酸血症临床研究
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摘要
目的:观察健脾化湿祛瘀方治疗高尿酸血症的有效性。方法:选取青年高尿酸血症患者132例,依据24 h尿酸排泄量分为尿酸生成过多亚组与尿酸排泄减少亚组,每个亚组再采用随机数字表法分为2个组别。尿酸排泄减少亚组,亚组1共47人,亚组2共45人;尿酸生成过多亚组,亚组3和亚组4各20人。亚组1和亚组3均服用健脾化湿祛瘀方治疗,亚组2口服苯溴马隆治疗,亚组4口服别嘌醇治疗。疗程均为6个月,治疗结束后比较肾功能以及转氨酶诸项指标变化。结果:亚组1总有效率为87.23%,亚组2总有效率为91.11%,2组比较,差异无统计学意义(P> 0.05)。亚组3总有效率为80.00%,亚组4总有效率为95.00%,2组比较,差异无统计学意义(P> 0.05)。治疗前,尿酸排泄减少亚组2组之间血尿酸水平比较,差异无统计学意义(P> 0.05)。治疗后,尿酸排泄减少亚组2组血尿酸水平均较治疗前降低(P <0.05);但是治疗后,亚组1和亚组2比较,差异无统计学意义(P> 0.05)。治疗前,尿酸生成过多亚组2组之间血尿酸水平比较,差异无统计学意义(P> 0.05)。治疗后,尿酸生成过多亚组2组血尿酸水平均较治疗前降低(P <0.05);但是治疗后,亚组3和亚组4比较,差异无统计学意义(P> 0.05)。亚组3治疗后血肌酐(CREA)水平较治疗前明显下降(P <0.05)。亚组1急性痛风性关节炎发生4例(8.51%),亚组2急性痛风性关节炎发生12例(26.67%),2组比较,差异有统计学意义(χ~2=5.275, P=0.022)。亚组3急性痛风性关节炎发生1例(5.00%),亚组4急性痛风性关节炎发生8例(40.00%),2组比较,差异有统计学意义(χ~2=5.161,P=0.023)。结论:健脾化湿祛瘀方与苯溴马隆、别嘌醇一样均能有效降低血尿酸水平,且安全有效。
Objective:To observe the effectiveness of Jianpi Huashi Quyu prescription in treating hyperuricemia. Methods:A total of 132 cases of young patients with hyperuricemia were divided into the excessive uric acid production subgroup and the reductive uric acid excretion subgroup according to 24-hour uric acid excretion. Each subgroup was divided into two groups according to the random number table method,with 47 patients in Subgroup 1 and 45 in Subgroup 2 in the reductive uric acid excretion subgroup,and with 20 in Subgroup 3 and 20 in Subgroup 4 in the excessive uric acid production subgroup.Subgroup 1 and Subgroup 3 were treated with Jianpi Huashi Quyu prescription;Subgroup 2 received oral administration of benzbromarone;Subgroup 4 was given allopurinol orally for treatment. The treatment lasted for 6 months. After treatment,the changes in the indexes concerning kidney function and transaminase were compared. Results:The total effective rate was 87.23% in Subgroup 1 and 91.11% in Subgroup 2,there being no significance in the difference(P > 0.05). The total effective rate was 80.00% in Subgroup 3 and 95.00% in Subgroup 4,there being no significance in the difference(P > 0.05).Before treatment,there was no significant difference being found in the comparison of the level of blood uric acid between the two subgroups of the reductive uric acid excretion subgroup(P > 0.05). After treatment,the levels of blood uric acid in the two subgroups of the reductive uric acid excretion subgroup were decreased when compared with those before treatment(P < 0.05),there being no significance in the difference between subgroup 1 and subgroup 2(P > 0.05). Before treatment,there was no significant difference being found in the comparison of the level of blood uric acid between the two subgroups of the excessive uric acid production subgroup(P > 0.05). After treatment,the levels of blood uric acid in the two subgroups of the excessive uric acid production subgroup were decreased when compared with those before treatment(P < 0.05),there being no significance in the difference between subgroup 3 and subgroup 4(P > 0.05). After treatment,the level of serum creatinine(CREA)in Subgroup 3 was significantly decreased when compared with that before treatment(P < 0.05). There were 4 cases of acute gouty arthritis in Subgroup 1(8.51%)and 12 cases in Subgroup 2(26.67%),the difference being significant(χ~2=5.275,P=0.022). There was 1 case of acute gouty arthritis in Subgroup 3(5.00%) and 8 cases in Subgroup 4(40.00%),the difference being significant(χ~2=5.161,P=0.023). Conclusion:Jianpi Huashi Quyu prescription,as well as benzbromarone and allopurinol,can effectively reduce the level of blood uric acid,and is safe with significant effect.
Objective:To observe the effectiveness of Jianpi Huashi Quyu prescription in treating hyperuricemia. Methods:A total of 132 cases of young patients with hyperuricemia were divided into the excessive uric acid production subgroup and the reductive uric acid excretion subgroup according to 24-hour uric acid excretion. Each subgroup was divided into two groups according to the random number table method,with 47 patients in Subgroup 1 and 45 in Subgroup 2 in the reductive uric acid excretion subgroup,and with 20 in Subgroup 3 and 20 in Subgroup 4 in the excessive uric acid production subgroup.Subgroup 1 and Subgroup 3 were treated with Jianpi Huashi Quyu prescription;Subgroup 2 received oral administration of benzbromarone;Subgroup 4 was given allopurinol orally for treatment. The treatment lasted for 6 months. After treatment,the changes in the indexes concerning kidney function and transaminase were compared. Results:The total effective rate was 87.23% in Subgroup 1 and 91.11% in Subgroup 2,there being no significance in the difference(P > 0.05). The total effective rate was 80.00% in Subgroup 3 and 95.00% in Subgroup 4,there being no significance in the difference(P > 0.05).Before treatment,there was no significant difference being found in the comparison of the level of blood uric acid between the two subgroups of the reductive uric acid excretion subgroup(P > 0.05). After treatment,the levels of blood uric acid in the two subgroups of the reductive uric acid excretion subgroup were decreased when compared with those before treatment(P < 0.05),there being no significance in the difference between subgroup 1 and subgroup 2(P > 0.05). Before treatment,there was no significant difference being found in the comparison of the level of blood uric acid between the two subgroups of the excessive uric acid production subgroup(P > 0.05). After treatment,the levels of blood uric acid in the two subgroups of the excessive uric acid production subgroup were decreased when compared with those before treatment(P < 0.05),there being no significance in the difference between subgroup 3 and subgroup 4(P > 0.05). After treatment,the level of serum creatinine(CREA)in Subgroup 3 was significantly decreased when compared with that before treatment(P < 0.05). There were 4 cases of acute gouty arthritis in Subgroup 1(8.51%)and 12 cases in Subgroup 2(26.67%),the difference being significant(χ~2=5.275,P=0.022). There was 1 case of acute gouty arthritis in Subgroup 3(5.00%) and 8 cases in Subgroup 4(40.00%),the difference being significant(χ~2=5.161,P=0.023). Conclusion:Jianpi Huashi Quyu prescription,as well as benzbromarone and allopurinol,can effectively reduce the level of blood uric acid,and is safe with significant effect.
引文
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[11]孙红,王少明,庄捷,等.土茯苓等中药抑制URAT1表达及降尿酸作用筛选研究[J].中国临床药理学与治疗学,2012,17(4):403-407.
[2]冯玫,李玉翠.关注无症状高尿酸血症[J].中华全科医师杂志,2014,13(6):475-477.
[3]Bove M,Cicero AF,Veronesi M,et al.An evidence-based review on urate-lowering treatments:implications for optimal treatment of chronic hyperuricemia[J].Vasc Health Risk Manag,2017,13(2):23-28.
[4]中华医学会风湿病学分会.原发性痛风诊断和治疗指南[J].中华风湿病学杂志,2011,15(6):410-413.
[5]黄庆仪,周新华,吕天越,等.高尿酸血症相关因素及其与中医证型的关系研究[J].新中医,2010,42(6):27-28.
[6]国家中医药管理局医政司.22个专业95个病种中医临床诊疗方案[M].北京:中国中医药出版社,2012:270.
[7]中国医师协会心血管内科医师分会.无症状高尿酸血症合并心血管疾病诊治建议中国专家共识[J].中国全科医学,2010,13(4B):1145-1149.
[8]杨传经,李雪梅,孔德明,等.单味中药黄芪改善胰岛素抵抗对血尿酸影响的相关性研究[J].时珍国医国药,2009,20(7):1621-1623.
[9]陆潭,张李阳,陈玉胜.一种黄芪药渣发酵产物的抗高尿酸血症活性[J].江苏农业科学,2013,41(9):288-291.
[10]费洪荣,毛幼桦,朱玮,等.粉萆薢降尿酸作用研究[J].医药导报,2007,26(11):1270-1272.
[11]孙红,王少明,庄捷,等.土茯苓等中药抑制URAT1表达及降尿酸作用筛选研究[J].中国临床药理学与治疗学,2012,17(4):403-407.