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目的:观察中西药结合治疗尿酸性肾病的疗效。方法:60例患者随机分为治疗组和对照组,各30例。两组均以低嘌呤饮食,戒酒,多饮水,碱化尿液。对照组以别嘌醇治疗,治疗组在对照组治疗的基础上辨证为瘀热痹阻,关节不利;湿热下注,损伤肾络;脾虚湿盛,水湿内停;血瘀痰阻,水湿浸渍;脾肾亏虚,水湿不化;脾肾虚衰,湿邪留滞6型,分别采用桃红四物汤合三妙丸;八正散合石苇散;运脾渗湿汤;身痛逐瘀汤合五苓散;济生肾气丸合参苓白术散;温脾汤合真武汤治疗,并根据证型合理应用抗痛风中药。对比两组治疗效果。结果:治疗组治疗后血沉、血尿酸、肌酐水平明显优于对照组,差异均有统计学意义(P﹤0.05)。治疗后,治疗组总有效率优于对照组,差异有统计学意义(P﹤0.05)。治疗组服药前后未发现不良反应。对照组不良反应6例,主要表现为食欲不振,恶心呕吐及腹泻等胃肠道反应,多数患者尚能耐受。另外白细胞降低1例,肝功能轻度损害1例,过敏性皮疹2例。结论:采用辨证分型配合别嘌醇和合理应用抗痛风中药治疗本病,疗效较好,且无毒副反应,可供临床医师参考应用。
Objective: To observe the curative effect of combination of Chinese and western medicine on uric acid nephropathy. Methods: Sixty patients were randomly divided into treatment group and control group, 30 cases each. Both groups are low-purine diet, abstinence, drinking water, alkalinizing urine. The control group with allopurinol treatment, the treatment group in the control group based on the treatment of syndrome differentiation as stasis block resistance, joint detrimental; damp heat bet, damage renal network; Spleen wet Sheng, water wet stop; blood stasis sputum resistance, water Wet impregnation; spleen and kidney deficiency, water is not wet; spleen and kidney failure, dampness evil lag type 6, respectively, using the Taohong Siwu Tang combined with three Miao Wan; Pain by stasis Decoction Wulingsan; Jisheng Shenqi pill combined with Atractylodes; Wenpi Decoction with Zhenwu Tang treatment, and based on the type of anti-gout medicine rational use. Compare the two groups treatment effect. Results: After treatment, the levels of erythrocyte sedimentation rate, serum uric acid and creatinine in the treatment group were significantly better than those in the control group (P <0.05). After treatment, the total effective rate of the treatment group was better than that of the control group, the difference was statistically significant (P <0.05). The treatment group did not find any adverse reactions before and after treatment. The adverse reactions in the control group 6 cases, mainly manifested as loss of appetite, nausea, vomiting and diarrhea and other gastrointestinal reactions, most patients are still able to tolerate. Another case of leukopenia in 1 case, mild liver damage in 1 case, 2 cases of allergic rash. Conclusion: The use of syndrome differentiation with allopurinol and rational use of anti-gout herbs for the treatment of the disease, better efficacy, and no toxic side effects, for reference for clinicians.