【作者】 舒亮辉；

【导师】 盛梅笑；

【作者基本信息】 南京中医药大学 ， 中医内科学， 2011， 硕士

【摘要】 目的：在优质低蛋白低嘌呤饮食、碱化尿液、降压、调脂的基础上,观察降尿酸方治疗慢性肾脏病3～4期伴高尿酸血症的疗效,以及血尿酸(SUA)改变对肾功能的影响,探讨其治疗机制。方法：2009年1月至2010年12月在江苏省中医院门诊或住院治疗的符合纳入条件的患者56例,治疗组、对照组各28例,在优质低蛋白低嘌呤饮食、碱化尿液、降压、调脂等治疗的基础上,治疗组予降尿酸方结合辨证加味治疗,对照组予中医辨证治疗,疗程8周。观察治疗前后血尿酸(SUA)及血尿素氮(Bun)、肌酐(Scr)的变化,以及24h尿蛋白定量(U-TP)、血浆白蛋白(Alb)、总胆固醇(TC)、甘油三脂(TG)、不良反应等。结果：1、高尿酸血症(HUA)及肾功能的疗效,治疗组优于对照组(P<0.05)。2、治疗组治疗后SUA明显下降,对照组无明显变化,两组比较有统计学意义(P<0.05)。3、治疗组治疗后Bun、Scr下降,eGFR升高,对照组均无明显变化,其中Scr、eGFR两组比较有统计学意义(P<0.05)。4、治疗组治疗后U-TP亦有下降,对照组无明显变化,两组比较有统计学意义(P<0.05),两组患者Hb、A1b、TG、TG治疗前后均无明显变化。5、SUA水平变化与肾功能变化之间存在直线正相关。结论：1、降尿酸方能降低慢性肾脏病3～4期伴高尿酸血症患者的SUA水平。2、降低SUA水平有助于延缓慢性肾脏病3～4期伴高尿酸血症患者肾功能的进展。更多还原

【Abstract】 Objective:On the basis of quality low-protein, low purine diet, alkaline urine, pressure control and lipid regulation, to observe the curative effect of JIANG-NIAO-SUAN-FANG treating the chronic kidney disease 3-4 phase with hyperuricemia, as well as the influence of serum uric acid changing to renal function, to discuss the treatment mechanism.Methods:Collect 56 qualified outpatients or hospitalized patients of Chinese medicinehospital in Jiangsu Province hospital from January 2009 to December 2010, and the number of patient in the treatment group or control group is 28. On the basis of low purine diet, alkaline urine, pressure control and lipid regulation, the period of the treatment group(n = 28) treated with JIANG-NIAO-SUAN-FANG and the control group(n=28) treated with routine Chinese medicinem is 8 weeks. The patients are observed on the change of serum uric acid(SUA), blood urea nitrogen(Bun), Creatinine(Scr) before and after treatment, meanwhile observed on the change of 24h urine protein with quantitative(U-TP), plasma albumin(Alb), total cholesterol(TC), triglycerides(TG) and adverse reaction.Results:1. Judge from the effect of hyperuricemia and renal function, the curative effect of treatment group is better than control group(P<0.05).2. The SUA level of patients in treatment group falls down significantly, with no obvious change in the control group, two groups of comparison has a statistical significance(P<0.05).3. In the treatment group, the Bun, Scr level of patients is down but eGFR level is up after treatment with no obvious change in the control group, and two therapeutic indexes(Scr, eGFR) change, two groups of comparison has a statistical significance(P<0.05).4. The U-TP level of patients in treatment group is down too after treatment, with no obvious change in the control group, two groups of comparison has a statistical significance(P<0.05); Hb, Alb, TC and TG of patients in two groups do not change obviously before and after treatment, two groups of comparison has no statistical significance(P>0.05).5. There is a positive correlation between SUA and renal function.Conclusions:1. JIANG-NIAO-SUAN-FANG can reduce the SUA level of patients who have the Chronic kidney disease(CKD) 3-4 phase with hyperuricemia.2. Reducing the SUA level is helpful for improving the renal funcion status of patients who have the Chronic kidney disease(CKD) 3-4 phase with hyperuricemia.更多还原