【作者】 陈美南；

【导师】 李富玉；

【作者基本信息】 中国人民解放军军医进修学院 ， 中西医结合临床， 2010， 硕士

【摘要】 李富玉教授医德高尚,学验俱丰,在疑难杂症的诊断、治疗、预防等方面积累了丰富的经验,根据多年的临证经验,提出了“毒邪致病说”,认为疑难杂症多迁延难愈,是因毒邪滞留体内所致,可从毒论治。目前高尿酸血症发病率有逐年增加的趋势,李教授根据其形成原因、致病特点、流行病学调查等,并结合自己的临床研究心得,认为其基本病机是肾脏亏损、浊毒内蕴,浊毒贯穿于高尿酸血症的全过程,提出以补肾泄浊解毒为治则,并注重未病先防,既病防变,取得了较好的疗效。本课题根据李富玉教授的临证经验,进行补肾泄浊解毒饮治疗高尿酸血症的临床研究。目的：通过观察补肾泄浊解毒饮和别嘌呤醇治疗高尿酸血症的临床疗效,及治疗前后对血尿酸(SUA)、尿尿酸(UUA)、尿pH值、血清总胆固醇(TCH)和甘油三酯(TG)等指标的影响,进而评价补肾泄浊解毒饮治疗高尿酸血症的临床疗效。方法：将符合高尿酸血症诊断标准的60例患者随机分为中药治疗组30例和别嘌呤醇组30例。中药治疗组给予补肾泄浊解毒饮,口服；西药对照组给予别嘌呤醇片,口服,4周为一个疗程,治疗一个疗程后观察治疗前后临床疗效,并对血尿酸、尿尿酸、尿pH值、血清总胆固醇和甘油三酯等指标进行比较。结果：中药治疗组临床总有效率93.3%,别嘌呤醇组临床总有效率90.0%,两组比较,无显著性差异(P>0.05)；中药治疗组和别嘌呤醇组两组在降低血尿酸方面,各自进行治疗前后的对比,均有显著性差异(P<0.05),但两组进行治疗后血尿酸水平的对比,则无显著性差异(P>0.05),在其他各项观察指标中,中药治疗组能增加尿尿酸的排泄,提高尿pH值,降低总胆固醇、甘油三酯,而别嘌呤醇组则无此作用。结论：补肾泄浊解毒饮具有降低血尿酸的作用,其降低血尿酸的效果与别嘌呤醇相当,同时补肾泄浊解毒饮还有增加尿尿酸排泄、提高尿pH值、降低总胆固醇及甘油三酯等作用,因此,补肾泄浊解毒饮是治疗高尿酸血症的有效方药之一,值得进一步研究开发及推广应用。更多还原

【Abstract】 Professor Li Fu-yu is a man of strong moral fiber and good medical technology. He has rich experience in diagnosis, treatment and prevention of difficult and complicated diseases. According to many years’clinical experience, he propounds a theory of diseases induced by Toxin. Recently, the rate of hyperuricemia has increased. Professor Li thinks difficult and complicated diseases are usually caused by toxin, so those diseases can be treated by relieving internal toxin. Hyperuricemia is also a subclinical disease. Based on the modern medical research in the formation mechanism, pathogenic characteristics and epidemiological investigation and Prof. Li’s clinical experience, he proposes a view that the essential pathogenesis of hyperuricemia is kidney deficiency and toxin stasis. Toxin plays an important role in the development of hyperuricemia. Furthermore, he points out that tonifying the kidney and relieving internal toxin are two principles of treatment. He also emphasizes protection before the onset and preventing disease from exacerbating in the treatment of hyperuricemia.This study was a clinical research aimed to evaluate the efficacy of tonifying the kidney and relieving internal toxin on the treatment of hyperuricemia. Objective:To observe the clinical efficacy of Bu-shen-xie-zhuo-jie-du decoction on hyperuricemia by comparison of uric acid, total cholesterol, triglyceride in the blood and acidum uricum, pH value in the urine before and after treatment. Methods:60 patients with a diagnosis of hyperuricemia were randomly divided into two groups. There are 30 patients in control group treated with allopurinol, and 30 patients in treatment group treated with herbal decoction. Four weeks was a treatment course. After a course, the clinical effects were evaluated and the indexes of uric acid, total cholesterol, triglyceride in the blood and uric acid, pH value in the urine were compared. Results:The total clinical effective rate was 93.3% in the treatment group, and 90.0% in the control group. There is no significant difference between two groups (p>0.05). The uric acid in both two groups had decreased after treatment. There are no significant difference between two groups(p>0.05). And in compare with the control group, the herbal decoction can promote the excretion of uric acid, higher the pH values, lower the total cholesterol, triglyceride. Conclusion:The effect of Bu-shen-xie-zhuo-jie-du decoction in lowering the blood uric acid is equal to the effect of allopurinol. However, the herbal decoction can also promote the excretion of uric acid, higher the pH values, lower the total cholesterol and triglyceride. So Bu-shen-xie-zhuo-jie-du decoction is an effective decoction in the treatment of hyperuricemia and should be recommended for a wider use.更多还原