大黄牡蛎汤灌肠治疗痛风性肾病临床观察.docVIP

大黄牡蛎汤灌肠治疗痛风性肾病临床观察 　　摘要：目的研究大黄牡蛎汤灌肠治疗痛风性肾病的临床效果，为临床痛风性肾病的治疗提供依据。方法将86例痛风性肾病患者随机分为2组，治疗组46例，对照组40例，2组患者均予低盐低嘌呤饮食，对照组予别嘌呤醇、碳酸氢钠片口服，治疗组则在对照组基础上加用大黄牡蛎汤保留灌肠，观察2组治疗前后患者血尿酸、血肌酐、尿素氮及24 h尿蛋白定量。结果治疗组总有效率为8913%，对照组总有效率为725%，2组比较，有显著性差异（P005）；但在改善肾功能及尿蛋白水平方面，治疗组疗效优于对照组（P005）。结论大黄牡蛎汤保留灌肠治疗痛风性肾病，对于降低血尿酸及减轻蛋白尿，延缓肾功能损害等方面疗效显著，无明显不良反应，值得临床推广。 　　关键词：大黄牡蛎汤；灌肠；痛风性肾病；肾功能；血尿酸；蛋白尿 　　中图分类号：R692文献标志码：B文章编号：1007-2349（2017）07-0045-03 　　【Abstract】Objective： To study the clinical effect of Rhubarb Oyster Decoction on the treatment of gouty nephropathy， and to provide the basis for the treatment of clinical gouty nephropathy Methods： 86 patients with gouty nephropathy were randomly divided into a treatment group （n=46） and a control group （n=40） All the patients were given low salt and hypopurine diet The control group was treated with allopurinol and sodium bicarbonate tablets while the treatment group was given retention enema treatment with rhubarb oyster soup on the basis of treatment of the control group The levels of serum uric acid， serum creatinine， urine nitrogen and 24-hour urine protein were observed before and after treatment Results： The total effective rate of the treatment group was 8913% while that of the control group was 725% There was significant difference between the two groups （P005） Conclusion： Rhubarb Oyster Decoxtion retention enema treatment is significantly effective to gouty nephropathy and can reduce blood uric acid and proteinuria and delay renal function damage， no significant adverse reactions and worthy of wide clinical application 　　【Key words】Rhubarb Oyster Decoction， enema， gouty nephropathy， renal function， uric acid， proteinuria 　　痛?L性肾病是由于体内嘌呤代谢紊乱，血尿酸生成过多或排泄减少导致血尿酸升高，过多的尿酸盐在肾脏发生结晶沉积于肾间质、肾小管腔内，引起肾脏组织结构与肾功能损害的病变，迁延可发展至慢性肾衰竭[1]。本病在临床上较常见，其临床表现主要有反复关节肿痛、少量蛋白尿、夜尿增多、血尿酸升高及肾功能的损害。目前西医多采用抑制尿酸的生成或促进尿酸排泄的药物来缓解症状，但不能减轻蛋白尿及改善肾功能，且药物副作用大，很不容易被患者接受。中医采用中药灌肠疗法治疗慢性肾功能不全已在临床运用多年，具有一定的疗效，近年来笔者采用大黄牡蛎汤保留灌肠治疗痛风性肾病，在改善患者UA、BUN、CREA及24h尿蛋白方面有较好的效果，现报道如下。 　　1资料与方法 　　11一般资