李娟 蒙向欣 赵威 周艳利

摘要 目的：研究五仁潤肠加味汤对痛风性肾脏病变伴慢性肾功能不全患者尿素氮（BUN）、肌酐（Scr）、纤维链接蛋白（FN）及Ⅳ型胶原（ColⅣ）水平的影响。方法：选取2015年1月至2018年1月广州市中医医院收治的痛风性肾脏病变伴慢性肾功能不全患者120例作为研究对象，按照随机抽签法分为对照组和观察组，每组60例。对照组予以常规西药联合胃肠透析液治疗，观察组则予以五仁润肠加味汤治疗。分别比较2组患者临床疗效，治疗前后BUN、Scr、FN及ColⅣ水平变化情况，不良反应发生情况。结果：治疗后观察组总有效率高于对照组（P<0.05），在BUN、Scr水平、血清ColⅣ水平方面观察组低于对照组（均P<0.05），观察组血清FN水平高于对照组（P<0.05）。2组患者在不良反应发生率方面观察组更低（P<0.05）。结论：五仁润肠加味汤治疗痛风性肾脏病变伴慢性肾功能不全患者的疗效显著，可明显患者的BUN、Scr、FN及ColⅣ水平，降低不良反应发生风险。安全性较好，值得临床推广应用。

关键词  痛风性肾脏病变;慢性肾功能不全;五仁润肠加味汤;肾功能;临床疗效;不良反应;纤维链接蛋白;Ⅳ型胶原

Gouty Nephropathy with Chronic Renal Iinsufficiency Ttreated by Wuren Runchang Jiawei Decoction

LI Juan， MENG Xiangxin， ZHAO Wei， ZHOU Yanli

（Department of Nephrology， Guangzhou Hospital of Traditional Chinese Medicine，Guangzhou 510103，China）

Abstract Objective：To study the effect of Wuren Runchang Jiawei Decoction on the levels of urea nitrogen （BUN）， creatinine （Scr）， fibronectin （FN） and collagen Ⅳ （Col Ⅳ） in patients with gouty nephropathy with chronic renal insufficiency.Methods：A total of 120 patients with gouty nephropathy accompanied by chronic renal insufficiency admitted to the Guangzhou Hospital of Traditional Chinese Medicine hospital from January 2015 to January 2018 were selected as the research object.They were divided into an observation group and a control group according to the random drawing method.The control group was treated with conventional Western medicine combined with gastrointestinal dialysate， and the observation group was treated with Wuren Runchang Jiawei Decoction.The clinical efficacy of the two groups， the changes of BUN， Scr， FN and Col Ⅳ levels before and after treatment， and the occurrence of adverse reactions were compared.Results：The total effective rate of the observation group after treatment was higher than that of the control group （P<0.05）， and the observation group was lower than the control group in terms of BUN， Scr levels， and serum Col IV levels （all P<0.05）， and the serum FN level of the observation group was higher than that of the control group （P<0.05）.The incidence rate of adverse reactions was lower in the observation group （P<0.05）.Conclusion：The effect of Wuren Runchang Jiawei Decoction in the treatment of patients with gouty nephropathy and chronic renal insufficiency is significant.It can significantly increase the BUN， Scr， FN and Col Ⅳ levels of patients and reduce the risk of adverse reactions.The safety is better and it is worthy of clinical application.

Keywords Gout nephropathy; Chronic renal insufficiency; Wuren Runchang Jiawei Decoction; Renal function; Clinical curative effect; Adverse reactions; Fiber link protein; Collagen type Ⅳ

中图分类号：R255.9 文献标识码：A doi：10.3969/j.issn.1673-7202.2020.08.015

相关研究调查数据表明，随着近年来人们过多摄入富含别嘌醇的食物，从而易增加高血压、泌尿系结石、糖尿病以及高黏血症等疾病的发生风险[1]。而上述疾病均易导致痛风症，其发病率约为0.5%～1.0%，如不予以及时有效的治疗，随着病程的不断延长，约有25%的患者的可发展为痛风性肾脏病变伴慢性肾功能不全，进一步可能引发尿毒症，最终导致患者死亡[2-3]。迄今为止，痛风性肾脏病变伴慢性肾功能不全是全球范围内的一种奇难症以及危重症，因此寻找一种安全有效的治疗方式显得尤为重要。鉴于此，本文通过研究五仁润肠加味汤对痛风性肾脏病变伴慢性肾功能不全患者尿素氮（BUN）、肌酐（Scr）、纤维链接蛋白（FN）及Ⅳ型胶原（ColⅣ）水平的影响，旨在更好地服务临床治疗，现作以下报道。……