降尿酸方治疗肝郁脾虚型高尿酸血症的临床观察

发布时间：2018-08-23 13:22

【摘要】：目的：本课题通过观察降尿酸方治疗肝郁脾虚型高尿酸血症的临床症状及实验室指标变化,评价其临床效果,揭示在中医理论指导下,通过辨证施治,以疏肝健脾、利湿化瘀为法组方的降尿酸方治疗肝郁脾虚型高尿酸血症的临床疗效及其作用机制,一方面为高尿酸血症提供有效的治疗途径和方法,另一方面为开发治疗高尿酸血症中药打下基础。方法：本课题在循证医学原则指导下,采取单盲、随机、平行对照的设计实验方案。将符合诊断标准的56例病例(均来自于襄阳市中医医院内分泌科2015年6月至2016年3月期间的门诊或住院患者)按照随机分组的原则,分为治疗组(中药治疗组)和对照组(西药治疗组),以下简称为治疗组和对照组。其中治疗组男24例,女7例,平均年龄为(39.5±13.6)岁,血尿酸(sUA)(514.3±63.20)umol/L;对照组男19例,女6例,平均年龄为(39.34±12.9)岁,血尿酸(510.74±62.50)umol/L。两组间一般资料比较,差异无统计学意义(P0.05),具有可比性。治疗组口服降尿酸方(柴胡10g,郁金15g,苍术10g,泽泻15g,生薏苡仁20g,粉萆參20g,茯苓15g,生黄芪15g,丹参15g,川牛膝15g,泽兰15g,车前子15g,威灵仙10g,桃仁18g。襄阳市中医医院制剂室提供),每次10粒,每天3次；对照组口服别嘌醇片(广州白云山制药股份有限公司广州白云山制药总厂,国药准字H44021492),每次100mg,每天2次。两组均予以基础治疗,清淡低嘌呤饮食,足量饮水。30天为1个疗程。观察两组治疗前后临床症状体征积分及治疗期间血尿酸、血脂、血糖、肝肾功能、尿常规、血常规等疗效指标及安全性指标的变化。实验结束后所有测定数据均以均数±标准差((?)±s)表示,自身前后对照采用t检验,两组间比较采用x~2检验。应用SPSS19.0软件进行统计学数据处理分析,从而得出研究结果。结果：治疗组愈显率为73.3%,总有效率为86.20%。对照组愈显率为65.3%,总有效率为为77.03%(P0.05)。治疗组不良反应率为12.90%,对照组不良反应率为28.00%。统计学比较,两组高血尿酸治愈率(x~2值2.093),P0.05,治疗组与对照组疗效相当。两组总有效率及愈显率(x~2值9.451),P0.05,治疗组优于对照组疗效。提示在改善临床症状及体征的改善方面,治疗组明显优于对照组。两组不良反应发生率及安全性指标观察提示降尿酸方药物不良反应较低,安全性较好。结论：降尿酸方组在降低患者的血尿酸方面与对照组相当,但在改善患者的临床症状及体征方面,其治疗效果明显优于对照组。降尿酸方以中医理论为指导,在调理脏腑功能,通过辨证施治,以疏肝健脾、化瘀利湿为法,能够显著降低血尿酸,且无明显毒副作用,临床疗效确切,临床症状缓解较明显,有较高的临床临床实用价值,可作为临床新药进一步加以研究开发。
[Abstract]:Objective: To observe the clinical symptoms and laboratory indexes of Jianguric acid prescription in treating hyperuricemia of liver depression and spleen deficiency type, evaluate its clinical effect, and reveal the clinical effect of Jianguric acid prescription in treating hyperuricemia of liver depression and spleen deficiency type by syndrome differentiation and treatment under the guidance of traditional Chinese medicine theory. The mechanism of action, on the one hand, provides an effective treatment for hyperuricemia and methods, on the other hand, lays the foundation for the development of traditional Chinese medicine for the treatment of hyperuricemia.Methods: Under the guidance of evidence-based medicine, the subject adopted a single blind, randomized, parallel control design experimental scheme. According to the principle of random grouping, the outpatients and inpatients in the Department of Endocrinology of the Municipal Hospital of Traditional Chinese Medicine from June 2015 to March 2016 were divided into treatment group (Chinese medicine treatment group) and control group (western medicine treatment group), hereinafter referred to as treatment group and control group. 0) umol/L; 19 males and 6 females in the control group, with an average age of (39.34 + 12.9) years, serum uric acid (510.74 + 62.50) umol/L. There was no significant difference between the two groups in general data (P 0.05), with comparability. Shen 15g, Sichuan Achyranthes Bidentata 15g, Zelan 15g, Cheqianzi 15g, Wellingxian 10g, Taoren 18g, Xiangyang Hospital of Traditional Chinese Medicine Preparation Room, 10 tablets each time, three times a day; the control group was orally administered allopurinol tablets (Guangzhou Baiyunshan Pharmaceutical General Factory, Guangzhou Baiyunshan Pharmaceutical Co., Ltd., the Chinese character H44021492), 100 mg each time, twice a day. The clinical symptoms and signs integral before and after treatment and the changes of blood uric acid, blood lipids, blood glucose, liver and kidney function, urine routine, blood routine and other therapeutic and safety indexes were observed in both groups. Results: The more obvious rate of the treatment group was 73.3%, the total effective rate was 86.20%. The more obvious rate of the control group was 65.3%, the total effective rate was 77.03%(P 0.05). The adverse reaction rate of the treatment group was 12.90%, and the adverse reaction rate of the control group was 86.20%. The response rate was 28.00%. Statistical comparison showed that the cure rate of hyperuricemia in the two groups (x~2 value 2.093), P 0.05, the treatment group and the control group had the same curative effect. The total effective rate and recovery rate of the two groups (x~2 value 9.451), P 0.05, the treatment group was better than the control group. The observation of birth rate and safety index indicated that the side effect of Jianguric acid prescription was lower and its safety was better. Conclusion: The Jianguric acid prescription group was similar to the control group in reducing serum uric acid, but its curative effect was better than the control group in improving clinical symptoms and signs. The function of zang-fu organs can be treated according to syndrome differentiation, with the methods of soothing the liver and strengthening the spleen, removing blood stasis and eliminating dampness, which can significantly reduce serum uric acid without obvious toxic and side effects. The clinical curative effect is definite and the clinical symptoms are relieved obviously. It has higher clinical practical value and can be further studied and developed as a new clinical drug.
【学位授予单位】：湖北中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R259

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