Clinical Study On The Effect Of Yishen Huashi Xiezhuo Prescription On Delaying The Progression Of Uric Acid Nephropath

OBJECTIVE: Based on a retrospective analysis method,we compared the clinical efficacy of a Chinese medical treatment regimen(Yi Kidney Transformation and Dampness Drainage Formula),a Western medical treatment regimen(Febuxostat),and a combined Chinese and Western medical treatment regimen(Yi Kidney Transformation and Dampness Drainage Formula combined with Febuxostat)on patients with gouty nephropathy,and then sought the best treatment regimen.MATERIALS AND METHODS:Patients attending the outpatient and inpatient departments of the Department of Nephrology at the Affiliated Hospital of Liaoning University of Chinese Medicine from January 2020 to October 2022 were screened through the Hospital Information System(HIS).A total of 80 complete cases with 8 weeks of continuous medication and meeting the diagnostic criteria of uric acid nephropathy and the inclusion and exclusion criteria of this study,and meeting the TCM evidence of spleen and kidney qi deficiency,dampness and turbidity,and e GFR ≥ 30 ml/min.1.73 m2 were screened.29 cases were treated with the TCM treatment regimen(Yi Kidney Dampness Drainage Formula)alone,20 cases were treated with the Western medicine treatment regimen(Febuxostat Tablets)alone,and 20 cases were treated with the combined TCM treatment(Yi Kidney Dampness Drainage Formula).A total of 31 cases were treated with a combination of Chinese and Western medicine(Yi Kidney,Dampness and Drainage Formula combined with Febuxostat tablets).Data were collected: serum creatinine,urea,blood uric acid,glomerular filtration rate,urinary NAG,urinary β2-MG,urinary α1-MG,TCM symptom score and safety indexes before and after the treatment regimen of the three groups,and the efficacy of TCM symptom and disease treatment were evaluated.The international standard statistical software SPSS25.0 was used for data analysis.Results:1.serum creatinine,urea and glomerular filtration rate: all three groups improved significantly after treatment,and there was no significant difference between the TCM group and the TCM group after treatment,and the TCM group and the TCM treatment group were better than the Western group,which was statistically significant.2.Blood uric acid: all three groups improved significantly after treatment,and the Chinese and Western medicine groups were better than the Western medicine group after treatment,and the Western medicine group was better than the Chinese medicine group,which was statistically significant.3.Renal tubular function:(1)urinary NAG: the three groups decreased after treatment,and the Chinese and Western medicine group was better than the Western medicine group after treatment,and the Western medicine group was better than the Chinese medicine group after treatment,which was statistically significant.(2)Urinary α1-MG: The three groups improved significantly after treatment,and there was no significant difference between the Chinese medicine group and the Chinese and Western medicine group after treatment,and the Chinese medicine group and the Chinese and Western medicine treatment group were superior to the Western medicine group,which was statistically significant.(3)Urinary β2-MG: There was no significant difference between the three groups after treatment.4.Treatment efficiency of TCM symptoms and disease treatment efficiency: the treatment efficiency of TCM symptoms was 89.66% in the TCM group,55.00% in the Western medicine group,and 93.55% in the Chinese and Western medicine group;the treatment efficiency of disease treatment was 86.21% in the TCM group,65.00% in the Western medicine group,and 90.32% in the Chinese and Western medicine group.5.Total points of TCM symptoms: The total points of TCM symptoms in all three groups decreased after treatment,and the difference was statistically significant,and there was no statistical difference between the TCM group and the Western and Chinese medicine group after treatment,and they were all better than the Western medicine group,which was statistically significant.6.Safety evaluation: None of the patients in the three groups showed any clinical symptoms such as drug discomfort and induced acute attack of gout,while none of the patients showed acute deterioration of renal function and the liver function indexes(AST,ALT)were in the normal range or not significantly elevated.Conclusion1.Yi kidney,dampness and turbidity formula can slow down the progression of renal function and tubular damage in patients with uric acid nephropathy and improve the treatment of Chinese medicine evidence points.2.The combination of Kidney Relieving Dampness and Draining Turbidity Formula with febuxostat tablets can lower blood uric acid and reduce tubular damage better than the treatment with Kidney Relieving Dampness and Draining Turbidity Formula alone.3.The effect of febuxostat tablets in lowering blood uric acid was better than that of TCM treatment,but the effect of Yi Kidney Huayu Drainage Formula in delaying the progression of renal function in uric acid nephropathy and in treating the patient’s TCM symptom score was more significant.