Clinical Research On Tonifying Kidney And Spleen Method In Treating The Chronic Uric Acid Nephropathy's Patients In The Form Of Spleen And Kidney Qi Deficiency

Objective:To evaluate the clinical significance and the effect of serum uric acid revealed with prescription of tonifying kidney and spleen method? including decoction,current prescriptions and common prescription, for the chronic uric acid nephropathy patients with the form of spleen and kidney qi deficiency,and to explore the effect of lowing serum uric acid(SUA) therapy on estimating glomerular filtration rate(eGFR),24 hours urinary protein quantitation(24hUPQ), serum creatinine(Scr), blood urea nitrogen(Bun),etc.Methods:92 patients with spleen and kidney deficiency type chronic uric acid nephropathy were randomly divided into traditional chinese medicine(TCM) group of 46 cases, modern medicine conventional (MMC) group of 46 cases.MMC group were given chronic uric acid nephropathy education, diet control, drinking more water, oral sodium bicarbonate for alkaline urine,and at the beginning of the second month given allopurinol 0.05g once a day,If there is no adverse reaction, then 2 days after to add to 0.1g once a day taking control of SUA.Keeping drinking water not less than 1.5L everyday, urine PH value is maintained at between 6.0 to 7.0, the SUA in men and postmenopausal women less than 408umol/l, premenopausal women less than 360umol/l, after giving the minimum allopurinol dose to maintain; chronic uric acid nephropathy education, diet control, drinking water, oral sodium bicarbonate for alkaline urine are same as MMC,TCM group from the second month to give to be tonifying spleen and kidney prescription therapies, commonly used in medicine,such as Astragali Radix 15g, Codonopsis Radix 15g,Poria 15g,Atractylodis Macrocephalae Rhizoma 6g,Pseudostellariae Radix 15gg,Rehmanniae Radix 15g,Corni Fructus 15g, Dioscoreae Rhizoma 15g,Smilacis Glabrae Rhizoma15g,Plantaginis Semen 15g,Rhus Chinensis 15g,watered decoction to 200 ml and taken morning and evening.meanwhile,regularly examining SUA, Scr, Bun, eGFR,24hUPQ, and the change of clinical symptom score in TCM before and after treatment.Results:(1) TCM group total effective rate was 84.78%,MMC group was 76.09%, the two groups had significant difference (P<0.01), the efficacy of TCM group was better than MMC group; and in terms of improving the clinical symptoms, but TCM group is superior to MMC group (Z=-2.829,P=0.005,P<0.01).(2) Compared with before treatment, the strict low-purine diet, drink plenty of water and oral sodium bicarbonate for alkaline urine in lowering uric acid is statistically significant (P<0.05),but in the reduction of patients with Scr, Bun, increase eGFR,improve renal function in patients with no significant effect(P>0.05). (3) Compared with before treatment,both TCM group and CCM group have the effect of lowering uric acid (P<0.01), and both reduce uric acid level was no difference (P=0.092, P> 0.05). (4)Compared with before treatment,there are significant differences between TCM and MMC group in Scr, Bun,eGFR,24hUPQ,24h uric acid excretion rate,blood ?2-microglobulin(?2-MG),urine ?2-MG,proteinuria level, hematuria level(P<0.05),and the efficacy of TCM group is better man CCM group. In the reduction of patients with creatinine, urea nitrogen, improve eGFR, improve renal function in patients with no significant effect.Conclusion:(1)A simple give strict diet control, water and alkalization of urine can significantly reduce the level of blood uric acid, but in patients with decreased creatinine, urea nitrogen, improved eGFR, improve renal function in patients with had no significant effect.(2)There are not significant differences between TCM and MCC in Uric acid level reduction,and the mechanism maybe that TCM promote uric acid excretion.(3)Tonifying kidney and spleen method on patients with spleen and kidney qi deficiency can decrease Scr, Bun,24hUPQ,blood ?2-MG,urine ?2-MG,proteinuria level, hematuria level,increase eGFR,improve the patients with glomerular and renal tubular function is better than that of MMC group.(4)Tonifying kidney and spleen method on the chronic uric acid nephropathy patients with spleen and kidney qi deficiency in improving clinical symptoms is superior to MMC group.