| Background and objective:With the development of living condition,the incidence of Hyperuricamia(HUA),which affects human health more and more aggravated,increased from year to year.Recent studies have found that HUA became the independent risk factors of nephropathy progression.Clinically,the general therapeutic principle of HUA is the improving of living styles,alkalization of urine and uric-acid-lowering drug.Febuxostat(Fx),a new type of Xanthine oxidase inhibitors,metabolized through liver,has a higher selectivity than allopurinol.Fx can be safely used in patients with mild to moderate renal insufficiency,and Fx treatment is tolerant and effective to patients with allopurinol intolerance.In recent years,many large sample randomized controlled trial studies showed that Fx is more effective than allopurinol in the aspect of lowering uric acid.Medicinal charcoal has an excellent adsorption of urea,creatinine,and uric acid but less side effect.In the past 5 years,encouraging progress was made in treating Hyperuricamic nephropathy through Fx.This study investigates the clinical effect of the combination on Febuxostat and Medicinal charcoal in the treatment of Hyperuricamic nephropathy and its effects on patients’ life quality.Method:From Jan.2014 to Oct.2015,a total of 86 Hyperuricamic nephropathy cases in Department of Urology,the 252 nd Hospital of PLA,were reviewed.All cases were divided into two groups: combination group and Febuxostat group.The combination group was given Febuxostat(Wan Bang Biochemistry,Jiang Su,0.5g)treatment,daily 1 time,40 mg for each;Medicinal Charcoal Tablets(Chang Tian,Bao ding,0.5g)treatment,daily 3 times,1.5g for each.During the period of treatment,other drug should be given 2 hours apart.The Febuxostat group was given Febuxostat(Wan Bang Biochemistry,Jiang Su,0.5g)treatment,daily 1 time,40 mg for each.Patients’ baseline,and blood urea nitrogen,creatinine,blood uric acid values were collected respectively after treating for 4 weeks,12 weeks and 24 weeks.In order to examine the differences,the number of renal insufficiency through the treatment in both groups was recorded;the adverse reactions appeared during the therapy in both groups were observed,and medication safety was compared.Result:1.In both groups,blood uric acid decreased obviously,and the differences with(P<0.05),and the difference was significance P<0.05.The Combination of Febuxostat and Medicinal charcoal was significantly better at reducing UA than the Febuxostat group,and with time UA control effect could be more stable.In the aspect of improving renal function,the combination treatment was significantly better than single Febuxostat.In Febuxostat group there was no obvious change in Cr or BUN which reduced obviously in combination group(P<0.05).In both groups,there was no obvious change on blood routine,blood fat and liver function before and after treatment(P>0.05),and the difference was not statistically significant.2.Using Febuxostat treatment within 24 weeks,the difference in gout between two groups was not significant(P>0.05).In both groups,for patients with hypertension whose blood pressure were kept around 150/100 mmHg,there were discomforts such as headache,dizziness,nausea etc.,and the difference was not statistically significant.None of cardiovascular death occurred.The difference in adverse reaction between two groups was not statistically significant(P>0.05).Conclusion:1.The standard rate of reducing blood uric acid in the combination therapy group(95.7%)is significantly better than that of the other group(65%).2.Febuxostat combined Medicinal Charcoal Tablets in improving renal function is better than the single use of Febuxostat,Febuxostat has no significant changes in creatinine and urea nitrogen levels,and serum creatinine in the combination therapy group is significantly lower than that in the former,and 76% of the patients has a marked reduction in serum creatinine and renal symptoms. |
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