Clinical Study On The Treatment Of Gout With Dampness And Turbid Stasis By Prescription Of Xiezhuo Quyu Decoction Combined With Febuxostat

Objective: To observe the clinical efficacy and safety of Xiezhuo Quyu decoction combined with Febuxostat in treating gouty nephropathy,and to find a safe and effective treatment strategy for treating gouty nephropathy.Methods: A total of 80 cases of acute gouty nephropathy who were admitted to Renmin Hospital of Wu University from September 2016 to December 2018 were selected and randomly divided into study group and control group,with 40 cases in each.The control group was treated with Febuxostat(40 mg per day,ororally),while the treatment group was treated with Xiezhuo Quyu decoction on the basis of the control group(decoction of water,one dose per day,400 ml of juice,early,medium oral).The two groups were treated with 4 weeks as a course of treatment.The curative effect was observed after 2 consecutive courses of treatment.Observe the improvement of clinical symptoms and signs before and after treatment,and design a quantitative scoring table to score TCM syndromes;Visual analogue score(VAS)was used to evaluate the pain in the two groups;Visual analogue score(VAS)was used to evaluate the pain in the two groups,urinary protein [24 hour urinary protein quantification(24hu-TP),urinary ?2 microglobulin(?2-MG),?1 micr-oglobulin(?1-MG)]and the renal injury marker [N-acyl-B-D-glucosaminidase(NAG),retinol binding protein(RBP-U),neutrophil gelatinase-associated lipid carrier protein(NGAL)].Results: 1)Clinical efficacy: the total effective rate in the treatment group was97.50%,which was higher than that in the control group(77.50%),the difference between the two groups was statistically significant(P<0.05);2)TCM syndrome score: after treatment,the total score of TCM syndromes and the scores of major syndromes in the treatment group were significantly better than those in the control group,and the symptoms were obviously improved(P<0.05);3)VAS score:the VAS score in the treatment group was lower than that in the control group,(P<0.05);4)Laboratory indexes: the laboratory data of renal function(UA,Cr,BUN),urine protein(24hu-TP,?2-MG,?1-MG)and renal injury marker(NAG,RBP-U,NGAL)in the treatment group were lower than those in the control group,the level of e GFR was higher than that of the control group.The renal function,urine protein and renal injury were improved significantly(P<0.05);5) Safety of medication: less adverse reactions such as gastrointestinal symptoms(nausea,vomiting,diarrhea,constipation),liver function changes(transaminase),skin allergy occurred during the course of treatment,there was no significant difference between the two groups(P>0.05).Conclusion: the combination of Xiezhuo Quyu decoction and Febuxosta is effective in treating gouty nephropathy,and the effective rate of clinical treatment is high;It can obviously relieve all kinds of uncomfortable symptoms,such as pain of lumbar spine,swelling and pain of joint,swelling and so on;Improve the renal function,proteinuria,renal injury and other conditions,improve the physiological indicators of patients;In the course of treatment,the adverse reaction was lighter and less,and the safety of medication was better.