Clinical Observation Of Gout Decoction In The Treatment Of Phlegm And Blood Stasis Obstruction Gouty Nephropathy

Objective: To observe the clinical effect of gout decoction in treating patients with gout nephropathy with phlegm and stasis,and to explore the possible mechanism of gout decoction to reduce renal tubule damage,and to provide new ideas for the treatment of TCM.Methods: 1.A random group was used for 72 patients with gout nephropathy who met the diagnosis and included the criteria.They were divided into gout Decoction group and Western medicine group.Each group had 36 cases.2.The Western Medicine Group gave lifestyle interventions(including diet control,drinking more water,alkaline urine,weight control),the second month was given febuxostat 20 mg QD,to control blood uric acid at 180-300μmol/L,and then the lowest dose was maintained(20mg qod);3.The lifestyle of the Chinese medicine group interfered with the Western medicine group.From the second month,gout decoction group was added on the basis of Western medicine group.The two groups of treatment courses were 8 weeks.During the treatment,the changes of symptoms,signs and indicators such as UA,Scr,BUN,e GFR,24 h U-TP,24 h uric acid,urine α1-MG,and ACR were observed before and after treatment,and the results were statistically analyzed and compared.Result: 1.There were no significant differences in general data(gender,age,course of disease),observation indexes(UA,Scr,BUN,e GFR,24 h U-TP,24 h uric acid,urine alpha 1-MG,ACR,urine RBC,TC,TG,HDL,LDL),TCM syndrome scores between the two groups before treatment(P>0.05),which were comparable.2.Uric acid in Tongfeng Decoction group increased 24 hours after treatment,and there was significant difference between groups(P<0.05).The result of gout Decoction group was better than that of Western medicine group.3.After treatment,UA decreased in both groups,and there was significant difference between the two groups(P<0.05).The effect of gout group was better than that of Western medicine group.4.After treatment,the levels of U-TP,urinary alpha-1-microglobulin,ACR decreased in both groups,with significant difference between the two groups(P<0.05).The results of gout Decoction group were better than those of Western medicine group.5.After treatment,TC and TG in the gout Decoction group decreased,and there was significant difference between the two groups(P<0.05).The results in the gout Decoction group were better than those in the western medicine group.6.After treatment,the e GFR did not decrease,and there was no significant difference between the groups(P>0.05).Conclusion: 1.Gout Decoction combined with western medicine has more advantages in improving the syndrome of phlegm and blood stasis obstruction and clinical outcome of gouty nephropathy than western medicine alone.2.gout Decoction combined with western medicine has better effect on reducing uric acid than simple western medicine,and its mechanism may be to promote the excretion of uric acid.3.Gout Decoction combined with western medicine can lower the levels of urinary protein and urinary alpha-1-microglobulin,and reduce the damage to the renal tubules.4.Gout decoction combined with western medicine is superior to western medicine only in reducing TC and TG.5.Gout soup has no obvious adverse reactions during the period of observation and is an effective drug for the clinical treatment of gout nephropathy.