目的 :观察利湿泄浊、益气活血法对慢性肾脏病(CKD)3⁴期伴高尿酸血症的血尿酸水平及肾功能的影响,探讨血尿酸水平变化对肾功能的影响。方法:60例CKD 3⁴期伴高尿酸血症患者按就诊先后顺序分为对照组和治疗组各30例。对照组采用西医常规治疗,治疗组在西医常规治疗的基础上加用利湿泄浊、益气活血法治疗,两组均治疗8周。观察两组治疗前后血尿酸水平及肾功能指标血肌酐(Scr)、血尿素氮(BUN)、肾小球滤过率(GFR)的变化。结果:两组治疗后血尿酸水平较治疗前均下降,差异有统计学意义(P<0.05或P<0.01);治疗组治疗后的血尿酸水平低于对照组,差异有统计学意义(P<0.05)。治疗组治疗后的Scr、BUN、GFR水平较治疗前改善,差异有统计学意义(P<0.05);治疗组治疗后的Scr、BUN、GFR水平改善优于对照组,差异有统计学意义(P<0.05)。结论:利湿泄浊、益气活血法能降低患者血尿酸水平,改善患者肾功能,血尿酸水平的改善有助于延缓CKD伴高尿酸血症患者肾功能恶化。

Objective:To observe the effect of removing dampness,clearing away turbidness,tonifying qi and promoting blood circulation method on serum uric acid level and renal function of patients with stage 3 ⁴ chronic kidney disease(CKD) accompanied with hyperuricemia,and to explore the influence of changes of serum uric acid level on renal function. Methods:Sixty patients with stage 3⁴ CKD accompanied with hyperuricemia were divided into control group and treatment group according to the sequence of seeing doctor.The control group was treated with conventional western medicine. Besides the conventional western medicine,the treatment group was treated with removing dampness,clearing away turbidness,tonifying qi and promoting blood circulation method. Both groups were treated for 8 weeks. The changes of serum uric acid level and renal function indexes including serum creatinine(Scr),blood urea nitrogen(BUN) and glomerular filtration rate(GFR) of the two groups were observed before and after treatment. Results:After treatment,the serum uric acid level of the two groups were decreased. Compared with that before treatment,the difference was statistically significant(P<0.05 or P<0.01). The serum uric acid level of the treatment group was lower than that of the control group and the difference was statistically significant(P<0.05). The levels of Scr,BUN and GFR of the treatment group were significantly improved compared with those before treatment and the differences were statistically significant(P<0.05). After treatment,the levels of Scr,BUN and GFR of the treatment group were better than those of the control group and the differences were statistically significant(P <0.05). Conclusion:The method of removing dampness,clearing away turbidness,tonifying qi and promoting blood circulation can reduce the serum uric acid level and improve the renal function of the patients. The improvement of serum uric acid level can delay the renal function deterioration in patients with CKD accompanied with hyperuricemia.