| 摘要: |
| ［摘要］ 目的 探讨固本祛湿化瘀方联合非布司他治疗痛风性肾病（GN）的效果及对氧化应激指标水平的影响。方法 招募2022年1月至2025年1月上海市光华中西医结合医院收治的GN患者106例，采用随机数字表法将其分为观察组和对照组，各53例。对照组予以非布司他治疗，观察组予以固本祛湿化瘀方联合非布司他治疗，两组疗程均为3个月。比较两组治疗前后主证证候积分、肾功能指标、尿蛋白指标以及氧化应激指标水平。比较两组临床疗效以及不良反应发生情况。结果 治疗后，观察组关节疼痛、关节肿胀、肌肤麻木、屈伸不利等证候积分低于对照组，血清肌酐（Scr）、尿素氮（BUN）、尿酸（UA）、丙二醛（MDA）、尿β2微球蛋白（Uβ2-MG）、尿白蛋白肌酐比（UACR）、24 h尿蛋白定量（24hUTP）水平低于对照组，肾小球滤过率（eGFR）、超氧化物歧化酶（SOD）、谷胱甘肽过氧化物酶（GSH-Px）水平高于对照组，差异有统计学意义（P<0.05）。观察组临床总有效率显著高于对照组（94.34% vs 81.13%； χ2=4.296，P=0.038）。两组不良反应总发生率比较差异无统计学意义（15.09% vs 11.32%； χ2=0.329，P=0.566）。结论 固本祛湿化瘀方联合非布司他可有效改善GN患者的临床症状和肾功能，且安全性好，其可能通过降低氧化应激指标水平发挥作用。 |
| 关键词: 痛风性肾病 固本祛湿化瘀方 非布司他 临床疗效 氧化应激 肾功能 |
| DOI：10.3969/j.issn.1674-3806.2026.06.16 |
| 分类号:R 589.7 |
| 基金项目:“十四五”中医特色专科和中医急诊能力提升（第一批）项目（编号：ZYJZNLTS1-5）；上海中医药大学理科预算内项目（编号：2021LK009） |
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| Analysis on the clinical efficacy of Guben Qushi Huayu formula combined with febuxostat in treatment of gouty nephropathy and its influence on levels of oxidative stress indicators |
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XIN Jiechen, WANG Xiaoyan, ZHANG Feng, ZHAO Longshu
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Emergency Intensive Care Unit, Shanghai Guanghua Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai 200052, China
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| Abstract: |
| ［Abstract］ Objective To explore the clinical efficacy of Guben Qushi Huayu formula(GQHF) combined with febuxostat in treatment of gouty nephropathy(GN) and its influence on levels of oxidative stress indicators. Methods A total of 106 GN patients admitted to Shanghai Guanghua Hospital of Integrated Traditional Chinese and Western Medicine from January 2022 to January 2025 were recruited and divided into observation group and control group by random number table method, with 53 patients in each group. The control group was treated with febuxostat, while the observation group was treated with GQHF combined with febuxostat. The patients in both groups were treated for 3 months. The scores of main traditional Chinese medicine(TCM) syndromes, renal function indicators, urinary protein indicators and levels of oxidative stress indicators were compared between the two groups before and after the treatment. The clinical efficacy and the occurrence of adverse reactions were compared between the two groups. Results After the treatment, the TCM syndrome scores of joint pain, joint swelling, skin numbness, and difficulty in flexion and extension in the observation group were lower than those in the control group, and the levels of serum creatinine(Scr), blood urea nitrogen(BUN), uric acid(UA), malondialdehyde(MDA), urinary β2-microglobulin(Uβ2-MG), urinary albumin-to-creatinine ratio(UACR) and 24-hour urinary total protein(24hUTP) in the observation group were lower than those in the control group, and the levels of estimated glomerular filtration rate(eGFR), superoxide dismutase(SOD) and glutathione peroxidase(GSH-Px) in the observation group were higher than those in the control group, with statistically significant differences between the two groups(P<0.05). The total clinical effective rate of the observation group was significantly higher than that of the control group(94.34% vs 81.13%; χ2=4.296, P=0.038 ). There was no statistically significant difference in the total incidence of adverse reactions between the two groups(15.09% vs 11.32%; χ2=0.329, P=0.566). Conclusion The combination of GQHF and febuxostat is safe in treatment of GN and can effectively improve the patients′ clinical symptoms and renal function. The combined treatment may exert the effects by reducing the levels of oxidative stress indicators. |
| Key words: Gouty nephropathy(GN) Guben Qushi Huayu formula(GQHF) Febuxostat Clinical efficacy Oxidative stress Renal function |
