Clinical Study Of Zegui Wuzi Formula In The Treatment Of Gouty Nephropathy Of Dampness Blocking Meridian Type

Objective:To observe the effect of Zegui Wuzi prescription combined with western medicine on clinical symptoms and observation indexes of patients with gouty nephropathy of damp obstruction meridian type,to clarify its clinical efficacy and safety,and to provide a certain basis for the development of empirical prescription.inherit and develop the advantages of traditional Chinese medicine "warming yang and transforming qi" in the differential treatment of gouty nephropathy.Methods:Sixty-eight patients with gouty nephropathy diagnosed by western medicine and TCM syndrome belonging to "dampness blocking meridians" and signed informed consent were randomly divided into control group(n = 34)and experimental group(n = 34).The control group was given routine treatment of western medicine,and the experimental group was treated with "Zegui Wuzi Fang" granules on this basis.SUA,Scr,BUN,24h-UPro,GFR,urine PH,urinary occult blood,proteinuria,TCM syndrome score,TCM syndrome efficacy,disease efficacy and safety indexes(T,P,R,BP,WBC,RBC,HGB,PLT,ALT,AST,ALB,TBIL,PT,ECG)of all patients before and after treatment were observed and recorded before and after treatment(4 weeks).At the same time,adverse reactions and adverse events were observed.Analyze and process the experimental data with spss26.0 and explore the comprehensive effect of combination of traditional Chinese and western medicine based on Zegui Wuzi prescription in the treatment of gouty nephropathy of dampness obstruction meridian type.Results:1.Baseline analysis: 68 patients were enrolled in the group,7 cases were removed,61 cases were effective,30 cases in the experimental group and 31 cases in the control group.There was no significant difference in basic condition(sex,age,course of disease),efficacy index and safety index between the two groups before treatment(P > 0.05).2.Clinical effect of disease: The effective rate of the test group was 86.66%,and that of the control group was 74.19%.The curative effect of the test group was better than that of the control group(P < 0.05).3.Curative effect of TCM syndrome: The effective rate of TCM syndrome was 83.33% in the experimental group and 70.97% in the control group.The curative effect of the experimental group was better than that of the control group(P < 0.05).4.TCM syndrome integral: Both of the two treatments could significantly reduce the total score of TCM syndrome(P < 0.01).Compared with the control group,the experimental group had better effect in improving clinical symptoms and reducing the score of TCM syndrome(P < 0.05).The experimental group was effective in improving fatigue,lumbago and knee weakness,low back pain,edema,joint pain,joint swelling,heavy limb sleepiness,poor flexion and extension,poor appetite(P < 0.05),but not in improving nausea and stickiness in the mouth(P > 0.05),while the control group was effective in the treatment of edema,joint pain,joint swelling,limb sleepiness and adverse flexion and extension(P < 0.05).There was no obvious effect in the treatment of fatigue,sore waist and knees,low back pain,lack of food,nausea and stickiness in the mouth(P > 0.05).The effect of the test group was better than that of the control group in improving low back and knee pain,low back pain and joint pain(P < 0.05).5.Renal function(SUA,Scr,BUN,24h-Upro,GFR): Both treatments can significantly reduce SUA,Scr,BUN,24h-Upro and increase GFR in patients(P < 0.05).In comparison between groups,the effect of reducing SUA and 24h-Upro in the test group was better than that in the control group,and the two groups had the same effect in reducing Scr,BUN and increasing GFR(P >0.05).6.Urine examination and analysis(urine PH,urinary occult blood,urinary protein): Both of the two treatments can improve the urine PH,in the treatment of urinary occult blood and reduce urinary protein(P < 0.05).The treatment of urinary occult blood in the experimental group was better than that in the control group(P < 0.05),and the effect of improving urinary PH in the experimental group was similar to that in the control group(P > 0.05).7.Safety evaluation: there were no adverse reactions in the two groups,and there was no significant difference in safety indexes before and after treatment(P > 0.05).Conclusion:1.Zegui Wuzi prescription can warm yang and remove dampness and dredge collaterals,combined with western medicine treatment can significantly reduce the TCM syndrome scores of patients with gouty nephropathy of damp obstruction meridian type,and improve clinical symptoms such as knee and waist pain,low back pain,joint pain and so on.2.Both of the two treatments can reduce SUA,Scr,BUN and 24 h UPRO of patients with gout nephropathy of dampness blocking meridian type,increase GFR,improve urinary PH,treat urinary occult blood,reduce urinary protein,and then protect renal function of patients.It is more effective to treat urinary occult blood and reduce urinary protein with Zegui Wuzi Fang to reduce SUA and 24 h UPro.it is better to treat urinary occult blood and reduce urinary protein.3.Based on Zegui Wuzi prescription,the clinical effect of combination of traditional Chinese and western medicine in the treatment of gouty nephropathy of dampness blocking meridians is better.No adverse reactions were found in this study,which shows that the clinical application of Zegui Wuzi prescription is safe and effective and is worthy of further exploration.