参苓降酸方联合非布司他治疗脾肾气虚、痰浊内阻型尿酸性肾病的临床疗效观察OA

Objective To observe the clinical efficacy and safety of Shenling Jiangsuan Decoction(modified from Shenling Baizhu San)combined with febuxostat in the treatment of uric acid nephropathy(UAN)of spleen-kidney qi deficiency and phlegm-turbidity internal obstruction syndrome patterns.Methods Seventy patients with UAN of spleen-kidney qi deficiency and phlegm-turbidity internal obstruction syndrome patterns who visited the Department of Nephrology of Bao'an Hospital of Traditional Chinese Medicine Affiliated to Guangzhou University of Chinese Medicine(i.e.,Shenzhen Bao'an Traditional Chinese Medicine Hospital Group)from December 2024 to November 2025 were selected and randomly divided into control group and observation group by random number table method,with 35 cases in each group.The control group was treated with oral febuxostat tablets,and the observation group was treated with Shenling Jiangsuan Decoction on the basis of the control group,with a course of 8 weeks for both groups.The changes of Traditional Chinese Medicine(TCM)syndrome scores,serum uric acid(SUA),serum creatinine(SCr),blood urea nitrogen(BUN),estimated glomerular filtration rate(eGFR),urinary albumin-to-creatinine ratio(UACR),microalbuminuria(mAlb)and urinary β2-microglobulin(U-β2MG)levels were observed in both groups before and after treatment,and the TCM syndrome efficacy and medication safety were evaluated.Results(1)In terms of efficacy:after 8 weeks of treatment,the total effective rate was 91.43%(32/35)in the observation group and 60.00%(21/35)in the control group.Intergroup comparison(by chi-square test)showed that the TCM syndrome efficacy of the observation group was significantly superior to that of the control group(P＜0.05).(2)In terms of TCM syndrome scores:after treatment,the TCM syndrome scores in both groups were decreased compared with those before treatment(P＜0.05),but the reduction was smaller in the control group and more significant in the observation group.Intergroup comparison showed that the reduction degree of TCM syndrome scores in the observation group was significantly superior to that in the control group(P＜0.001).(3)In terms of laboratory indexes:after treatment,the levels of SUA,SCr,BUN,UACR,mAlb and U-β2MG in both groups were significantly decreased compared with those before treatment(P＜0.05),while the eGFR values were significantly increased(P＜0.05).The reduction degrees of SUA,SCr,BUN,UACR,mAlb and U-β2MG and the increase degree of eGFR in the observation group were significantly superior to those in the control group(P＜0.05).(4)In terms of safety:no serious adverse events occurred in either group during treatment.Conclusion Shenling Jiangsuan Decoction combined with febuxostat can effectively improve clinical symptoms,reduce uric acid levels and protect renal function in patients with UAN of spleen-kidney qi deficiency and phlegm-turbidity internal obstruction syndrome patterns,with favorable safety,and its efficacy is significantly superior to febuxostat alone.