自拟益肾活血方对老年高尿酸血症血尿酸及性激素影响的临床研究
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摘要
目的:观察自拟益肾活血方对老年高尿酸血症患者血尿酸及性激素水平的影响。方法:对本院符合纳入标准的病人随机分为中药治疗组和西药对照组各42例,中药组为自拟益肾活血方口服,对照组为苯溴马隆口服治疗。观察治疗后8周的实验室指标。结果:中药组治疗显著降低血尿酸水平(P<0.05),而对尿尿酸水平无显著影响(P>0.05);根据性别分男、女亚组将治疗组与对照组性激素水平在治疗前后进行比较,中药治疗组可显著升高男性病例T水平、降低E_2/T水平(P<0.05),可显著升高女性病例E_2、E_2/T水平(P<0.05),降低T水平。结论:自拟益肾活血方具有良好的降血尿酸疗效,且治疗期间不易诱发痛风急性发作,安全有效,而其作用机制可能是通过双向调节E_2/T比值以影响老年患者性激素水平。
Objective:To observe rve the clinical effect of Self-made Yishen Huoxue Decoction on blood uric acid and sex hormones in elderly patients with hyperuricemia.Methods:The patients who met the inclusion criteria were randomly divided into the Chinese medicine treatment group and the Western medicine control group with 42 cases in each.The Chinese medicine group was treated with Self-made Yishen Huoxue Decoction,and the control group was treated with oral benzbromarone.The clinical indexes of 8 weeks after treatment were observed.Results:Chinese medicine treatment group significantly decreased the level of serum uric acid(P<0.05),but had no significant effect on uric acid level(P>0.05).According to the gender of male and female sub groups,the treatment group and the control group′s hormone levels were compared before and after treatment.The treatment group can significantly increase the T level of male patients,reduce the level of E_2/T(P<0.05).Female patients could significantly increase the level of E_2/T and E_2(P<0.05) and reduce the level of T.Conclusion:Self-made Yishen Huoxue Decoction has good curative effect for blood uric acid,and the treatment period is not easy to induce acute attacks of gout.It is safe and effective,and its mechanism may be to influence the level of sex hormone in elderly patients by modulating the ratio of E_2/T.
Objective:To observe rve the clinical effect of Self-made Yishen Huoxue Decoction on blood uric acid and sex hormones in elderly patients with hyperuricemia.Methods:The patients who met the inclusion criteria were randomly divided into the Chinese medicine treatment group and the Western medicine control group with 42 cases in each.The Chinese medicine group was treated with Self-made Yishen Huoxue Decoction,and the control group was treated with oral benzbromarone.The clinical indexes of 8 weeks after treatment were observed.Results:Chinese medicine treatment group significantly decreased the level of serum uric acid(P<0.05),but had no significant effect on uric acid level(P>0.05).According to the gender of male and female sub groups,the treatment group and the control group′s hormone levels were compared before and after treatment.The treatment group can significantly increase the T level of male patients,reduce the level of E_2/T(P<0.05).Female patients could significantly increase the level of E_2/T and E_2(P<0.05) and reduce the level of T.Conclusion:Self-made Yishen Huoxue Decoction has good curative effect for blood uric acid,and the treatment period is not easy to induce acute attacks of gout.It is safe and effective,and its mechanism may be to influence the level of sex hormone in elderly patients by modulating the ratio of E_2/T.
引文
[1] 刘湘源,肖玉兰,任素琴.老年人高尿酸血症调查及影响因素分析[J].中华风湿病学杂志,2005,9(5): 280-283.
[2] Richette P,Bardin T.Gout[J].Lancet,2010,375:318-328.
[3] Feig DI,Kang D-H,Johnson RJ.Uric acid and cardiovascular risk[J].N Engl J Med,2008,359:1811-1821.
[4] Feig D,Kang DH,Johnson RJ.Uric acid and cardiovascular risk[J].N-Engl J Med,2008,359(17):1811-1821.
[5] Curhan GC,Mitch WE.Diet and kidney disease.Brenner BM.The Ki-dney[M].8th ed.Philadelphis: Saunders Elsevier,2008: 1827-1847.
[6] 陆再英,钟南山.内科学[M].7版.北京:人民卫生出版社,2010:830-834.
[7] 张春天,彭隽,杨成,等.血清尿酸男性激素水平的相关性分析[J].华南国防医学杂志,2012,26(4):381-382.
[8] 丁国林.老年和更年期女性尿酸代谢特点[J].国外医学老年医学分册.2007,28(3):144.
[9] 陈涛,李卫,王杨,等.高尿酸血症的患病情况及相关因素分析[J].中华临床医师杂志(电子版),2012,6(13):49-52.
[10] 王凯,吕煜焱,熊婧,等.北上海社区65岁及以上人群血清尿酸水平与亚临床靶器官损害相关指标间的关系[J].上海医学,2016,9(39):521-525.
[11] 王勇强,邓玉奎,林松,等.绝经期后女性血尿酸参考区间的建立及与雌激素相关性研究[J].标记免疫分析与临床,2014,21(3):249-254.
[12] Cheng X,Klaassen C D.Tissue distribution,ontogeny,and hormona-l regulation of xenobiotic transporters in mouse kidneys[J].Drug Metab Dispos,2009,37:2178-2185.
[13] Takiue Y,Hosoyamada M,Kimura M,et al.The effect of female hor-mones upon urate transport systems in the mouse kidney[J].Nucleos-ides Nucleotides Nucleic Acids,2011,30:113-119.
[14] 周冬青,高书荣.温肾泄浊汤对中老年男性无症状高尿酸血症血尿酸及性激素的影响[J].上海中医药杂志,2014,10(48):48-50.
[15] 肖雯晖,温成平,谢志军.从调节生殖内分泌环境探讨中医防治高尿酸血症的思路[J].中华中医药杂志,2013,8(28):2350-2353.
[16] 闫朋宣,杜宝俊,罗然.中药类激素样作用研究进展[J].中华中医药杂志,2014,2(29):531-534.
[17] 刘旭颖,姜敏,程羽萱,等.老年人血清性激素、性激素结合球蛋白、胰岛素水平与血尿酸水平的相关性分析[J].宁夏医科大学报,2014,5(36):556-558.
[2] Richette P,Bardin T.Gout[J].Lancet,2010,375:318-328.
[3] Feig DI,Kang D-H,Johnson RJ.Uric acid and cardiovascular risk[J].N Engl J Med,2008,359:1811-1821.
[4] Feig D,Kang DH,Johnson RJ.Uric acid and cardiovascular risk[J].N-Engl J Med,2008,359(17):1811-1821.
[5] Curhan GC,Mitch WE.Diet and kidney disease.Brenner BM.The Ki-dney[M].8th ed.Philadelphis: Saunders Elsevier,2008: 1827-1847.
[6] 陆再英,钟南山.内科学[M].7版.北京:人民卫生出版社,2010:830-834.
[7] 张春天,彭隽,杨成,等.血清尿酸男性激素水平的相关性分析[J].华南国防医学杂志,2012,26(4):381-382.
[8] 丁国林.老年和更年期女性尿酸代谢特点[J].国外医学老年医学分册.2007,28(3):144.
[9] 陈涛,李卫,王杨,等.高尿酸血症的患病情况及相关因素分析[J].中华临床医师杂志(电子版),2012,6(13):49-52.
[10] 王凯,吕煜焱,熊婧,等.北上海社区65岁及以上人群血清尿酸水平与亚临床靶器官损害相关指标间的关系[J].上海医学,2016,9(39):521-525.
[11] 王勇强,邓玉奎,林松,等.绝经期后女性血尿酸参考区间的建立及与雌激素相关性研究[J].标记免疫分析与临床,2014,21(3):249-254.
[12] Cheng X,Klaassen C D.Tissue distribution,ontogeny,and hormona-l regulation of xenobiotic transporters in mouse kidneys[J].Drug Metab Dispos,2009,37:2178-2185.
[13] Takiue Y,Hosoyamada M,Kimura M,et al.The effect of female hor-mones upon urate transport systems in the mouse kidney[J].Nucleos-ides Nucleotides Nucleic Acids,2011,30:113-119.
[14] 周冬青,高书荣.温肾泄浊汤对中老年男性无症状高尿酸血症血尿酸及性激素的影响[J].上海中医药杂志,2014,10(48):48-50.
[15] 肖雯晖,温成平,谢志军.从调节生殖内分泌环境探讨中医防治高尿酸血症的思路[J].中华中医药杂志,2013,8(28):2350-2353.
[16] 闫朋宣,杜宝俊,罗然.中药类激素样作用研究进展[J].中华中医药杂志,2014,2(29):531-534.
[17] 刘旭颖,姜敏,程羽萱,等.老年人血清性激素、性激素结合球蛋白、胰岛素水平与血尿酸水平的相关性分析[J].宁夏医科大学报,2014,5(36):556-558.