Uric acid is the end product of purine metabolism, slightly soluble in water, easy to form crystals, its alcohol formula is weakly acidic, and it is excreted with urine. Under normal circumstances, the uric acid in the body is about 1200 mg, and the amount of new production and excretion per day is basically the same, which is in a balanced state. Normal levels of uric acid are not harmful to the human body.
If too much is produced in the body and too late to excrete or the uric acid excretion mechanism is degraded, too much uric acid retention in the body will occur. Excessive fatigue or insufficient rest can also lead to relatively slow metabolism and lead to acidification of human body fluids and hyperuricemia. Long-term neglect will lead to complications such as gout and kidney damage.
Uric acid nephropathy is a renal lesion caused by hyperuricemia due to excessive or decreased excretion of blood uric acid, commonly called gout nephropathy, and the clinical manifestations may include uric acid stones, small molecule proteinuria, edema, nocturia, hypertension, hematuria, elevated uric acid, and tubular dysfunction. The disease is more common in the north of the mainland, there is no obvious seasonality, and the incidence of obesity, carnivorous and alcoholics is high. The ratio of men to women is 9:1, and 85% are middle-aged and elderly. If early diagnosis and appropriate treatment includes control of hyperuricemia and protection of renal function, renal lesions can be reduced or halted. Delayed or inadequate treatment can lead to worsening of the condition and progression to end-stage renal failure.
Zhang Zhenzhong, a TCM expert at Beijing Lianke Traditional Chinese Medicine Nephrology Hospital, said that the clinical treatment of uric acid kidney disease should first start with a low-purine diet and eat less food such as heart, liver, kidneys, sardines and alcohol. Drink plenty of water and maintain urine output 〉2000 ml / day, alkalinize urine, avoid the use of drugs that inhibit uric acid excretion, and use drugs to control uric acid production and increase uric acid excretion. Kidney stones and standing water should be treated symptomatically. If renal function damage occurs, it is necessary to actively treat kidney disease and complications while reducing uric acid to reduce kidney damage. Traditional Chinese medicine treatment is mainly based on dialectical typing, the use of uric acid lowering and promoting uric acid excretion of traditional Chinese medicine, improve kidney blood flow, reduce the damage of inflammatory cells and inflammatory mediators to the renal tubulo-interstitial.
Men do not smoke and drink but love to eat a dish to cause kidney failure, and the combination of traditional Chinese and Western medicine is stable in reducing uric acid
The patient, xxx, male, 33 years old, a takeaway guy. After graduating from college 10 years ago, I went to work in a company, because the company was not well run, the performance declined, I was laid off by the company after about 3 years of work, and after losing my job, I felt that life was very stressful, because there was a family that needed to be supported and taken care of.
I heard a friend say that delivering takeaways is very profitable, so I decided to deliver takeaways. It's a lot of hard work, and the more you send, the higher the salary. After joining the company, I desperately ran a single, in order to be able to take more orders, earn a little more money, in order to be able to buy a house of my own in the city, every day is desperate to send a single, has been the first place to send a single, colleagues persuade not to be so desperate, or physical health is the most important. However, in order to be able to live in a new house as soon as possible, patients feel that they are young and have nothing to work hard. Get up early and get dark, have no holidays, and never ask for leave to rest. This is more than 6 years.
About half a year ago, the patient felt that his legs, there was a feeling of swelling, but there was no other uncomfortable place, he thought that it was too hard recently, running a single to send too much caused, and he did not pay attention to it and continued to send a single. After a few months, the swelling in the legs did not subside, and there was a painful feeling in the waist, still thinking that it was tired, thinking about pasting a few plasters. One day when I was resting, I felt a sharp pain coming from my waist, and I couldn't walk up straight, so my family hurriedly dialed 120 for help and was taken to the local hospital.
After the doctor's first aid pain relief, immediately do the examination, the test results show that the uric acid in the body is as high as 860umol / L, blood creatinine 453umol / L, high blood pressure, dyslipidemia, these uric acid has crystallized in the kidneys to form urate, kidney function is seriously impaired, was diagnosed with uric acid nephropathy, kidney failure. Immediately admitted to the hospital for inpatient treatment. Through communication, the doctor found that the patient's onset was related to the usual diet. After consultation with experts in traditional Chinese and Western medicine, the use of integrated traditional Chinese and Western medicine, the use of Western medicine to lower uric acid, lower blood pressure, lower blood lipids, use traditional Chinese medicine to regulate the function of various organs of the internal organs, promote waste discharge, assist in lowering uric acid, activate blood stasis, improve blood viscosity, promote blood flow, increase kidney nutrient supply, provide a good internal environment for glomerular repair, adjust the patient's diet, control high-purine food, low-salt high-quality protein diet, after comprehensive treatment, creatinine declines, uric acid drops to the normal range, other indicators gradually return to normal, and edema gradually subsides. After being stable, he was discharged home and continued to take medicine according to the doctor's instructions, regularly reviewed, and followed up.
Doctors said that the main cause of patients' kidney failure is kidney damage caused by high uric acid, and elevated uric acid is related to daily diet and overwork. Because the usual work is very hard, patients listen to others say that eating more pork liver can supplement iron and play a strong effect, so they will buy some pork liver every day to eat at home. As everyone knows, these foods contain toxic substances such as high purines and heavy metals, long-term consumption leads to increased uric acid, and the patient's overwork leads to a slowdown in the excretion of uric acid, which causes uric acid to accumulate in the body for a long time and causes hyperuricemia, resulting in the precipitation of uric acid crystals in the kidneys, seriously damaging the kidneys and causing kidney failure.
Moreover, regular consumption of pig liver will lead to an increase in the detoxification burden in the human body, and the heavy metals remaining in pig liver will also endanger kidney health and cause serious toxic damage to the kidneys. Pig liver contains very high purines, often eat pig liver and other animal viscera will increase the uric acid in the body, accelerate the urate crystallization in the body, easy to cause gout, urinary tract stones, kidney stones and other diseases, and uric acid crystals will also damage the renal tubules caused by lesions.
Why does high uric acid damage the kidneys?
Hyperuricemia not only causes gout attacks, but also causes atherosclerosis, inducing cardiovascular and cerebrovascular diseases; can aggravate metabolic diseases, cause insulin resistance, and make blood sugar difficult to control; more importantly, high uric acid can cause "uric acid kidney disease". Because the kidney is an important place to clear uric acid, when the human blood uric acid level is at a very high level, excess urate crystals will be deposited in the tubule and renal interstitium, obstructed uric acid can activate local chronic inflammation, immune damage, microangiopathy of the kidney, resulting in chronic kidney disease.
Clinically, there are three main forms of "uric acid kidney disease": one is acute uric acid kidney disease. It is rare that a large number of uric acid crystals are widely blocked in the lumen of the renal tubule, which can directly lead to the appearance of acute renal failure. The second is uric acidic stones. That is, uric acid is deposited in the kidneys, ureters, bladder and other stones in the entire urinary system. Large stones can directly obstruct the urethra, and renal colic, hematuria, etc. appear. The third is chronic urate nephropathy. Chronic interstitial nephritis caused by hyperuric acid can be manifested in the early stages as a small amount of proteinuria and hematuria, impaired renal concentration, increased nocturia, eventually impaired renal function, chronic renal failure, and eventually developed into "uremia".
Clinically, the most intractable is "chronic urate nephropathy". Because of its high incidence, secret onset, and lack of attention, such patients can be accompanied by irreversible renal damage, and the severity of the damage is often related to the duration and magnitude of the increase in blood uric acid.
How does TCM treat hyperuric acid kidney disease?
According to Zhang Zhenzhong, an expert in traditional Chinese medicine, Chinese medicine believes that uric kidney disease belongs to the category of "low back pain", "stone shower", "edema", "paralysis", "calendar festival", "gout", "kidney labor" and other medical evidence. Due to insufficient innate endowments, or excessive fatigue to injure the kidneys, resulting in kidney deficiency; or eating disorders, weak temper, dysfunction of the internal organs, can not be transformed into qi and blood subtle, but brewed damp and hot phlegm, the inside and flow into the internal organs, and the outside and paralyzing the joint meridians. Spleen and kidney weakness is the key to the occurrence and development of this disease, and damp and hot sputum is an important aspect of the occurrence and development of the disease. The disease is prolonged for a long time, and the spleen and kidney weakness and humid and hot sputum are intertwined, causing each other and forming a vicious circle.
However, there is no unified standard for the dialectical classification of uric acid kidney disease in Traditional Chinese medicine, and according to the clinical experience of traditional Chinese medicine, the traditional Chinese medicine conditioning of uric acid kidney disease should be carried out from the aspects of congenital and acquired nature and the virtual standard. The key to the pathogenesis of uric kidney disease lies in the deficiency of the spleen and kidneys, the internal resistance of turbidity and evil as the standard, and the overall evidence of the virtual standard, and its treatment should be based on the basic treatment of healthy spleen and kidney, dampness and turbidity. Healthy spleen and kidney li wet turbidity decoction in the treatment of uric acid kidney disease, clinical research on efficacy:
The researchers randomly divided 64 patients diagnosed with gouty nephropathy into a treatment group and a control group of 32, including 59 male patients and 5 female patients, with an average of 523 serum uric acid, an average of 149 serum creatinine, and an average glomerular filtration rate of 74. General treatment: both groups have a low purine diet, control meat and alcohol, encourage more drinking, and be sure to keep the urine output at 2000 to 3000ml. If the urine is acidic, the urine is alkalinized with sodium bicarbonate or citrate so that the urine PH value is between 6.2 and 6.9. Control group: take allopurinol.
Treatment group: On the basis of the control group treatment method, the treatment of healthy spleen and kidney benefit wet and turbid soup was given, and the group was: astragalus, dang ginseng, baishu, goji berries, dogwood, coix kernel, soil poria, Sichuan root, ox knee, angelica, knotweed, salvia, etc. Method of addition and subtraction: damp and hot, fangzhong to white art plus cang technique, yellow cedar. Constipated, plus raw rhubarb. If there are kidney stones combined, add chicken gold and stone reeds to the square. If the blood stasis is serious, add peach kernels and safflower to the square. If the joint pain is serious, add stretcher grass and chicken blood vine in the square. If the yin deficiency is serious, add the female virgin and the dry lotus grass. Yang qi is weak, and the goat weed is added to the square. It is taken as usual, 1 dose per day for 2 months.
Treatment group: 15 effective, 13 effective, 4 ineffective. Control group: 9 effective, 10 effective, 13 ineffective. In terms of efficacy, the Chinese medicine group was significantly better than the control group. The blood uric acid decreased significantly after treatment in both groups, and the Traditional Chinese medicine group was significantly better than the control group. The treatment group with 24-hour urine protein and serum creatinine was also significantly better than that of the control group. It shows that the spleen and kidney benefits the wet and turbid soup has the effect of significantly reducing blood uric acid and improving kidney function.
Experts said that among the soup recipes of healthy spleen and kidney benefit, astragalus, dang ginseng and white art have the effect of strengthening the spleen and benefiting qi; goji berries and dogwood have the effect of tonifying kidney essence; soil poria, Sichuan amaranth, knotweed, etc. have the effect of clearing turbidity, detoxifying and dispelling damp tongli joints; coix kernel jian spleen and dampness; angelica and salvia live blood stasis; ox knee blood tonic kidney can also lead medicine down. If the usual allopurinol is halved, and then combined treatment with healthy spleen and kidney li wet and turbid soup, the effect is more obvious.
(Text/Li Lie, Physician/Zhang Zhenzhong; about 3200 words)