Observation on therapeutic effect of modified Xiaotong Anshen prescription in adjuvant treatment of gouty nephropathy and exploration on the related mechanisms

LI Li; MA Jinrong; ZHAO Li; PAN Hongmei; ZHANG Linyan; YAO Shuoshuo; LI Yuelin

doi:10.3969/j.issn.1674-3806.2025.11.13

Abstract：Objective To observe the therapeutic effect of modified Xiaotong Anshen prescription in adjuvant treatment of gouty nephropathy(GN)and to explore the related mechanisms.Methods A total of 106 patients with GN who were admitted to Cangzhou Hospital of Integrated Traditional Chinese and Western Medicine from April 2021 to March 2024 were recruited.The stages of chronic kidney disease of these patients were stages 3 to 4.The GN patients were divided into observation group and control group by using random number table method,with 53 patients in each group.The control group was treated with conventional Western medicine,while the observation group was treated with conventional Western medicine plus modified Xiaotong Anshen prescription.The treatment course for both groups was 3 weeks.The clinical efficacy,as well as the scores of traditional Chinese medicine(TCM)symptoms,renal function indicators[blood urea nitrogen(BUN),serum creatinine(Scr),24-hour urine total protein(24 h UTP),β2-microglobulin(β2-MG)],serum uric acid,erythrocyte sedimentation rate(ESR),and the levels of proteins related to the phosphoinositide 3-kinase(PI3K)/threonine kinase(AKT)/nuclear factor-κB(NF-κB)signaling pathway were compared between the two groups before and after treatment.The occurrence of adverse reactions during the patients'treatment period was recorded.Results The total clinical effective rate of the observation group was significantly higher than that of the control group(94.34％vs 77.36％,x2=6.290,P=0.012).After treatment,the TCM syndrome scores of joint skin redness and swelling,joint burning,joint pain,facial or lower limb edema,and heavy limbs in both groups were lower than those before treatment,and the TCM syndrome scores of the observation group were lower than those of the control group after treatment,with statistically significant differences(P＜0.05).After treatment,the levels of BUN,Scr,24 h UTP,β2-MG,serum uric acid and ESR in both groups were lower than those before treatment,and the levels in the observation group were lower than those in the control group after treatment,with statistically significant differences(P＜0.05).After treatment,the levels of phosphorylated PI3K(p-PI3K),phosphorylated AKT(p-AKT),and phosphorylated NF-κB(p-NF-κB)proteins in both groups were lower than those before treatment,and the levels in the observation group were lower than those in the control group after treatment,with statistically significant differences(P＜0.05).During the treatment period,1 case of diarrhea occurred in the observation group,and 2 cases of nausea and 2 cases of constipation occurred in the control group.There was no statistically significant difference in the total incidence of adverse reactions between the two groups(P＞0.05).Conclusion The modified Xiaotong Anshen prescription combined with Western medicine has definite effect and good safety in treatment of GN.It may play a therapeutic role through the PI3K/AKT/NF-κB signaling pathway.