肾衰Ⅱ号方治疗CKD 3-4期患者的临床疗效观察  

Clinical Effects of "No.Ⅱ Renal Failure Recipe" on Patients with Chronic Kidney Disease at 3-4 Stage

作　　者：周圆[1] 王琛[1] 庞欣[1] 侯卫国[1] 何立群[1] 

机构地区：[1]上海中医药大学附属曙光医院肾病科肝肾疾病病证教育部重点实验室,上海201203

出　　处：《上海中医药大学学报》2011年第4期37-40,共4页Academic Journal of Shanghai University of Traditional Chinese Medicine

基　　金：国家自然科学基金资助项目(30973723);上海市科学技术委员会科研计划资助项目(08411962400)

摘　　要：目的:观察肾衰Ⅱ号方治疗脾肾两虚、湿浊瘀阻型CKD 3-4期患者的临床疗效。方法:67例CKD 3-4期患者随机分为治疗组(n=33)和对照组(n=34),两组患者均采用西医一体化治疗方案,治疗组在上述治疗基础上加用肾衰Ⅱ号方治疗,疗程均为4个月。观察并比较两组患者治疗前后的血常规指标、肾功能指标及血清钙、血清磷、24 h尿蛋白定量等的变化。同时对两组患者的临床疗效进行评价,并比较两组患者慢性肾脏病分期的变化。结果:治疗组患者的疾病疗效及中医证候疗效均明显优于对照组(P<0.05)。在改善肾功能方面,治疗后,治疗组Scr较治疗前有降低趋势,但无统计学差异(P>0.05),而对照组Scr水平较治疗前明显升高(P<0.01);治疗组UA水平较治疗前明显降低(P<0.05),而对照组较治疗前无明显改善(P>0.05),且两组UA水平比较有统计学差异(P<0.05);治疗组GFR有升高趋势,但无统计学意义(P>0.05),而对照组GFR较治疗前明显降低(P<0.05),且治疗组GFR较对照组明显升高(P<0.05)。在纠正贫血方面,两组治疗前后的红细胞及血红蛋白水平均无明显升高(P>0.05)。在改善电解质紊乱及24 h尿蛋白定量方面,治疗后,治疗组血Ca2+水平明显升高(P<0.05),血P3-水平明显降低(P<0.05),而对照组血Ca2+水平无显著变化(P>0.05),血P3-水平明显升高(P<0.05),且两组血Ca2+及血P3-水平比较均具有统计学差异(P<0.05);治疗组24 h尿蛋白定量较治疗前无统计学差异(P>0.05),对照组较治疗前则明显升高(P<0.05),且治疗组24 h尿蛋白定量较对照组亦明显降低(P<0.05)。在改善CKD分期方面,治疗组CKD分期的改善明显优于对照组(P<0.05)。结论:在西医一体化治疗方案的基础上加用肾衰Ⅱ号方治疗CKD 3-4期患者,对保护残余肾功能、延缓肾功能恶化、逆转或延缓CKD进程具有一定的治疗作用。Objective： To observe the clinical effects of ＂No.Ⅱ Renal Failure Recipe＂ on chronic kidney disease（CKD） of spleen-kidney deficiency and dampness-blood stasis at 3-4 stage.Methods： Sixty-seven patients with CKD at 3-4 stage were randomly divided into control group（n=34） which was treated by modern medicine integration therapeutic regimens and treatment group（n=33） which was treated by ＂No.Ⅱ Renal Failure Recipe＂ based on above treatment.The course of treatment in two groups was four months.The indexes of blood routine and renal function,the levels of serum calcium and phosphorus,and the 24 h urine protein quantitation（UPQ） were observed.Meanwhile,the clinical effects were evaluated,and the changes of CKD stages were compared.Results： The clinical effects on disease and syndromes of traditional Chinese medicine in treatment group were better than control group（P0.05）.On the aspect of improving renal function,after treatment the level of Scr in treatment group decreased compared with before treatment,but with no statistical difference（P0.05）,while the level of Scr in control group increased obviously（P0.01）;the level of UA in treatment group decreased obviously compared with before treatment（P0.05）,while the control group was not improved（P0.05）,and the level of UA between two groups had a significant difference（P0.05）;the level of GFR in treatment group had increasing tendency compared with before treatment,but with no significant difference（P0.05）,while the level of GFR in control group decreased obviously（P0.05）,and the level of GFR of treatment group was higher than that of control group（P0.05）.On the aspect of improving anemia,the levels of red blood cell（RBC） and hemoglobin had no significant difference between two groups before and after treatment（P0.05）.On the aspect of improving electrolyte disturbances and 24 h UPQ,after treatment the level of Ca2＋ in treatment group increased obviously（P0.05）,the level of P decreased obvi

关 键 词：肾衰Ⅱ号方 慢性肾脏病 脾肾两虚、湿浊瘀阻 肾功能 

分 类 号：R277.5[医药卫生—中医学]