抗纤灵二号方对慢性肾脏病肾小管间质损伤的影响  

Effect of No.2 Kangxianling Decoction on Tubulointerstitial Injury in Chronic Kidney Disease

作　　者：张权[1] 陈刚[1] 王怡[2] 周家俊[3] 何立群[1] 

机构地区：[1]上海中医药大学附属曙光医院肾内科,上海市普安路185号200021 [2]上海中医药大学附属岳阳医院 [3]上海中医药大学附属上海市中医医院

出　　处：《中医杂志》2012年第24期2100-2104,共5页Journal of Traditional Chinese Medicine

基　　金：国家自然科学基金面上项目(81173219);科技部中医药行业科研专项(201007005);高等学校博士学科点专项科研基金资助项目(20093107110006);上海市科学技术委员会科研计划项目(11ZR1437700);上海市卫生局中医药科研基金项目(2010L028A);上海市教育委员会科研创新项目(2012Z10268047);上海高校创新团队(第二期)建设项目;浦东新区中医中青年骨干培养项目资助(PWZ2008-20-q02)

摘　　要：目的观察中药复方抗纤灵二号方对慢性肾脏病伴发肾小管间质损伤患者脾肾阳(气)虚兼血瘀证候的临床疗效。方法将56例患者随机分为治疗组和对照组各28例。在基础治疗的同时,治疗组加服抗纤灵二号方,每日1剂,分2次服;对照组加服百令胶囊,每日3次,每次1.5g,两组均治疗90天后评价疗效并观察治疗前后中医证候总积分、主要中医症状及体征积分,检测尿α1微球蛋白(α1-MG)、β2微球蛋白(β2-MG)、N-乙酰β-D-葡萄糖苷酶(NAG)、视黄醇结合蛋白(RBP)、24小时尿蛋白定量(24hUPro)和肾功能等指标变化。结果治疗组总有效率76.92%,对照组总有效率57.69%,治疗组临床疗效明显优于对照组(P<0.05)。两组治疗后中医证候总积分均明显改善,且治疗组明显优于对照组(P<0.01)。治疗组畏寒肢冷、腰部冷痛、身体浮肿、面色晦暗、血瘀舌象和腰痛积分改善明显优于对照组(P<0.05或P<0.01)。治疗组治疗后尿β2-MG、α1-MG、24hUPro均明显降低(P<0.05或P<0.01)。治疗后治疗组血肌酐(SCr)降低明显优于对照组(P<0.05)。结论抗纤灵二号方能显著改善肾小管间质损伤患者的临床症状,保护肾小管功能,改善肾功能。Objective To observe the therapeutic effect of No. 2 Kangxianling Decoction （No. 2 decoction against renal tubu- lointerstitial fibrosis） on chronic kidney disease complicated by tubulointerstitial injury. Methods Fifty six patients were ran- domized into treatment group and control group, with 28 cases in each. On the basis of basic treatment, the treatment group was given one dosage of No. 2 Kangxianling Decoction twice daily and the control group was given 1.5g of Bailing Capsule （Cordyceps Capsule） once, three times daily. The treatment course lasted for 90 days. The changes of Chinese syndrome scores, urine ~l-microglobulin （al-MG）, ~2-microglobulin （~]2-MG）, N-acetyl-^-D-glucosidase （NAG）, retinol binding protein （RBP）, 24-hour urine protein （24hUPro） and renal function were observed before and after treatment. Results The total ef- fective rate of the treatment group was ？6. 92~, which was superior to 57.69% of the control group （P^0, 05）. No. 2 Kan- gxianling Decoction could significantly reduce the scores of spleen-kidney qi （yang） deficiency with blood stasis syndrome （P~ 0.01）. The excretions of al-MG, 92-MG and 24hUPro were significantly decreased in the treatment group （P〈0.01, P〈 0.05, P^0.05）. No. 2 Kangxianling Decoction could significantly reduce eystatin-C and serum ereatinine （P〈0.05）. Conclu- sion No. 2 Kangxianling Decoction can significantly relieve clinical symptoms, protect renal tubular and improve renal function for tubulointerstitial injury.

关 键 词：脾肾阳(气)虚 血瘀证 抗纤灵二号方 肾小管间质损害 慢性肾脏病 

分 类 号：R285.5[医药卫生—中药学]