中医辨证治疗慢性肾脏病(CKD1-2期)前瞻性多中心临床研究  

Clinical Research of Syndrome Differentiation- Based Treatment with Traditional Chinese Medicine for Patients with Chronic Kidney Disease( CKD1- 2):A Prospective,Multicenter Trials

作　　者：朱祎[1] 何立群[1,2] 袁敏[3] 丁小强[3] 张欣贤 侯卫国[1] 

机构地区：[1]上海中医药大学附属曙光医院,上海200021 [2]上海市中医临床重点实验室,上海200021 [3]上海复旦大学附属中山医院,上海200032

出　　处：《辽宁中医杂志》2015年第6期1175-1177,I0001,共4页Liaoning Journal of Traditional Chinese Medicine

基　　金：科技部中医药行业专项(201007005);上海市卫生局中药新药及院内制剂研发项目(2011ZJ011)

摘　　要：目的:研究中医辨证组方联合基础治疗与氯沙坦联合基础治疗对慢性肾脏病蛋白尿的临床疗效。方法:对92例入组患者采用前瞻性、随机、对照的研究方法,将患者分为中药组(69例),按脾肾气阴两虚、脾肾气阳两虚予中医辨证组方内服;西药组(23例)予氯沙坦50 mg/d口服。在治疗24周后,判定两组治疗前后不同时间点的24 h尿蛋白定量(24 h UP)、尿微量白蛋白/尿肌酐(MA/Cr)及肾小球滤过率(e GFR)的水平。结果:中药组在降低24 h尿蛋白定量,MA/Cr均优于西药组,中药组与西药组在治疗e GFR上疗效无明显差异。结论:中医辨证组方联合基础治疗对慢性肾脏病患者在减少尿蛋白方面显示了良好的临床疗效。Objective：To evaluate the clinical efficacy of syndrome differentiation -based treatment with traditional Chinese medicine （TCM） versus losartan therapy in addition to basic treatment for management of proteinuria in patients with chronic kid- ney disease. Methods ： This randomized and case - controlled clinical trial was conducted among 92 patients. The patients were ran- domized consecutively to receive TCM treatments according to the syndrome patterns in TCM （ spleen and kidney Qi and Yin defi- ciency, and spleen and kidney Qi and Yang deficiency, n = 69） or oral losartan therapy （50 rag/day, n = 23 ） in addition to the basic treatments. The treatment lasted for 24 weeks. The 24 hUP, MA/Cr and eGFR were detected before and after treatment in TCM group and losartan group. Results ： The levels of 24 h UP and MA/Cr in TCM group were significantly lower than those in losartan group. There was no significant difference between TCM group and losartan group in eGFR. Conclusion ： Syndrome differ- entiation -based treatment with traditional Chinese medicine in addition to basic treatments can produce satisfactory therapeutic effects on patients with chronic kidney disease by reducing proteinuria.

关 键 词：慢性肾脏病 蛋白尿 中医辨证组方 氯沙坦 

分 类 号：R692[医药卫生—泌尿科学]