益肾清利活血方联合大黄合剂灌肠治疗慢性肾脏病2～3期临床观察  

Clinical Observation on Treatment of Combination of Yishen Qingli Huoxue Decoction and Enema by Rhubarb Mixture in Patients with CKD in 2～3 Stages

作　　者：殷玲[1] 孙伟[1] 张露[1] YIN Ling;SUN Wei;ZHANG Lu(Department of Nephrology, Jiangsu Province Hospital of Chinese Medicine, Nanjing 210029, Jiangsu, China)

机构地区：[1]江苏省中医院肾内科

出　　处：《中华中医药学刊》2018年第2期280-283,共4页Chinese Archives of Traditional Chinese Medicine

基　　金：国家自然科学基金青年科学基金项目(81503533)

摘　　要：目的：观察益肾清利活血方联合大黄合剂灌肠治疗慢性肾脏病（CKD）2~3期患者的临床疗效。方法：采用随机对照的方法,将符合CKD2~3期的门诊或住院的70例患者分为治疗组（35例）和对照组（35例）。对照组给予基础治疗,治疗组加用益肾清利活血方内服和大黄合剂灌肠治疗,连续观察6个月。观察指标包括：治疗前后的肾功能（BUN、Scr、eGFR）、24 h Upro、血常规、肝功能（ALB、ALT）、临床症状和生活质量（SF-36量表）,以及监测治疗期间不良反应。结果：最终完成观察研究65例,其中对照组32例,治疗组33例;与治疗前相比,治疗后两组患者的肾功能和24h Upro改善明显（P〈0.05或P〈0.01）,治疗组的改善效果优于对照组,但二者之间差异无统计学意义（P〉0.05）;与治疗前相比,治疗后两组患者的多个症状有明显改善（P〈0.05或P〈0.01）,治疗组与同期对照组相比,差异有统计学（P〈0.05）;与治疗前相比,两组患者的SF-36量表总体评分都有提高,但只有治疗组的一般情况（GH）、情感职能（RE）、社会功能（SF）、躯体疼痛（BF）和精力（VT）评分有统计学意义（P〈0.05或P〈0.01）,治疗组患者的GH、SF和VT评分与同期对照组的相比,差异有统计学意义（P〈0.05）;治疗中未发生严重不良反应。结论：益肾清利活血方联合大黄合剂灌肠可改善CKD2~3期患者的肾功能、24 h Upro、临床症状和生活质量,且具有良好的安全性,值得临床推广。Objective ： To observe the clinical effect of the combination of Yishen Qingli Huoxue Decoction and enema by rhubarb mixture in patients with CKD in 2 - 3 stages. Methods ： Seventy patients with CKD in 2 - 3 stages were divid- ed into treatment group （35 cases） and control group （35 cases） randomly. Control group received basic therapy, while treatment group received basic therapy, Yishen Qingli Huoxue Decoction and enema by rhubarb mixture for 6 months. Observation indexes include BUN, SCR and EGFR, 24 h Upro, blood routine, ALB, ALT, clinical symptoms, quality of life （ SF - 36） before and after treatment, as well as monitoring adverse reactions. Results ： Sixty - five cases finished fi- nally, including 32 cases in control group, 33 cases in treatment group. Compared with before, renal function （ BUN, Scr, eGFR） and 24 h Upro in the 2 groups were significantly improved after treatments （P 〈0. 05 or P 〈0. 01 ） , further, the effects in treatment group were better than control group, but the difference was not significant （ P 〉 0. 05 ）. Com- pared with before, several symptoms were improved significantly in the 2 groups after treatments （ P 〈 O. 05 or P 〈 0.01）, moreover, the difference between the 2 groups were significant （P 〈 0. 05 ）. Compared with before, SF -36 scores in the 2 groups were improved, however, only general health perception （GH）, role limitations due to emotional problems （RE）, social functioning （SF）, bodily pain （BF） and vitality （VT） scores were statistically significant （P 〈 0.05 or P 〈 0.01 ）. Furthermore, GH, SF and VT scores between the 2 groups were statistically significant （ P 〈 O. 05 ）. There was no serious adverse reaction during the treatment. Conclusion ： The combination of Yishen Qingli Huoxue Decoc- tion and enema by rhubarb mixture can improve renal function, 24 h Upro, clinical symptoms and quality of life in pa- tients with CKD in 2 -3 stages. Moreover, this method is safe, and thus it can

关 键 词：慢性肾脏病2~3期 益肾清利活血方 灌肠 临床观察 

分 类 号：R692[医药卫生—泌尿科学]