中药治疗与CKD 3～4期患者肾功能进展相关性的回顾性分析  

Association of Prescribed Chinese Medicine with Risk of CKD Progression in Patients with Stage 3～4 CKD: A Retrospective Cohort Study

作　　者：陈姣伊 严美花[1] 李佳霖[1,2] 李平[1] Chen Jiaoyi;Yan Meihua;Li Jialin;LI Ping(Beijing Key Lab Immune-mediated Inflammatory Diseases,Institute of Clinical Medical Sciences,China-Japan Friendship Hospital,Beijing 100029,China;Beijing University of Chinese Medicine,Beijing 100029,China)

机构地区：[1]中日友好医院临床医学研究所,北京市免疫炎性疾病重点实验室,北京100029 [2]北京中医药大学,北京100029

出　　处：《世界中医药》2018年第6期1325-1331,共7页World Chinese Medicine

基　　金：国家自然科学基金国际(地区)合作与交流项目(81620108031);“十二五”国家科技支撑计划《中医药治疗慢性肾脏病5期(非透析)的效果比较研(2013BAI102B04)

摘　　要：目的:探讨中药治疗与慢性肾脏病(CKD)3~4期患者肾功能进展的相关性,为中药治疗CKD提供循证依据。方法:选取2010—2017年于中日友好医院接受诊疗长达1年及以上的CKD 3~4期成年患者966例,每组483例,根据患者是否曾于我院接受中药治疗,将患者分为中药组及非中药组,运用倾向性评分匹配筛选2组间年龄、性别、合并症、合并用药的分布,观察过去7年间2组患者CKD进展的累计发生率和风险比。结果:截止至2017年12月,共有524例患者发生CKD进展,其中非中药组275例,发病率为16%,中药组250例,发病率为13%,2组患者发生CKD进展的平均时间分别为非中药组(54.6±1.4)个月、中药组(61.6±1.3)个月,中药组较非中药组CKD进展的风险显著降低25%(HR 0.75,95%CI 0.63-0.89),差异有统计学意义(P<0.05)。结论:中药治疗与CKD 3~4期患者肾功能进展风险降低呈显著相关,具有临床推广的价值。Objective： To retrospectively explore the association of prescribed Chinese medicine use with risk of CKD（ chronic kidney disease） progression in patients with stage 3 ~ 4 CKD,and to provide evidence for the Chinese medicine treating CKD.Methods： According to whether received Chinese medicine treatment,patients with newly diagnosed stage 3 ~ 4 CKD in China-Japan Friendship Hospital from 2010 to 2017 were categorized into use or nonuse of prescribed Chinese medicine groups.These patients were followed until death,dialysis initiation,or till the end of 2017 after adjustment for confounding variables by using propensity score matching（ PSM）.The incidence rate of CKD progression and hazard ratio（ HR） was investigated between the two groups in the end.Results： Overall,after adjustment for confounding variables by using PSM,a total of 524 patients developed CKD progression,including 275 in the non-use group with a incidence rate of 16/100 person-year,250 cases in the use group with a incidence rate of 13/100 person-year.The average time for CKD progression was 61.6 ± 1.3 months in Chinese medicine group and 54.6 ±1.4 months in non-Chinese medicine group.The use group exhibited a significant 25% reduced CKD progression risk（ HR 0.75,95% CI 0.63-0.89,P = 0.001） compared with the nonuse group.Conclusion： Chinese medicine treatment is associated with reduced CKD progression risk in patients with stage 3 ~ 4 CKD.

关 键 词：慢性肾脏病 疾病进展中药 中草药 回顾性分析 

分 类 号：R256.5[医药卫生—中医内科学]