补脾益肾法治疗老年衰弱患者的临床疗效及安全性研究  

The Investigation of Clinical Efficacy and Safety on BupiYishen Prescription in Elderly Frailty Patients

作　　者：洪秀芳[1] 汤小芳[1] 张学锋[1] 斯彩娟[1] HONG Xiu-fang;TANG Xiao-fang;ZHANG Xue-feng(Department of Geriatrics,Zhejiang Hospital,Hangzhou,Zhejiang 310013,China)

机构地区：[1]浙江医院老年医学科,浙江杭州310013

出　　处：《中华全科医学》2019年第4期653-656,共4页Chinese Journal of General Practice

基　　金：浙江省自然科学基金项目(LY16H270012);浙江省中医药科学研究基金资助项目(2016ZB012);浙江省医药卫生学科平台项目(2015KYB012)

摘　　要：目的观察中医补脾益肾法对老年衰弱患者的临床疗效及安全性。方法将2016年1月—2018年6月浙江医院收治的120例老年衰弱及衰弱前期患者(65～91岁)采用随机数字法分为治疗组60例,对照组60例。对照组给予常规药物治疗、营养健康宣教、康复锻炼指导,每月随访1次;治疗组在对照组基础上联合补脾益肾中药方,每日1剂水煎服,分2次口服,每次约150 mL,连续治疗12周。比较2组患者治疗前后Fried衰弱量表评分,血清营养相关蛋白变化及不良反应发生率。结果治疗12周后,与对照组Fried衰弱量表评分[(3.0±1.4)分]相比,治疗组[(2.6±1.2)分]下降更明显(P<0.05);2组血清前白蛋白、总蛋白、白蛋白、视黄醇结合蛋白较治疗前均有不同程度改善;治疗组治疗前各指标分别为血清前白蛋白(213.49±46.29)mg/L、白蛋白(38.64±3.73)g/L、视黄醇结合蛋白(39.30±10.38)mg/L,治疗后各指标分别为血清前白蛋白(231.98±52.75)mg/L、白蛋白(40.06±3.44)g/L、视黄醇结合蛋白(44.39±15.56)mg/L,与治疗前比较明显升高(均P<0.05)。2组患者均未出现不良事件及严重不良反应。结论在老年衰弱常规治疗的基础上联合使用中医补脾益肾法可以增强临床疗效,且不良反应少,对中西医结合防治老年衰弱具有一定的参考价值。Objective To investigate the effect and safety of frailty treatment with BupiYishen prescription in older frail patients aged over 65 years. Methods One hundred and twenty older frail patients(65-91 years old) were randomly divided into therapy group and control group with 60 of each. The control group was received only western medicine treatment. In addition to western medicine treatment, therapy group was received BupiYishen prescription, one agent per day. The agent was decocted with water for oral intake, and twice a day, 150 mL each time. Before and 12 weeks after treatment, scores of Fried frailty criteria, serum levels of nutrition-related proteins and clinical adverse reactions were observed. Results After treatment for 12 weeks,compared with control group(3.0±1.4), frailty scores of therapy group(2.6±1.2) decreased more significantly(P<0.05). In the therapy group, compared with levels of serum prealbumin [PA,(213.49±46.29) mg/L], albumin [ALB,(37.47±3.28) g/L] and retinol binding protein [RBP,(39.30±10.38) mg/L] before the treatment, 12 weeks after the treatment, levels of PA [(231.98±52.75) mg/L], ALB [(40.06 ±3.44) g/L], RBP [(44.39±15.56) mg/L] increased more significantly(P<0.05). No severe adverse reactions were found in both groups. Conclusion BupiYishen prescription can safely enhance clinical efficacy for the treatment of frailty. Results of the investigation may provide some reference to the prevention and treatment of frailty.

关 键 词：老年衰弱 营养不良 中医药 补脾益肾 

分 类 号：R242[医药卫生—中医临床基础] R153.3[医药卫生—中医学]