加减复方积雪草汤治疗慢性肾小球肾炎慢性肾脏病3期临床研究  

Clinical Study on Modified Compound Jixuecao Tang for Chronic Glomerulonephritis and Chronic Kidney Disease at the Third Stage

作　　者：朱梦洁 包自阳[3] 俞立强 葛丹枫 王林 郑姣 ZHU Mengjie;BAO Ziyang;YU Liqiang;GE Danfeng;WANG Lin;ZHENG Jiao

机构地区：[1]浙江中医药大学,浙江杭州310053 [2]杭州市富阳区中医院,浙江杭州311400 [3]杭州市中医院,浙江杭州310007

出　　处：《新中医》2019年第11期128-131,共4页New Chinese Medicine

基　　金：浙江省中医药科学研究基金项目(2018ZB092);富阳区科技项目(2018SK006)

摘　　要：目的:观察加减复方积雪草汤治疗慢性肾小球肾炎慢性肾脏病(CKD) 3期患者的临床疗效。方法:将86例慢性肾小球肾炎CKD3期患者随机分成2组,对照组予常规治疗,治疗组在对照组治疗方案的基础上加用加减复方积雪草汤治疗,疗程均为3个月,观察2组治疗后症状、证候积分、血肌酐(SCr)、尿蛋白/肌酐比值(Upr/Cr)、24 h尿蛋白定量(24 h Upr)、尿素氮(BUN)、肾小球滤过率(eGFR)、安全性等指标变化。结果:临床疗效总有效率治疗组88.37%,对照组为67.44%,差异均有统计学意义(P<0.05),治疗组优于对照组。治疗后,与本组治疗前及对照组治疗后比较,治疗组中医证候积分明显下降,差异均有统计学意义(P<0.01);治疗组SCr、BUN、24 h Upr、Upr/Cr各值分别与治疗前比较,且与对照组同期比较,均显著降低,差异均有统计学意义(P<0.05);治疗组eGFR较治疗前明显升高(P<0.05);对照组eGFR与治疗前比较,差异无统计学意义(P>0.05)。治疗组治疗后e GFR明显高于对照组,差异有统计学意义(P<0.05)。与药物相关的不良反应,治疗组3例,对照组2例,2组比较,差异无统计学意义(P>0.05)。且治疗过程中不良反应程度较轻,对症处理后指标好转,可继续参与研究。结论:加减复方积雪草汤可减少慢性肾小球肾炎CKD3期患者24 h尿蛋白量,改善肾功能,延缓肾病进展,对慢性肾小球肾炎CKD3期有确切疗效,且安全性好。Objective:To observe the clinical effect of modified compound Jixuecao tang for chronic glomerulonephritis and chronic kidney disease(CKD) at the third stage.Methods:A total of 86 cases of patients with chronic glomerulonephritis and CKD at the third stage were randomly divided into two groups.The control group was given routine treatment,and the treatment group was additionally treated with compound Jixuecao tang based on the treatment of the control group.Both groups were treated for three months.The changes of the scores of symptoms as well as syndromes,the indexes of serum creatinine(SCr),ratio of urinary protein to creatinine(Upr/Cr),24-hour urinary protein(Upr/24 h),blood urea nitrogen(BUN) as well as estimated glomerular filtration rate(eGFR) after treatment and the safety in the two groups were observed.Results:The total clinical effective rate was 88.37% in the treatment group,better than that of 67.44% in the control group,differences being significant(P<0.05).After treatment,the Chinese medicine syndrome score in the treatment group was significantly decreased when compared with that before treatment and that in the control group after treatment respectively,differences being significant(P<0.01);the values of SCr,BUN,Upr/24 h and Upr/Cr in the treatment group were significantly decreased when compared with those before treatment and those in the control group at the same period respectively,differences being significant(P<0.05);e GFR in the treatment group was significantly increased when compared with that before treatment(P<0.05);in the control group,there was no significant difference being found in the comparison of e GFR before and after treatment(P>0.05).After treatment,eGFR in the treatment group was significantly higher than that in the control group,the difference being significant(P<0.05).There were three cases of medicine-related adverse reactions in the treatment group and two cases in the control group,there being no significance in the difference(P>0.05).The adverse reactions during treat

关 键 词：慢性肾小球肾炎 慢性肾脏病 加减复方积雪草汤 血肌酐(SCr) 尿蛋白/肌酐 24H尿蛋白定量 尿素氮 肾小球滤过率 

分 类 号：R682.31[医药卫生—骨科学]