肾炎防衰液延缓慢性肾脏病5期非透析患者透析时机的探索研究  

Exploration the effects of Shenyan Fangshuai Decoction on delaying dialysis time of nondialysis patients with CKD stage 5

作　　者：马雷雷 王明哲[2] 刘玉宁[3] 杨洪涛[1] 王耀献[2] MA Lei-lei;WANG Ming-zhe;LIU Yu-ning;YANG Hong-tao;WANG Yao-xian(Departmentof Nephrology,First Teaching Hospital of Tianjin University of Traditional Chinese Medicine,Tianjin 300193,China;Beijing University of Chinese Medicine,Beijing 100029,China;Department of Nephrology,Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine,Beijing 100700,China)

机构地区：[1]天津中医药大学第一附属医院肾病科,天津300193 [2]北京中医药大学,北京100029 [3]北京中医药大学东直门医院肾病科,北京100700

出　　处：《中华中医药杂志》2020年第4期2120-2123,共4页China Journal of Traditional Chinese Medicine and Pharmacy

基　　金：国家自然科学基金项目(No.81774298);国家中医药管理局中医肾病学重点学科项目(No.424);北京中医药大学“111”协同创新院级合作项目(No.2016-DZM111-ZY007)。

摘　　要：目的:初步探索肾炎防衰液延缓CKD5期非透析患者透析时机的作用。方法:将136例CKD5期非透析患者分为对照组(67例)和治疗组(69例),对照组予以常规西医治疗,治疗组予以肾炎防衰液中医辨证加减治疗,随访结束后通过Kaplan-Meier生存曲线分析两组治疗延缓患者首次透析时间以及累积生存率。结果:治疗组终点事件发生率34.78%(24/69)显著低于对照组终点事件发生率83.58%(56/67)(P<0.01)。Kaplan-Meier生存曲线分析显示治疗组患者中位生存时间25个月(95%CI:18.2-31.8),对照组中位生存时间9个月(95%CI:7.6-10.4),log-rank检验显示差异有统计学意义(P<0.01)。治疗组平均延缓首次透析时间12.6个月(95%CI:10.5-14.7),对照组平均延缓首次透析时间8.5个月(95%CI:7.4-9.6),差异有统计学意义(P<0.01)。结论:以肾炎防衰液为主方的中医药辨证治疗可以延缓CKD5期非透析期患者首次进入透析时间,减少CKD5期患者透析事件发生率。Objective:To explore the effects of Shenyan Fangshuai Decoction on delaying dialysis timing in CKD stage 5 non-dialysis patients.Methods:A total of 136 cases of CKD stage 5 non-dialysis patients were divided into control group(67 cases)and treatment group(69 cases).The control group was treated with routine western medicine,while the treatment group was treated with Shenyan Fangshuai Decoction based on syndrome differentiation and subtraction.After the follow-up,Kaplan-Meier survival curve was used to analyze the time of first dialysis and the cumulative survival rate of the two groups.Results:The incidence of terminal events was 34.78%(24/69),and that in the control group was 83.58%(56/67).The difference was statistically significant(P<0.01).Kaplan-Meier survival curve analysis showed that the median survival time of patients in the treatment group was 25 months(95%CI:18.2-31.8),while that of the control group was 9 months(95%CI:7.6-10.4).The logrank test showed that the difference was statistically significant(P<0.01).The average delaytime of first dialysis was 12.6 months(95%CI:10.5-14.7)in the treatment group and 8.5 months(95%CI:7.4-9.6)in the control group.The difference was statistically significant(P<0.01).Conclusion:TCM differentiation of symptoms and signs with Shenyan Fangshuai Decoction can delay the first dialysis time of CKD stage 5 non-dialysis patients and reduce the incidence of dialysis events of CKD stage 5 patients.

关 键 词：肾炎防衰液 慢性肾脏病5期 非透析 透析时机 

分 类 号：R277.5[医药卫生—中医学]