加减活血降氮汤对急性肾损伤(风湿)的保护作用  

Clinical Effects on Huoxue Jiangdan Decoction Treating Acute Kidney Injury

作　　者：麻志恒[1] 倪建俐[1] 黄美琴[1] 王静[1] MA Zhiheng;NI Jianli;HANG Meiqin;WANG Jing(Chongming Branch of Xinhua Hospital Affiliated to School of Medicine,Shanghai Jiaotong University,Shanghai 202150,China)

机构地区：[1]上海交通大学医学院附属新华医院崇明分院,上海202150

出　　处：《实用中医内科杂志》2020年第8期72-75,共4页Journal of Practical Traditional Chinese Internal Medicine

基　　金：上海市崇明区“可持续发展科技创新行动计划”项目(CKY2017-07);上海交通大学医学院附属新华医院崇明分院优青后培养基金计划项目(2017);上海市中医药事业发展三年行动计划(2018—2020);医疗机构治未病服务能力提升项目(ZY〔2018-2020〕-ZWB-1001)。

摘　　要：目的观察加减活血降氮汤对急性肾损伤(风湿)患者的保护作用。方法采用随机对照原则,选取符合纳入标准的急性肾损伤(风湿型)患者80例,按照数字列表法随机分为治疗组和对照组,每组各40例,对照组予西医常规治疗:包括补充血容量,纠正血压,血糖;控制饮食(低盐、低脂、优质低蛋白),控制感染,同时纠正水、电解质、酸碱失衡等治疗。治疗组在对照组基础上加用加减活血降氮汤治疗,疗程8周,8周后观察两组疗效及治疗前后血中胱抑素C(Cys-C),β2-微球蛋白(β2-MG),肌酐(CRE),尿酸(UA),尿素(BUN)及尿中白介素18(IL-18),N-乙酰-β-D氨基葡萄糖苷酶(NAG),尿常规的变化。结果两组在年龄,性别,发病原因,病程等方面,经统计学分析,P>0.05,具有可比性。治疗后总有效率治疗组高于对照组,组间比较有显著性差异(P<0.05)。与治疗前比较,治疗后两组血中Cys-C,β2-MG,CRE、BUN、UA及尿IL-18,NAG,尿常规有所好转(P<0.05或P<0.01),治疗后两组比较,治疗组在改善CRE,UA,Cys-C,NAG及尿常规部分指标方面更为明显(P<0.05)。结论加减活血降氮汤对急性肾损伤(风湿型)患者具有一定的保护作用。Objective To observe the protective effect of Jiajian Huoxue Jiangdan Decoction on patients with acute kidney injury( rheumatic type). Method According to the principle of randomized control,80 patients with acute kidney injury( rheumatic type) who meet the inclusion criteria were selected and randomly divided into treatment group and control group according to the number list method,each group of 40 patients,and the control group received conventional Western medicine treatment: Including blood volume,correcting blood pressure,blood sugar;controlling diet( low salt,low fat,high quality and low protein),controlling infection,and correcting water,electrolyte,acid-base imbalance and other treatments. The treatment group was treated with Jiajian Huoxue Jiangdan Decoction on the basis of the control group. The course of treatment was8 weeks. After 8 weeks,the curative effect of the two groups of patients after treatment and the blood cystatin C( Cys-C) andβ2-microspheres before and after treatment were observed. Protein( β2-MG),creatinine( CRE),uric acid( UA),urea( BUN) and urine interleukin 18( IL-18),N-acetyl-β-D glucosaminidase( NAG),urine routine Variety. Results The two groups of patients were comparable in terms of age,sex,cause of disease,and course of disease. After statistical analysis,( P > 0. 05). After treatment,the total effective rates of the treatment group and the control group were 87. 5% and 75. 0%respectively. There was a significant difference between the groups( P < 0. 05). Compared with before treatment,Cys-C,β2-MG,CRE,BUN,UA and urine IL-18,NAG in the blood of the two groups of patients after treatment improved( P < 0. 05 or P< 0. 01). After treatment Comparing the two groups,the treatment group was more obvious in improving CRE,UA,Cys-C,NAG and some indicators of urine routine( P < 0. 05). Conclusion Modified Huoxue Jiangdan Decoction has a certain protective effect on patients with acute kidney injury( rheumatic type).

关 键 词：急性肾损伤 加减活血降氮汤 风湿型 胱抑素C Β2-微球蛋白 白介素18 N-乙酰-Β-D氨基葡萄糖苷酶 

分 类 号：R256[医药卫生—中医内科学]