白通汤对脾肾阳虚型慢性肾脏病3期患者转归的影响及作用机制研究  

Therapeutic Effect and Mechanism of Baitong Decoction on the Prognosis of Patients with Stage 3 Chronic Kidney Disease Differentiated as Spleen and Kidney Yang Deficiency Syndrome

作　　者：张晶晶 王琮瑞 李涛 马娟 钟黎 ZHANG Jing-Jing;WANG Cong-Rui;LI Tao;MA Juan;ZHONG Li(The First Affiliated Hospital of Guizhou University of Traditional Chinese Medicine,Guiyang 550001 Guizhou,China;The Second Affiliated Hospital of Guizhou University of Traditional Chinese Medicine,Guiyang 550001 Guizhou,China)

机构地区：[1]贵州中医药大学第一附属医院,贵州贵阳550001 [2]贵州中医药大学第二附属医院,贵州贵阳550001

出　　处：《广州中医药大学学报》2021年第2期267-272,共6页Journal of Guangzhou University of Traditional Chinese Medicine

基　　金：贵州省中医药科研专项课题(编号:QZYY-2019-042)。

摘　　要：【目的】探讨白通汤对脾肾阳虚型慢性肾脏病(CKD)3期患者转归的影响及作用机制。【方法】将60例脾肾阳虚型CKD3期患者随机分为对照组和研究组,每组各30例。对照组给予常规西药治疗,研究组在对照组基础上加用白通汤治疗,疗程为4周。观察2组患者治疗前后中医证候总积分和谷胱甘肽过氧化物酶(GSH-Px)、超氧化物歧化酶(SOD)、白细胞介素6(IL-6)、肿瘤坏死因子α(TNF-α)、转化生长因子β1(TGF-β1)等实验室指标的变化情况,比较2组患者的临床疗效、疾病转归情况和用药安全性。【结果】(1)治疗4周后,研究组的总有效率为86.7%(26/30),对照组为63.3%(19/30),研究组的疗效明显优于对照组,差异有统计学意义(P<0.05)。(2)研究组的终点事件发生率为6.7%(2/30),明显低于对照组的26.7%(8/30),差异有统计学意义(P<0.05)。(3)治疗后,2组患者的中医证候总积分均较治疗前明显降低(P<0.05),且研究组的降低作用明显优于对照组,差异有统计学意义(P<0.05)。(4)治疗后,2组患者血清IL-6、TNF-α、TGF-β1、SOD、GSH-Px水平均较治疗前明显降低(P<0.05),且研究组的降低作用均明显优于对照组,差异均有统计学意义(P<0.05)。(5)治疗期间,对照组出现1例咳嗽,研究组出现2例头痛,1例头晕,但均未见心电图及肝功能异常。【结论】白通汤治疗脾肾阳虚型CKD3期患者的临床疗效确切,且安全性较高,可对病情进展起到有效延缓作用,其机制可能与该药能减轻肾间质纤维化、降低机体炎症水平、提高抗氧化能力有关。Objective To investigate the therapeutic effect and mechanism of Baitong Decoction on the prognosis of patients with stage 3 chronic kidney disease(CKD3)differentiated as spleen and kidney yang deficiency syndrome.Methods Sixty CKD3 patients with spleen and kidney yang deficiency syndrome were randomly divided into study group and control group,and each group had 30 cases.The control group was given conventional western medicine treatment,and the study group was given Baitong Decoction combined with conventional western medicine treatment.The course of treatment covered 4 weeks.Before and after treatment,the total scores of traditional Chinese Medicine(TCM)syndrome and serum levels of laboratory indicators such as glutathione peroxidase(GSH-Px),superoxide dismutase(SOD),interleukin 6(IL-6),tumor necrosis factorα(TNF-α),and transforming growth factorβ1(TGF-β1)in the two groups were observed.Meanwhile,the clinical efficacy,prognosis of disease,and medication safety in the two groups were compared.Results(1)After treatment,the total effective rate of the study group was 86.7%(26/30),and that of the control group was 63.3%(19/30).The intergroup comparison showed that the clinical efficacy of the study group was superior to that of the control group,the difference being statistically significant(P<0.05).(2)The incidence of end-point events in the study group was 6.7%(2/30),and was lower than that in the control group(26.7%,8/30),the difference between the two groups being statistically significant(P<0.05).(3)After treatment,the total scores of TCM syndrome in the two groups were obviously decreased in comparison with those before treatment(P<0.05),and the decrease in the study group was superior to that in the control group,the difference between the two groups being statistically significant(P<0.05).(4)After treatment,the serum levels of IL-6,TNF-α,TGF-β1,SOD and GSH-Px in the two groups were obviously decreased in comparison with those before treatment(P<0.05),and the decrease in the study group was superior t

关 键 词：慢性肾脏病3期 脾肾阳虚型 白通汤 疾病转归 肾间质纤维化 炎症 抗氧化 

分 类 号：R269.25[医药卫生—中西医结合]