益肾化浊法联合洛汀新治疗贝伐珠单抗诱发老年晚期结直肠癌患者蛋白尿肾虚兼湿浊证的临床观察  

Clinical effect of tonifying kidney and removing turbidity combined with benazepril in the treatment of proteinuria kidney deficiency and dampness turbidity syndrome induced by bevacizumab in elderly patients with advanced colorectal cancer

作　　者：孙怡婕 黄春锦 韩力 陈玺 张栩 Sun Yijie;Huang Chunjin;Han Li;Chen Xi;Zhang Xu(Department of Traditional Chinese Medicine,Huadong Hospital Affiliated to Fudan University,Laboratory of Geriatric Care Tech-niques and Inheritance,Institute of Geriatrics,Institute of Integrated Traditional Chinese and Western Medicine of Fudan University,Shanghai,200040,P.R.China;Department of General Surgery,Huadong Hospital Affiliated to Fudan University,Shanghai,200040,P.R.China;Department of Oncology,Huadong Hospital Affiliated to Fudan University,Shanghai,200040,P.R.China)

机构地区：[1]复旦大学附属华东医院中医科,复旦大学中西医结合研究院老年医学研究所老年保健技术和传承研究室,上海200040 [2]复旦大学附属华东医院普外科,上海200040 [3]复旦大学附属华东医院肿瘤科,上海200040

出　　处：《老年医学与保健》2021年第4期818-822,833,共6页Geriatrics & Health Care

基　　金：上海市科委医学引导类(中医)科技支撑项目(18401902000)。

摘　　要：目的探讨益肾化浊法联合洛汀新治疗贝伐珠单抗诱发老年晚期结直肠癌患者蛋白尿肾虚兼湿浊证的临床疗效。方法选择2019年1月-2021年1月在华东医院就诊的老年晚期结直肠癌因贝伐珠单抗诱发的蛋白尿肾虚湿浊证患者76例,随机分为观察组(n=38)和对照组(n=38)。观察组给予益肾化浊中药饮片联合洛汀新治疗,对照组采取洛汀新治疗,2组疗程均为6周。比较两组中医证候评分、尿蛋白定量、血肌酐、尿素氮、eGFR、血压等变化。结果观察组减毒疗效优于对照组(P<0.05),临床总有效率高于对照组(P<0.01);观察组治疗前后证候积分差值大于对照组(P<0.01)。观察组治疗后较治疗前蛋白尿下降、eGFR升高(P<0.01);对照组尿蛋白下降(P<0.05)。观察组尿蛋白、肌酐降幅高于对照组(P<0.01),eGFR升幅高于对照组(P<0.05)。2组血压治疗前后明显下降(P<0.01),但治疗后组间比较差异无统计意义(P>0.05)。结论益肾化浊法联合洛汀新可降低因贝伐珠单抗诱发老年晚期结直肠癌患者蛋白尿肾虚兼湿浊证的尿蛋白水平,改善肾功能,减毒,提高临床疗效。Objective To observe the clinical effect of tonifying kidney and removing turbidity combined with benazepril in the treatment of proteinuria kidney deficiency and dampness turbidity syndrome induced by bevacizumab in elderly patients with advanced colorectal cancer.Method 76 advanced colorectal cancer elderly patients with proteinuria,kidney deficiency and dampness syndrome induced by bevacizumab treated in the Huadong Hospital from January 2019 to January2021 were selected and randomly divided into observation group(n=38)and control group(n=38).The observation group was treated with tonifying kidney and removing turbidity decoction combined with benazepril hydrochloride tablets,and the control group was treated with benazepril hydrochloride tablets.The course of treatment for both groups was 6 weeks.The changes of traditional Chinese medicine(TCM)syndrome score,urinary protein,blood creatinine,urea nitrogen,eGFR and blood pressure were compared between the two groups.Results The detoxification efficacy of the observation group was higher than that of the control group(P<0.05),and the total clinical effective rate was higher than that of the control group(P<0.01).The difference of TCM syndrome scores before and after treatment in the observation group was greater than that in the control group(P<0.01).After treatment,proteinuria decreased and eGFR increased in the observation group compared with before treatment(P<0.01);urine protein decreased in the control group(P<0.05).The decrease of urinary protein and creatinine in the observation group was higher than that in the control group(P<0.01),and the increase of eGFR in the observation group was higher than that in the control group(P<0.05).The blood pressure of the two groups decreased significantly after treatment(P<0.01),but the difference between the two groups after treatment was not statistically significant(P>0.05).Conclusion Tonifying kidney and removing turbidity combined with benazepril can reduce urinary protein,improve renal function,reduce toxicity an

关 键 词：老年 晚期结直肠癌 蛋白尿 肾虚湿浊证 益肾化浊法 贝伐珠单抗 

分 类 号：R735.34[医药卫生—肿瘤]