缓下瘀血法治疗慢性肾脏病3~5期的回顾性研究  

Retrospective study on efficacy of laxation for blood stasis treatment on chronic kidney disease stage 3~5

作　　者：盖丰丰[1] 谢圣芳[1] 姚源璋[1] 王硕朋 方立明[1] 胡泳[1] 韦玲[1] 贺晓婷[1] GE Fengfeng

机构地区：[1]南京中医药大学附属中西医结合医院,江苏南京210028

出　　处：《中医临床研究》2021年第29期80-83,共4页Clinical Journal Of Chinese Medicine

基　　金：第三批江苏省中医临床优秀人才研修项目(苏中医科教[2017]18号);第三批江苏省老中医药专家学术经验继承工作(苏中医科教[2019]8号)。

摘　　要：目的:评价缓下瘀血法治疗慢性肾脏病(Chronic Kidney Disease,CKD)3~5期的临床疗效。方法:选用回顾性研究的方法,通过南京中医药大学附属中西医结合医院电子病历系统查询并筛选出2016-2021年在西医常规治疗基础上接受缓下瘀血法治疗的CKD 3~5期患者66例作为治疗组,44例作为对照组,比较治疗前后血清肌酐(Serum Creatinine,Scr)、血清尿素氮(Serum Urea Nitrogen,BUN)和估算的肾小球滤过率(estimated Glomerular Filtration Rate,eGFR),并比较缓下瘀血法对糖尿病和非糖尿病CKD患者以及蛋白尿是否超过1 g/24 h之间患者的疗效差异。结果:治疗组患者治疗后中医主要症状积分、Scr、BUN显著下降(P<0.05),eGFR亦显著升高(P<0.05),总有效率显著高于对照组(P<0.05);其中CKD4期的总有效率显著优于对照组(P<0.05);而CKD3期和CKD5期患者的总有效率和对照组对比差异无统计学意义(P>0.05)。缓下瘀血法对合并糖尿病和非糖尿病CKD患者的疗效对比差异无统计学意义(P>0.05),治疗组CKD4~5期合并糖尿病患者的总有效率高于对照组(P<0.05);治疗组蛋白尿≥1 g/24 h的CKD患者的疗效优于蛋白尿<1 g/24 h的CKD患者(P<0.05),治疗组蛋白尿≥1 g/24 h的CKD患者总有效率高于对照组,但差异无统计学意义(P>0.05)。结论:缓下瘀血法可以保护CKD患者的肾功能,临床应根据实际情况灵活、精准地运用。Objective:To evaluate the clinical efficacy of laxation for blood stasis on chronic kidney disease(CKD)stage 3~5.Methods:We selected retrospective study.66 CKD stage 3~5 patients(treatment group)received the treatment of laxation for blood stasis method on the basis of conventional treatment of Western medicine,while 44 patients were selected as the control group.Serum creatinine(Scr),serum urea nitrogen(BUN)and estimated glomerular filtration rate(eGFR)were compared before and after treatment.Patients with or without diabetes and whether proteinuria exceeded 1 g/24 h who received laxation for blood stasis treatment were compared.Results:After treatment,the main TCM symptom scores,Scr and BUN in CKD 3~5 treatment group were significantly decreased(P<0.05),eGFR was significantly increased(P<0.05),and the total effective rate was significantly higher than the control group(P<0.05).The total efficiency of CKD4 stage was significantly better than the control group(P<0.05).The total efficiency of CKD3 and CKD5 were no significant difference between and two groups(P>0.05).There was no statistical difference in the efficacy of laxation for blood stasis method on diabetes mellitus and non-diabetic CKD(P>0.05),The total efficiency of CKD stage 4~5 patients with diabetes in the treatment group was higher than the control group(P<0.05);patients with albuminuria≥1 g/24 h had better efficacy than patients with albuminuria<1 g/24 h(P<0.05),the total efficiency of CKD patients with proteinuria≥1 g/24 h in the treatment group was higher than the control group,but there was no statistical difference(P>0.05).Conclusion:Laxation for blood stasis method can protect the kidney function of patients with CKD,and can be used flexibly and accurately according to the actual situation of patients.

关 键 词：慢性肾脏病 缓下瘀血 回顾性研究 

分 类 号：R256.5[医药卫生—中医内科学]