益肾泄浊汤联合基础治疗肾虚湿浊证慢性肾脏病3~5期疗效及对血清FGF23和Klotho蛋白及钙磷代谢的影响  

Effect of Yishen Xiezhuo Decoction(益肾泄浊汤)Combined with Basic Treatment on Chronic Kidney Disease with Kidney Deficiency and Dampness-Turbid Syndrome at Stages 3~5 and Its Influence on Serum FGF23,Klotho Protein and Metabolism of Calcium and Phosphorus

作　　者：吴睿轩[1] 胡振奋[1] WU Ruixuan;HU Zhenfen(Wenzhou Hospital of Traditional Chinese Medicine,Wenzhou 325000,Zhejiang,China)

机构地区：[1]温州市中医院,浙江温州325000

出　　处：《中华中医药学刊》2021年第11期228-232,共5页Chinese Archives of Traditional Chinese Medicine

基　　金：浙江省中医药科技计划(2015zAl98)。

摘　　要：目的观察益肾泄浊汤联合基础治疗肾虚湿浊证CKD3~5期的疗效及对血清FGF23和Klotho蛋白及钙磷代谢的影响。方法采用随机数字表法将符合入选标准的80例CKD3~5期患者分为观察组和对照组,每组40例,对照组给予常规西医基础治疗,观察组在对照组的基础上予益肾泄浊汤治疗。连续治疗4周,比较两组治疗前后临床症状积分、肾功能指标[血肌酐(Scr)、尿素氮(BUN)、肾小球滤过率(eGFR)]、血清成纤维细胞生长因子23(FGF23)和Klotho蛋白水平及血钙和血磷改善状况,评估两组临床疗效及不良反应发生状况。结果观察组总有效率为82.5%(33/40),显著高于对照组总有效率60.0%(24/40)(P<0.05);治疗后,两组临床症状积分,血BUN、SCr指标,血清FGF23水平,血磷水平均明显低于治疗前(P<0.05),且观察组治疗以上指标均明显低于对照组(P<0.05);治疗后,观察组eGFR指标、血清Klotho蛋白水平及血钙水平均明显高于治疗前(P<0.05),且观察组治疗以上指标均明显高于对照组(P<0.05);两组均未出现明显不良反应。结论益肾泄浊汤联合西医基础治疗能够调节肾虚湿浊证CKD3~5期患者血清FGF23和Klotho蛋白表达,改善钙磷代谢紊乱,有助于缓解患者临床症状,保护患者残余肾功能,延缓患者疾病的进展,且安全可靠。Objective To observe the curative effect of Yishen Xiezhuo Decoction(益肾泄浊汤)combined with basic treatment on chronic kidney disease(CKD)with kidney deficiency and dampness-turbid syndrome at stages 3~5 and its influence on serum FGF23,Klotho protein and metabolism of calcium and phosphorus.Methods Eighty CKD patients at stages 3~5 were selected according to the inclusion criteria and were randomly divided into observation group and control group by the random number table method,with 40 cases in each group.The control group was treated with conventional western medicine,and the observation group was treated with Yishen Xiezhuo Decoction on the basis of the control group.After four weeks of continuous treatment,the clinical symptom scores,renal function indexes(SCR,BUN,eGFR),serum levels of FGF23 and Klotho protein,the improvement of serum calcium and phosphoru were compared between the two groups before and after treatment,and the clinical efficacy and adverse reactions of the two groups were evaluated.Results The total effective rate of the observation group was 82.5%(33/40),which was significantly higher than that of the control group(60.0%,24/40)(P<0.05).After treatment,the clinical symptom score,the levels of BUN,SCr,FGF23 and phosphorus in the two groups were significantly lower than those before treatment(P<0.05),and the above indexes in the observation group were significantly lower than those in the control group(P<0.05).After treatment,the indexes of eGFR,the serum levels of Klotho protein and calcium in the observation group were significantly higher than those before treatment(P<0.05),and the above indexes in the observation group were significantly higher than those in the control group(P<0.05).There were no obvious adverse reactions in both groups.Conclusion The application of Yishen Xiezhuo Decoction combined with basic treatment of Western medicine can regulate the expressions of FGF23 and Klotho protein in CKD at stages 3~5 with kidney deficiency and dampness-turbid syndrome,improve the d

关 键 词：益肾泄浊汤 肾虚湿浊 CKD3~5期 肾功能 血清FGF23 KLOTHO蛋白 钙磷代谢 

分 类 号：R269.92[医药卫生—中西医结合]