黄芪当归合剂治疗慢性肾脏病的中医疗效靶标研究  

The Study on the TCM Effective Targets of Astragalus and Angelica Mixture on Chronic Kidney Disease

作　　者：曹灿[1] 苏涛[2] 尹新鑫[3,4] 李深 王耀献[1] 李侠 李晓玫[2] CAO Can;SU Tao;YIN Xinxin(Department of Nephrology,Beijing University of Chinese Medicine,Dongzhimen Hospital,Beijing,100700)

机构地区：[1]北京中医药大学东直门医院肾病科,北京100700 [2]北京大学第一医院肾内科暨北京大学肾脏病研究所,北京100034 [3]中国中医科学院广安门医院,北京100530 [4]首都医科大学良乡医院肾内科,北京102488

出　　处：《中国中西医结合肾病杂志》2021年第11期968-971,共4页Chinese Journal of Integrated Traditional and Western Nephrology

基　　金：首都医学发展基金(中医药类)联合攻关项目(No.SF-2009-Ⅰ-08)。

摘　　要：目的:探讨不同疗程黄芪当归合剂(A&A)治疗慢性肾脏病(CKD)的中医疗效靶标。方法:采用多中心、自身对照研究方法,对43例CKD2~4期患者加用A&A(黄芪、当归各30 g)每日1剂,疗程3~12个月。比较治疗前后肾功能及中医证候要素积分的变化、不同疗效患者中医证候变化的差异,并对疗效相关指标进行多因素回归分析。结果:不同疗程A&A治疗均可使患者肾功能逐步改善(P<0.05)。与无效组相比,有效组的气虚、血虚、阴虚证候积分均显著降低(P<0.05),而浊毒证候积分升高(P<0.05)。多因素回归分析显示,与A&A疗效相关的主要影响因素是气虚、血瘀和浊毒证候积分变化。结论:A&A疗效不依赖于RASI,肾功能改善于治疗3个月起效,治疗12个月疗效更好。A&A更适合中医辨证有气虚、血虚、血瘀证的CKD患者,浊毒证者疗效欠佳。Objective:To explore the effective targets of traditional Chinese medicine for the treatment of chronic kidney disease(CKD)by applying different course of Astragalus and Angelica Mixture(A&A).Methods:A multi-center,self-controlled clinical design was used,and 43 CKD with inclusive criteria were recruited.Patients additionally took A&A(Astragalus and Angelica each 30 g)once a day.The course of treatment was 3 months to 12 months.The changes of renal function and TCM syndrome element integrals were compared before and after treatment.The differences of TCM syndrome changes in patients with different curative effects were observed,and than multivariate regression analysis on curative effect-related indicators was conducted.Results:Different courses of A&A treatment gradually improved the renal function of patients(P<0.05).Compared with the ineffective group,the scores of Qi deficiency,blood deficiency,and Yin deficiency of the effective group were significantly reduced(P<0.05),while the scores of turbid toxin syndromes increased(P<0.05).Multivariate regression analysis showed that the main influencing factors related to the efficacy of A&A were changes of the scores of Qi deficiency,blood stasis and turbidity toxin.Conclusion:A&A does not depend on the effectiveness of RASI to improve renal function,which initially effect at 3 months of treatment,and is even better after 12 months of treatment.A&A is mainly suitable for CKD patients with Qi deficiency,blood deficiency,and blood stasis syndrome based on TCM differentiation.The curative effect of turbid toxin syndrome is not good for A&A therapy.

关 键 词：黄芪当归合剂 慢性肾脏病 疗效 中医证候要素 

分 类 号：R277.5[医药卫生—中医学]