通腑泄浊益气活血法治疗早期慢性肾脏病临床疗效观察  

Clinical Efficacy Observation of the Method of Dredging Bowels and Discharging Turbidity Invigorating Qi and Activating Blood Circulation for Early Chronic Kidney Disease

作　　者：齐宁 杨宏伟[2] 宋姝西 刘香玉 高健 杨芳杰 QI Ning;YANG Hongwei;SONG Shuxi;LIU Xiangyu;GAO Jian;YANG Fangjie(The Affiliated Hospital of North China University of Science and Technology,Tangshan 063000,Hebei,China;Tangshan People's Hospital,Tangshan 063000,Hebei,China)

机构地区：[1]华北理工大学附属医院,河北唐山063000 [2]唐山市人民医院,河北唐山063000

出　　处：《辽宁中医药大学学报》2022年第9期123-126,共4页Journal of Liaoning University of Traditional Chinese Medicine

基　　金：河北省中医药管理局科研计划项目(2020218)。

摘　　要：目的观察通腑泄浊益气活血法治疗早期慢性肾脏病(chronic kidney disease,CKD)的临床疗效。方法选取华北理工大学附属医院中西医结合科及唐山市人民医院肾内科2018年6月—2019年6月收治的96例早期CKD患者,采用计算机随机数字法将所有患者分为对照组和观察组,对照组48例,为常规西药观察组;观察组48例,在对照组治疗方法基础上应用通腑泄浊益气活血方联合治疗,最后比较两组患者的治疗效果,即治疗前后血肌酐(serum creatinine,Scr)、尿素氮(blood urea nitrogen,BUN)、肾小球滤过率(glomerular filtration rate,GFR)和24 h尿蛋白等指标的变化情况。结果观察组总有效率为83.33%(40/48),高于对照组的64.58%(31/48),差异具有统计学意义(P<0.05);对照组和观察组治疗后的Scr、BUN和24 h尿蛋白定量分别为(185.41±21.66)、(159.15±9.76)μmol/L,(13.71±0.71)、(10.41±0.82)mmol/L,(1.50±0.03)、(1.27±0.06)g,均低于治疗前(206.29±35.87)、(200.23±22.00)μmol/L,(17.32±1.04)、(17.41±1.13)mmol/L,(1.83±0.05)、(1.82±0.04)g,对照组和观察组GFR治疗后分别为(55.50±0.97)、(59.96±1.81)mL/(min·1.73 m^(2)),高于治疗前(47.38±2.16)、(47.60±2.07)mL/(min·1.73 m^(2)),差异均有统计学意义(P<0.05);观察组治疗后的Scr、BUN和24 h尿蛋白均明显低于对照组,差异有统计学意义(P<0.05)。观察组治疗后的GFR明显高于对照组,差异有统计学意义(P<0.05)。治疗前两组患者的胱抑素C比较差异均无统计学意义(P>0.05);治疗后两组胱抑素C较治疗前均有所下降,差异有统计学意义(P<0.05),且观察组(1.37±0.31)mg/L较对照组(2.09±0.58)mg/L下降更多,差异有统计学意义(P<0.05)。治疗后观察组患者乏力和眼睑水肿的发生率(25.0%和35.4%)较对照组(52.1%和58.3%)更低,差异有统计学意义(P<0.05)。结论通腑泄浊益气活血法能够有效改善肾脏功能,显著减少尿蛋白,延缓CKD进展及临床症状,有很高的应用价值,值得临床推广�Objective To observe the clinical effect of dredging bowels and discharging turbidity,invigorating Qi and activating blood circulation method on early chronic kidney disease(CKD).Methods A total of 96 patients with early CKD admitted to the department of integrated Western medicine and the department of nephrology,Tangshan people's hospital from June 2018 to June 2019 were selected and randomly divided into control group and treatment group,which computer random number method is used.48 patients in the control group received conventional Western medicine treatment.The treatment group included 48 cases.On the basis of the control group,Tongfu Xiezhuo Yiqi Huoxue Decoction(通腑泄浊益气活血方)was combined.To compare the treatment effect,blood creatinine(Scr),urea nitrogen(BUN),glomerular filtration rate(GFR)and 24 h urine protein before and after treatment in the two groups.Results The total effective rate of observation group was 83.33%(40/48),which was higher than that of control group 64.58%(31/48),and the difference was statistically significant(P<0.05).The levels of Scr,BUN and 24-hour urine protein in control group and observation group after treatment were(206.29±35.87),(200.23±22.00)μmol/L,(17.32±1.04),(17.41±1.13)mmol/L and(1.83±0.05),(1.82±0.04)g,which were lower than those before treatment(185.41±21.66),(159.15±9.76)μmol/L,(13.71±0.71),(10.41±0.82)mmol/L and(1.50±0.03),(1.27±0.06)g.GFR of the control group and the observation group after treatment was(55.50±0.97),(59.96±1.81)mL/min·1.73m^(2),which were higher than that before treatment(47.38±2.16),(47.60±2.07)mL/min·1.73m^(2),the differences were statistically significant(P<0.05).Scr,BUN and 24-hour urine protein in the observation group were significantly lower than those in the control group after treatment,the differences were statistically significant(P<0.05).The GFR of the observation group was significantly higher than that of the control group after treatment,the difference was statistically significant(P<0.05).Cystatin

关 键 词：通腑泄浊益气活血法 慢性肾脏病 减少尿蛋白 改善肾脏功能 

分 类 号：R692[医药卫生—泌尿科学]