健脾活血益肾汤治疗慢性肾脏病3期合并颈动脉粥样硬化临床研究  

Clinical Study on Jianpi Huoxue Yishen Tang on Stage 3 Chronic Kidney Disease Complicated with Carotid Atherosclerosis

作　　者：张怡 陈妙 张倩倩 欧阳凌霞 ZHANG Yi;CHEN Miao;ZHANG Qianqian;OUYANG Lingxia

机构地区：[1]宁波市鄞州区第二医院肾内科,浙江宁波315100

出　　处：《新中医》2022年第19期110-115,共6页New Chinese Medicine

基　　金：浙江省中医药科技计划项目(2019ZA118)。

摘　　要：目的:观察健脾活血益肾汤治疗慢性肾脏病3期合并颈动脉粥样硬化的临床疗效及对炎症因子的影响。方法:采用随机数字表法将110例慢性肾脏病3期合并颈动脉粥样硬化患者分为观察组与对照组各55例。对照组采用肾衰宁治疗,观察组在对照组基础上联合健脾活血益肾汤治疗。比较2组临床疗效及不良反应、高钾血症发生率;比较2组治疗前后血清炎症因子水平、肾功能指标、颈动脉超声指标、中医证侯积分及血钾浓度。结果:治疗后,观察组总有效率为96.38%,高于对照组83.26%(P<0.05)。治疗后,2组白细胞介素-6 (IL-6)、肿瘤坏死因子-α (TNF-α)、C-反应蛋白(CRP)水平均较治疗前降低(P<0.05),观察组炎症因子水平低于对照组(P<0.05)。2组血尿素氮(BUN)、血肌酐(SCr)水平较治疗前降低(P<0.05),内生肌酐清除率(CCr)水平升高(P<0.05),观察组肾功能指标改善优于对照组(P<0.05)。治疗后,2组斑块数目、颈动脉斑块Crouse积分、中医证候积分、颈动脉内膜中层厚度(CIMT)较治疗前降低(P<0.05),血钾浓度升高(P<0.05),观察组上述指标改善优于对照组(P<0.05)。观察组不良反应发生率、高钾血症发生率低于对照组,但差异无统计学意义(P>0.05)。结论:健脾活血益肾汤治疗慢性肾脏病3期合并颈动脉粥样硬化疗效确切,能有效改善患者肾功能,减少炎性反应和颈动脉粥样硬化斑块,安全性较高。Objective: To observe the clinical effect of the therapy of Jianpi Huoxue Yishen tang on stage 3 chronic kidney disease complicated with carotid atherosclerosis and its effect on inflammatory factors. Methods:A total of 110 cases of patients with stage 3 chronic kidney disease complicated with carotid atherosclerosis were selected and divided into the observation group and the control group according to the random number table method, with 55 cases in each group. The control group was treated with Shenshuaining,and the observation group was additionally treated with Jianpi Huoxue Yishen tang based on the treatment of the control group. The clinical effects,incidence of adverse reactions and incidence of hyperkalemia in the two groups were compared between the two groups;before and after treatment,the levels of serum inflammatory factors, indexes of lung function, indexes of carotid artery ultrasound,Chinese medicine syndrome scores and levels of serum potassium were compared between the two groups. Results:After treatment,the total effective rate was 96.38% in the observation group,higher than that of 83.26% in the control group(P<0.05). After treatment,the levels of interleukin-6(IL-6),tumor necrosis factor-α(TNF-α) and C-reactive protein(CRP) in the two groups were decreased when compared with those before treatment(P<0.05),and the levels of inflammatory factors in the observation group were lower than those in the control group(P<0.05). The levels of blood urea nitrogen(BUN) and serum creatinine(SCr) were decreased when compared with those before treatment(P<0.05),and the levels of creatinine clearance rate(CCr) were increased(P<0.05), and the improvement in indexes of kidney function was better than that in the control group(P<0.05). After treatment, the numbers of plaque, Crouse carotid plaque scores and Chinese medicine syndrome scores and carotid artery intima-media thickness(CIMT) in the two groups were decreased when compared with those before treatment(P<0.05),and the levels of serum potassium were in

关 键 词：慢性肾脏病3期 颈动脉粥样硬化 健脾活血益肾汤 白细胞介素-6 炎症因子 

分 类 号：R543.4[医药卫生—心血管疾病]