健脾清化方治疗原发性慢性肾脏病3期脾肾气虚兼湿热证型患者的临床观察及对瘦素与白介素6的影响  

Clinical study of Jianpi Qinghua Formula in treating stage 3 of primary chronic kidney disease in patients with spleen-kidney qi deficiency and damp-heat syndrome and its effect on leptin and interleukin-6

作　　者：杨晓萍 张翼 张冯佐[1] 王杰[3] 吉晶 何立群[3] YANG Xiao-ping;ZHANG Yi;ZHANG Feng-zuo;WANG Jie;JI Jing;HELi-qun(Seventh People's Hospital of Shanghai University of Traditional Chinese Medicine,Shanghai 200137,China;Shanghai Tongren Hospital,Shanghai 200050,China;Shuguang Hospital of Shanghai University of Traditional Chinese Medicine,Shanghai 200021,China)

机构地区：[1]上海中医药大学附属第七人民医院,上海200137 [2]上海市同仁医院,上海200050 [3]上海中医药大学附属曙光医院,上海200021

出　　处：《中华中医药杂志》2022年第12期7526-7531,共6页China Journal of Traditional Chinese Medicine and Pharmacy

基　　金：何立群上海市名老中医学术经验研究工作室(No.SHGZS-2017027);2020-2021年度上海市卫生健康委员会中医药科研项目(No.2020LP016);上海市浦东新区卫生系统重点专科建设资助(No.PWZzk2017-01)。

摘　　要：目的:观察健脾清化方对原发性慢性肾脏病(CKD)脾肾气虚兼湿热证型患者的临床疗效及对瘦素(LEP)、白介素6(IL-6)的影响。方法:选择原发性CKD3期相关证型90例,应用软件随机分两组,对照组45例,给予基础治疗,治疗组45例,加用健脾清化方,疗程24周。检测0、8、16、24周的血肌酐(Scr)、血尿素氮(BUN)、24h尿蛋白定量(24hUpro)、估算肾小球滤过率(eGFR),计算中医证侯评分,评估疗效,并观察治疗前后LEP、IL-6变化。结果:治疗组的中医证候疗效总有效率93.3%(42/45)、临床疗效总有效率86.7%(39/45),均优于对照组(P<0.01,P<0.05)。治疗16周,两组eGFR值显著上升(P<0.01),且治疗组优于对照组(P<0.01)。治疗24周,两组LEP、CRP及IL-6显著下降(P<0.01,P<0.05),且治疗组优于对照组(P<0.01)。经Spearman检验,LEP、IL-6分别与eGFR呈负性直线关系(P<0.001),LEP、IL-6两者之间呈正性直线关系(P<0.001)。结论:健脾清化方能改善原发性CKD3期患者的临床症状,减少24hUpro,升高eGFR,并降低LEP、CRP与IL-6水平,延缓CKD进展。Objective:To observe the clinical effect of Jianpi Qinghua Formula(JPQH)on patients of primary chronic kidney disease(CKD stage 3)with spleen-kidney qi deficiency and damp-heat syndrome and JPQHs effect on leptin and interleukin-6.Methods:A total of 90 cases of primary CKD stage 3 with spleen-kidney qi deficiency and damp-heat syndrome were selected.SPss 21.0 software was used for complete randomization.45 cases in the control group were given basic treatment(amlodipine besylate tablets,carvedilol tablets,Atorvastatin calcium tablets),45 cases in the treatment group were given the basic treatment and JPQH.The course of treatment is 24 weeks.Detect blood creatinine(Scr),blood urea nitrogen(BUN),24-hour urine protein quantification(24hUpro),glomerular filtration rate(eGFR)at 0,8,16,and 24 weeks,and use the TCM syndrome score.Evaluate the clinical efficacy and the efficacy of TCM syndromes,and observe the changes of LEP and IL-6 before and after treatment.Results:The total effective rate of TCM syndrome curative effect in the treatment group was 93.3%(42/45),the total clinical effective rate of JPQH was 86.7%(39/45),which were better than that in the control group(P<0.01,P<0.05).The treatment group and the control group increased eGFR all at 16 weeks(P<0.01),and the treatment group was better than the control group(P<0.01).After 24 weeks,the LEP and IL-6 of the two groups decreased(P<0.01,P<0.05),and the treatment group was better than the control group(P<0.01).According to the Spearman test,LEP and IL-6 were negatively correlated with eGFR(P<0.001).There was a positive correlation between LEP and IL-6(P<0.001).Conclusion:JPQH can significantly improve the clinical symptoms of patients with primary CKD stage 3,reduce 24h Upro,LEP and IL-6,increase eGFR,hold up the progression of CKD.

关 键 词：健脾清化方 慢性肾脏病 瘦素 白介素6 慢性肾脏病3期 

分 类 号：R277.5[医药卫生—中医学]