畲医益肾泻浊方对慢性肾衰竭患者肾脏保护作用机制研究  

Study on the mechanism of She Medicine Yishen Xiezhuo prescription for renal protection in patients with chronic renal failure

作　　者：刘小菊[1] 王慧 余军[1] 雷强 LIU Xiaoju;WANG Hui;YU Jun;LEI qiang(Department of Nephrology,Lishui Hospital of Traditional Chinese Medicine,Lishui 323000,Zhejiang,China;Party and Government Office,Lishui Maternal and Child Health Hospital,Lishui 323000,Zhejiang,China)

机构地区：[1]丽水市中医院肾病科,浙江丽水323000 [2]丽水市妇幼保健院党政办公室,浙江丽水323000

出　　处：《中国现代医生》2023年第8期96-99,113,共5页China Modern Doctor

基　　金：浙江省中医药科技项目(2019ZA131)。

摘　　要：目的观察畲医益肾泻浊方对脾肾两虚、浊毒内蕴型早中期慢性肾衰竭患者的中医证候、肾功能、转化生长因子(transforming growth factor,TGF)-β1水平的影响,探讨该方肾脏保护机制。方法选取2019年6月至2020年12月丽水市中医院收治的早中期慢性肾衰竭的患者80例,采用随机数字表法分为对照组(n=40)和观察组(n=40),对照组给予西医常规治疗,包括生活习惯调整,饮食营养治疗,血压、血糖、血脂管理等,观察组在对照组的基础上加用畲医益肾泻浊方。观察两组患者治疗前后中医证候、肾功能、TGF-β1水平的变化。结果治疗前,两组中医证候积分比较,差异无统计学意义(P>0.05);治疗后,观察组中医证候积分明显下降且低于对照组,差异有统计学意义(P<0.05)。治疗后,对照组、观察组的总有效率分别为60%、82.50%,差异有统计学意义(P<0.05)。观察组在改善中医证候的疗效方面优于对照组,差异有统计学意义(P<0.05)。治疗前,两组的肌酐清除率(creatinine clearance rate,CCr)、血肌酐(serum creatinine,SCr)、血尿素氮(blood urea nitrogen,BUN)比较,差异无统计学意义(P>0.05);治疗后,观察组CCr高于对照组,SCr、BUN低于对照组,治疗12周后两组CCr、SCr、BUN比较,差异有统计学意义(P<0.05)。治疗前两组TGF-β1水平比较,差异无统计学意义(P>0.05),治疗后,观察组TGF-β1水平低于治疗组,差异有统计学意义(P<0.05)。观察组治疗末期未发生终末期肾病(end stage renal disease,ESRD),对照组ESRD发生3例,两组均未发生不良反应。结论畲医益肾泻浊方能缓解患者临床症状,可一定程度降低患者SCr、BUN水平及提高患者CCr而改善患者的肾功能,同时能一定程度减低TGF-β1水平,可能延缓患者的肾纤维化进程,临床疗效较好且安全,值得临床推广。Objective To observe the effects of She Medicine Yishen Xiezhuo prescription on traditional Chinese medicine(TCM)syndrome,renal function and transforming growth factor(TGF)-β1 level in patients with early and middle chronic renal failure with deficiency of spleen and kidney and turbidity toxin,and to explore the renal protection mechanism of this prescription.Methods A total of 80 patients with early to mid-stage chronic renal failure admitted to Lishui Hospital of Tradional Chinese Medicine from June 2019 to December 2020 were selected and divided into the control group(n=40)and the observation group(n=40)according to the random number table method.The control group was given conventional western medical treatment,including lifestyle adjustment,diet and nutrition treatment,blood pressure,blood glucose and lipid management.On the basis of the control group,the observation group was treated with She Medicine Yishen Xiezhuo prescription.The changes of TCM syndrome,renal function and TGF-β1 before and after treatment were observed in the two groups.Results Before treatment,there was no statistically significant difference between the two groups(P>0.05);after treatment,the TCM score of the observation group decreased significantly and was lower than that of the control group,and the difference was statistically significant(P<0.05).After treatment,the total effective rate of the control group and the observation group were 60%and 82.50% respectively, the difference was statistically significant (P<0.05).The observation group was better than the control group in improving the efficacy of TCM syndrome, and the difference was significant (P<0.05). Before treatment, the differences in creatinine clearance rate (CCr), blood creatinine (SCr) and blood urea nitrogen (BUN) between the two groups were not statistically significant (P>0.05);after treatment, CCr was higher in the observation group than that in the control group, while SCr and BUN were lower than those in the control group. After treatment, CCr, SCr and BUN in

关 键 词：畲医益肾泻浊方 慢性肾衰竭 肾纤维化 转化生长因子‐β1 肾功能 

分 类 号：R256.5[医药卫生—中医内科学]