补肾固精方治疗老年慢性肾脏病蛋白尿临床研究  

Clinical Study on the Treatment of Proteinuria in Elderly Chronic Kidney Disease with Kidney-Tonifying and Essence-Strengthening Decoction

作　　者：易小军 黄姝 沈小珩[3] YI Xiao-jun;HUANG Shu;SHEN Xiao-heng(Shuxin Town Community Health Service Center of Chongming District of Shanghai,Shanghai,China,202179;Xinhe Town Community Health Service Center of Chongming District of Shanghai,Shanghai,China,202156;Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine,Shanghai,China,200025)

机构地区：[1]上海市崇明区竖新镇社区卫生服务中心,上海202179 [2]上海市崇明区新河镇社区卫生服务中心,上海202156 [3]上海交通大学医学院附属瑞金医院,上海200025

出　　处：《河南中医》2023年第4期563-567,共5页Henan Traditional Chinese Medicine

基　　金：上海市崇明区科学技术委员会科研项目(CKY2021-35)。

摘　　要：目的:观察补肾固精方治疗老年慢性肾脏病(chronic kidney disease, CKD)蛋白尿的临床疗效。方法:将212例老年CKD蛋白尿患者,采用随机数字表法分为观察组和对照组,每组各106例。对照组采用西医常规治疗,观察组在对照组治疗的基础上加用补肾固精汤。检测两组患者治疗前后24小时尿蛋白定量(24 hour urinary protein, 24 hUP)、尿素氮(Blood urea nitrogen, BUN)、血肌酐(serum creatinine, Scr)和肾小球滤过率(glomerular filtration rate, GFR)水平,比较两组患者临床疗效、不良反应发生率及治疗前后各项中医证候积分变化情况。结果:两组患者治疗后24 hUP、BUN和Scr水平低于本组治疗前,且治疗后观察组低于对照组,差异具有统计学意义(P<0.05)。两组患者治疗后左肾GFR、右肾GFR和总GFR水平高于本组治疗前,且治疗后观察组高于对照组,差异具有统计学意义(P<0.05)。两组患者治疗后各项中医证候积分低于本组治疗前,且治疗后观察组低于对照组,差异具有统计学意义(P<0.05)。对照组有效率为79.25%,观察组有效率为89.62%,两组患者有效率比较,差异有统计学意义(P<0.05)。两组患者腹痛腹胀、转氨酶升高、血钾升高、肌肉酸痛和失眠多梦等不良反应发生率比较,差异无统计学意义(P>0.05)。结论:补肾固精方治疗老年CKD蛋白尿,可改善患者的临床症状及肾功能治疗,降低蛋白尿含量。Objective:To observe the clinical efficacy of Kidney-Tonifying and Essence-Strengthening Decoction on proteinuria in elderly chronic kidney disease(CKD).Methods:A total of 212 elderly CKD proteinuria patients were randomly divided into the observation group and the control group according to random number table method,with 106 cases in each group.The control group was treated with conventional Western medicine treatment,while the observation group was treated with Kidney-Tonifying and Essence-Strengthening Decoction on the basis of the control group.The 24-hour urinary protein(24 hUP),blood urea nitrogen(BUN),serum creatinine(Scr),and glomerular filtration rate(GFR)levels of the two groups were measured before and after treatment.The clinical efficacy,the incidence of adverse reactions,and the changes of various TCM syndrome scores before and after treatment were compared between the two groups.Results:After treatment,the 24-hour UP,BUN,and Scr levels of the two groups were lower than those of the same group before treatment,and the observation group's above levels were lower than those of the control group,and all the differences were statistically significant(P<0.05);The levels of left kidney GFR,right kidney GFR,and total GFR in the two groups were higher than those of the same group before treatment,and the observation group7 s above levels were higher than those of the control group,and all the differences were statistically significant(P<0.05).All the TCM syndrome scores of the two groups were lower than those of the same group before treatment,and the observation group's were lower than those of the control group,and all the differences were statistically significant(P<0.05).The effective rate of the control group was 79.25%,while that of the observation group was 89.62%.There was a statistically significant difference(P<0.05).However,there was no significant difference between the two groups in the incidence of adverse reactions such as abdominal pain,abdominal distension,transaminase increase,blood potas

关 键 词：慢性肾脏病 蛋白尿 老年 补肾固精方 中西医结合疗法 

分 类 号：R277.592[医药卫生—中医学]