解毒泄浊方联合血液透析治疗慢性肾功能衰竭患者疗效及对钙磷代谢的影响  

Efficacy of Jiedu Xiezhuo Decoction(解毒泄浊方)Combined with Hemodialysis in Treatment of Patients with Chronic Renal Failure and Its Effects on Calcium-Phosphorus Metabolism

作　　者：方美双 张世同[1] 高磊[1] 孙中德 许鑫 方朝晖[2] FANG Meishuang;ZHANG Shitong;GAO Lei;SUN Zhongde;XU Xin;FANG Zhaohui(Lu′an Chinese Medicine Hospital,Lu′an 237006,Anhui,China;The First Affiliated Hospital of Anhui University of Traditional Chinese Medicine,Hefei 230031,Anhui,China)

机构地区：[1]六安市中医院,安徽六安237006 [2]安徽中医药大学第一附属医院内分泌科,安徽合肥230031

出　　处：《辽宁中医杂志》2023年第4期90-93,共4页Liaoning Journal of Traditional Chinese Medicine

基　　金：国家自然科学基金项目(81774286)。

摘　　要：目的研究解毒泄浊方联合血液透析治疗慢性肾功能衰竭(chronic renal failure,CRF)脾肾亏虚夹湿浊证患者疗效及对肾功能和钙磷代谢水平的影响。方法选取2020年7月—2022年3月来院就诊的终末期CRF患者62例为样本进行前瞻性随机对照实验,将患者按照入组顺序进行编号并采用随机数字表法均分为观察组和对照组,每组31例,两组均进行血液透析和对症支持治疗,观察组在此基础上给予中药解毒泄浊方辅助治疗,比较两组治疗8周时疗效、中医症状积分、肾功能和钙磷代谢水平。结果观察组和对照组有效率分别为90.32%(28/31)和67.74%(21/31),两组比较差异有统计学意义(χ^(2)=4.769,P=0.029);治疗8周时观察组倦怠乏力、气短懒言、腰膝酸软和食少纳呆等主要症状评分均低于对照组(t=4.508、4.236、3.265、4.293,P<0.05);治疗8周时观察组血肌酐(Scr)、尿素氮(BUN)、β_(2)微球蛋白(β_(2)-MG)、磷离子和全段甲状旁腺激素(iPTH)均低于对照组(t=4.757、4.240、3.979、2.022、2.956,P<0.05),血清钙离子水平高于对照组(t=2.793,P<0.05);治疗8周时两组iPTH达标率分别为67.74%(21/31)和41.94%(13/31),差异有统计学意义(χ^(2)=4.769,P<0.05)。结论CRF脾肾亏虚夹湿浊证患者在血液透析基础上应用中药解毒泄浊方进行辅助治疗有利于缓解患者症状,改善肾功能和钙磷代谢,提升治疗效果。Objective To study the efficacy of Jiedu Xiezhuo(解毒泄浊方)combined with hemodialysis in the treatment of patients with chronic renal failure(CRF)of spleen-kidney deficiency and dampness-turbidity syndrome and its effects on renal function and calcium-phosphorus metabolism.Methods Sixty-two patients with end-stage CRF who were treated in the hospital from July 2020 to March 2022 were selected as the samples for prospective randomized controlled trial.The patients were numbered according to the enrollment sequence and were divided into the observation group and the control group by the random number table method,with 31 cases in each group.Both groups received hemodialysis and symptomatic support treatment,and the observation group was given traditional Chinese medicine Jiedu Xiezhuo Decoction adjuvant therapy on this basis.The efficacy,scores of TCM symptoms,renal function and calcium-phosphorus metabolism were compared between the two groups at 8 weeks of treatment.Results The effective rate was 90.32%(28/31)in the observation group and 67.74%(21/31)in the control group respectively(χ^(2)=4.769,P=0.029).After 8 weeks of treatment,the scores of major symptoms such as lassitude,shortness of breath and lazy speech,soreness and weakness of waist and knees and reduced appetite and anorexia in the observation group were lower than those in the control group(t=4.508,4.236,3.265,4.293,P<0.05).The levels of serum creatinine(Scr),blood urea nitrogen(BUN),β_(2) microglobulin(β_(2)-MG),phosphonium ion and intact parathyroid hormone(iPTH)in the observation group after 8 weeks of treatment were lower than those in the control group(t=4.757,4.240,3.979,2.022,2.956,P<0.05)while the level of serum calcium ion was higher than that in the control group(t=2.793,P<0.05).After 8 weeks of treatment,the iPTH compliance rates of the two groups were 67.74%(21/31)and 41.94%(13/31),respectively(χ^(2)=4.769,P<0.05).Conclusion On the basis of hemodialysis,adjuvant therapy with traditional Chinese medicine Jiedu Xiezhuo Decoction fo

关 键 词：肾功能衰竭 脾肾亏虚夹湿浊证 血液透析 解毒泄浊方 肾功能 钙磷代谢 

分 类 号：R692.5[医药卫生—泌尿科学]