益肾泻浊方加减联合西药治疗慢性肾功能衰竭疗效观察  

Clinical Observation of modified Yishen Xiezhuo Decoction combined with Western Medicine in the treatment of patients with chronic renal failure

作　　者：顾鸣佳 高磊平 邓正泊 GU Mingia;GAO Leiping;DENG Zhengbo(Department of Nephrology,Changshu Hosital of Truditional Chinese Medicine(Changshu New District Hospial),Changshu Jiangsu 215500,China;Changshu Hospial of Traditional Chinese Medicine(Changshu Nenc District Hospital)Department of Iaboratory Medicine,Changshu Jiangsu 215500,China)

机构地区：[1]常熟市中医院(常熟市新区医院)肾内科,江苏常熟215500 [2]常熟市中医院(常熟市新区医院)检验科,江苏常熟215500

出　　处：《四川中医》2023年第6期152-156,共5页Journal of Sichuan of Traditional Chinese Medicine

基　　金：江苏省中医药科技发展计划项目(编号:MS2022085);苏州市科技计划项目(编号:SKJY2021006)。

摘　　要：目的:探讨益肾泻浊方加减联合西药治疗慢性肾功能衰竭(CRF)患者的临床疗效。方法:选取2020年7月~2021年12月在我院接受治疗的CRF患者,按照随机信封法分为2组,对照组(n=40,缬沙坦胶囊+骨化三醇软胶囊+呋塞米片+碳酸氢钠),观察组(n=40,缬沙坦胶囊+骨化三醇软胶囊+呋塞米片+碳酸氢钠+益肾泻浊方加减),比较2组CRF患者治疗效果、中医症状积分、肾功能、氧化应激、微炎症反应与不良事件发生率。结果:干预12周后观察组治疗总有效率高于对照组(P<0.05);干预12周后观察组畏寒肢冷、食少纳呆、倦怠乏力、腰膝酸软与夜尿清长中医症状积分均低于对照组(P<0.05);干预12周后观察组血尿素氮(BUN)、血肌酐(Scr)与尿酸(UA)水平低于对照组(P<0.05),内生肌酐清除率(Ccr)水平高于对照组(P<0.05);干预12周后观察组丙二醛(MDA)水平低于对照组(P<0.05),超氧化物歧化酶(SOD)与总抗氧化能力(T-AOC)水平高于对照组(P<0.05);干预12周后观察组白细胞介素-6(IL-6)、高敏C反应蛋白(hs-CRP)与肿瘤坏死因子(TNF-α)水平低于对照组(P<0.05);2组患者干预后总不良事件发生率无区别(P>0.05)。结论:益肾泻浊方加减联合缬沙坦胶囊+骨化三醇软胶囊+呋塞米片+碳酸氢钠治疗可以提高CRF患者临床治疗效果,减轻临床症状,改善肾功能及氧化应激,减轻微炎症反应,且安全性良好。Objective:To explore the clinical efficacy of modified Yishen Xiezhuo decoction combined with western medicine in treating patients with chronic renal failure(CRF).Methods:The patients with CRF treated in our hospital from July 202Oto December 2021were selected and divided into two groups according to the random envelope method,including control group(n=40,valsartan capsule+calcitriol soft capsule+furosemide tablet+sodium bicarbonate)and observation group(n=40,valsartan capsule+calcitriol soft capsule+furosemide tablet+sodium bicarbonate+modified Yishen Xiezhuo decoction),the treatment effect,TCM symptom score,renal function,oxidative stress,micro-inflammatory response and incidence of adverse events of pa-tients with CRF in the two groups were compared.Results:After 12weeks of intervention,the total effective rate of treatment in observation group was higher than that in control group(P<0.05).The scores of TCM symptoms such as chilly sensation and cold limbs,lack of appetite and anorexia,fatigue,soreness and weakness of waist and knees,clear and much nocturia after 12weeks of intervention were lower in observation group than those in control group(P<0.05).After 12weeks of intervention,the levels of blood urea nitrogen(BUN),serum creatinine(Scr)and uric acid(UA)in observation group were lower than those in control group(P<0.05)while the levels of endogenous creatinine clearance rate(Ccr)was higher than that in control group(P<0.05).The levels of malondialdehyde(MDA)in observation group after 12weeks of intervention was lower(P<0.05)while the levels of superoxide dismutase(SOD)and total antioxidant capacity(T-AOC)were higher than those in control group(P<0.05).After 12weeks of intervention,the levels of interleukin-6(IL-6),high-sensitivity C-reactive protein(hs-CRP)and tumor necrosis factor(TNF-α)in observation group were lower compared with those in control group(P<0.05).There was no difference in the incidence of total adverse events between the two groups of patients after the intervention(P>0.05).Conclusion:M

关 键 词：益肾泻浊方 缬沙坦胶囊 骨化三醇软胶囊 呋塞米片 碳酸氢钠 慢性肾功能衰竭 

分 类 号：R692.5[医药卫生—泌尿科学]