畅中攻下益气活血法治疗慢性肾功能衰竭临床疗效及对微炎症状态的影响  

Clinical Effect of Methods of Freeing the Middle Energizer,Attacking the Lower Energizer,Boosting Qi and Invigorating Blood on Chronic Renal Failure and Its Influence on Microinflammation

作　　者：金玮 JIN Wei(Department of Nephrology,Jinhua Traditional Chinese Medicine Hospital Affiliated to Zhejiang Chinese Medical University,Jinhua Zhejiang 321000,China)

机构地区：[1]浙江中医药大学附属金华中医院肾病科,浙江金华321000

出　　处：《新中医》2023年第18期61-65,共5页New Chinese Medicine

摘　　要：目的:观察畅中攻下、益气活血法(真武汤加减)治疗慢性肾功能衰竭(CRF)的临床疗效及对微炎症状态的影响。方法:选择57例CRF患者,采用随机数字表法分为对照组28例与观察组29例。对照组采用西医常规治疗,观察组在对照组基础上加用真武汤加减治疗。比较2组治疗前后中医证候积分、肾功能[肾小球滤过率(GFR)、血肌酐(SCr)、血尿素氮(BUN)、胱抑素C (Cys-C)]、微炎症状态[C-反应蛋白(CRP)、白细胞介素-6 (IL-6)、肿瘤坏死因子-α (TNF-α)],治疗结束后评价2组临床疗效与用药安全性。结果:观察组总有效率为93.10%,对照组为67.86%,2组比较,差异有统计学意义(P<0.05)。治疗后,2组中医证候积分均较治疗前降低(P<0.05),且观察组中医证候积分低于对照组(P<0.05)。治疗后,2组GFR水平均较治疗前升高,SCr水平均较治疗前降低(P<0.05);且观察组GFR水平高于对照组(P<0.05),SCr水平低于对照组(P<0.05);2组BUN、Cys-C水平治疗前后比较,差异无统计学意义(P>0.05)。治疗后,2组CRP、IL-6、TNF-α水平均较治疗前降低(P<0.05),且观察组CRP、IL-6、TNF-α水平均低于对照组(P<0.05)。治疗结束时,2组三大常规、心电图、肝功能结果较治疗前无明显变化。结论:畅中攻下、益气活血法治疗CRF能提高临床疗效,有效改善患者中医证候,保护残余肾功能,其作用机制可能与下调CRP、IL-6、TNF-α水平有关。Objective:To observe the clinical effect of methods of freeing the middle energizer,attacking the lower energizer,boosting qi and invigorating blood(Modified Zhenwu Decoction) on chronic renal failure(CRF) and its influence on microinflammation.Methods:A total of 57 CRF patients were selected and divided into the control group(28 cases) and the observation group(29 cases) by random number table.The control group was treated with conventional western medicine,and the observation group was additionally treated with Modified Zhenwu Decoction based on the treatment of the control group.The traditional Chinese medicine(TCM) syndrome scores,kidney function indexes,including glomerular filtration rate(GFR),serum creatinine(SCr),blood urea nitrogen(BUN) and cystatin C(Cys-C),microinflammation,including C-reactive protein(CRP),serum interleukin-6(IL-6) and tumor necrosis factor-α(TNF-α),were compared between the two groups before and after treatment.The clinical effects and medication safety in the two groups were evaluated after treatment.Results:The total effective rate was 93.10% in the observation group and 67.86% in the control group,the difference being significant(P<0.05).After treatment,the TCM syndrome scores in the two groups were decreased when compared with those before treatment(P<0.05),and the TCM syndrome scores in the observation group was lower than that in the control group(P>0.05).After treatment,the GFR levels in the two groups were increased when compared with those before treatment,and the SCr levels were decreased when compared with those before treatment(P<0.05);and the GFR level in the observation group was higher than that in the control group(P<0.05),and the SCr level was lower than that in the control group(P<0.05);there was no significant difference in the comparison of BUN and Cys-C levels between the two groups before and after treatment(P>0.05).After treatment,the levels of CRP,IL-6 and TNF-α in the two groups were decreased when compared with those before treatment(P<0.05),and the level

关 键 词：慢性肾功能衰竭 畅中攻下 益气活血 真武汤 肾功能 微炎症状态 

分 类 号：R692.5[医药卫生—泌尿科学]