自拟中药汤剂治疗慢性肾功能不全Ⅲ~Ⅳ期脾肾气虚型患者疗效观察  

Observation on the Therapeutic Effect of Self-made Traditional Chinese Medicine Decoction on Patients with Chronic Renal Insufficiency Stage III-IV of Spleen and Kidney Qi Deficiency Type

作　　者：吕恩君 温玉玮 杜美娟 LYU Enjun;WEN Yuwei;DU Meijuan(Dandong Hospital of Traditional Chinese Medicine,Dandong 118000,Liaoning,China)

机构地区：[1]丹东市中医院,辽宁丹东118000

出　　处：《辽宁中医药大学学报》2023年第9期189-192,共4页Journal of Liaoning University of Traditional Chinese Medicine

基　　金：辽宁省中医重点专科建设项目。

摘　　要：目的探讨自拟中药汤剂对慢性肾功能不全Ⅲ~Ⅳ期脾肾气虚型患者的临床疗效及对中医症状积分、肾功能及半年内透析及病死率的影响。方法选择2019年1月—2020年12月丹东市中医院肾内科收治98例慢性肾功能不全Ⅲ~Ⅳ期脾肾气虚型患者作为研究对象,应用随机数字表将患者分为两组各49例,对照组患者给予降压、降糖、调血脂、纠正肾性贫血、纠正酸中毒、纠正离子紊乱、改善肾功能、利尿消肿、通便等常规治疗,观察组在此基础上联合自拟中药汤剂辨证加减治疗,对比两组患者治疗前后中医症状积分变化情况,并对两组患者血红蛋白、血肌酐、尿素氮、肌酐清除率指标进行对比。对两组患者均进行6个月随访,记录各自半年内透析及死亡人数,并进行对比。结果治疗前,两组患者临床症状包括水肿、乏力、心衰、便秘、胃肠不适等积分对比,差异无统计学意义(P>0.05);治疗后,两组患者临床症状水肿、乏力、心衰、便秘、胃肠不适症状积分均显著低于治疗前,且观察组较对照组更低(P<0.05)。治疗前,两组患者的血红蛋白、血肌酐、尿素氮、肌酐清除率水平比较,差异无统计学意义(P>0.05);治疗后,两组患者血肌酐、尿素氮水平均较治疗前有所降低,但观察组较对照组降低更明显;血红蛋白、肌酐清除率水平均较治疗前有所升高,且观察组明显高于对照组,均P<0.05。随访6个月,观察组透析人数、总病死率均低于对照组(P<0.05)。结论自拟中药汤剂联合西医常规治疗慢性肾功能不全Ⅲ~Ⅳ期脾肾气虚型患者,能够显著改善患者临床症状及肾功能指标,并且有助于延缓患者透析时间并降低短期病死率,值得临床广泛应用。Objective To investigate the clinical effect of self-made Chinese herbal decoction on chronic renal insufficiency CKD II-IV patients with spleen and kidney Qi deficiency type,and its influence on TCM symptom score,renal function,dialysis and mortality within six months.Methods From January 2019 to December 2020,98 patients with CKD il-IV of spleen and kidney Qi deficiency type were selected as the research object,who were treated in the department of nephrology of Dandong hospital of traditional Chinese medicine.The patients were divided into two groups with 49 cases in each group using random number table.The patients in the control group were given routine treatments such as lowering blood pressure,lowering blood sugar,regulating blood lipid,correcting renal anemia,correcting acidosis,correcting ionic disorder,improving renal function,diuresis,detumescence,and defecation.The observation group combined with the dialectical addition and subtraction of the self prepared Chinese herbal decoction on the basis of the control groups,compared the changes of TCM symptom scores of the two groups of patients before and after treatment,and compared the indexes of hemoglobin,blood creatinine,urea nitrogen and creatinine clearance rate of the two groups of patients.The two groups of patients were followed up for 6 months,and the number of dialysis patients and deaths within half a year were recorded and compared.Results Before treatment,there was no significant difference between the two groups in the scores of clinical symptoms,including edema,fatigue,heart failure,constipation,gastrointestinal discomfort,etc.(P>0.05);After treatment,the scores of clinical symptoms such as edema,fatigue,heart failure,constipation and gastrointestinal discomfort in the two groups were significantly lower than those before treatment,and the scores in the observation group were lower than those in the control group(P<0.05).Before treatment,the levels of hemoglobin,blood creatinine,urea nitrogen and creatinine clearance in the two groups were n

关 键 词：中药汤剂 慢性肾功能不全Ⅲ~Ⅳ期 脾肾气虚 症状积分 肾功能 透析 病死率 

分 类 号：R256.5[医药卫生—中医内科学] R692[医药卫生—中医学]