参芪延肾方对慢性肾脏病患者肾脏血流灌注的影响  

The effect of the Shenqi Yanshen prescription on renal blood perfusion in patients with chronic kidney disease

作　　者：刘承玄[1] 刘可[1] 欧阳晓琴[1] 李逊佳 熊维建[1] LIU Chengxuan

机构地区：[1]重庆市中医院,重庆400021

出　　处：《中医临床研究》2023年第29期106-109,共4页Clinical Journal Of Chinese Medicine

基　　金：重庆市科研机构绩效激励引导项目(cstc2018jxjl130023):肾毒清栓改善慢性肾脏病(CKD2-4期)肾功能及并发症的临床研究;重庆市科卫联合中医药项目(2019ZY3130):基于“肾虚络瘀”理论以超声评价参芪延肾方对慢性肾脏病的作用。

摘　　要：目的:以肾脏超声血流参数及弹性值为主要指标,评价参芪延肾方对慢性肾脏病患者肾脏血流灌注的影响。方法:按照纳入与排除标准共纳入80例慢性肾脏病(1~4期)患者,以入组先后为序号,按随机数字表法将患者分为治疗组(40例)和对照组(40例)。两组患者均给予肾病饮食指导,治疗原发疾病及纠正贫血,维持内环境稳定和水、电解质及酸碱平衡等,治疗组在对照组常规治疗的基础上加用参芪延肾颗粒。治疗1个月后,对比两组患者肾主动脉及段动脉的收缩期峰值流速(Peak Systolic Flow Velocity,PSV)、舒张末期流速(End Diastolic Flow Velocity,EDV)、血管阻力指数(Resistive Index,RI)、平面波超敏感血流显像等级、剪切波弹性成像(Shear Wave Elastography,SWE)值。结果:经过1个月治疗,治疗组患者的肾主动脉与段动脉EDV值较对照组患者高,肾主动脉RI值以及段动脉PSV、RI值较对照组患者低,治疗组患者平面波超敏感血流显像等级强的人次更多,组间差异有统计学意义(P<0.05);治疗组患者主动脉PSV、SWE值的差异无统计学意义(P>0.05)。结论:参芪延肾方能够提高慢性肾脏病(1~4期)患者肾脏主动脉EDV,段动脉PSV、EDV,肾脏平面波超敏感血流显像等级,同时降低主动脉、段动脉RI,从而改善肾脏血流灌注。Objective:To evaluate the effect of the Shenqi Yanshen prescription(参芪延肾方)on renal blood flow perfusion in patients with chronic kidney disease,with renal ultrasonic blood flow parameters and elastic values as the main indicators.Methods:According to the inclusion and exclusion criteria,a total of 80 cases were enrolled finally.The included patients were numbered according to the order of enrollment,and were divided into the treatment group(40 cases)and the control group(40 cases)by theO random number table method.The patients in both groups were given dietary guidance on nephrosis to treat the primary disease and correct anemia,maintain the stability of the internal environment and the balances of water,electrolyte and acid-base,etc..The patients in the treatment group took the Shenqi Yanshen granules(参芪延肾颗粒)more.One month after treatment,the PSV,EDV,vascular RI,plane wave supersensitive blood flow imaging grade,and SWE values of the renal aorta and segmental arteries in the two groups were compared.Results:After one month of treatment,the EDV value of renal aorta and segmental arteries in the treatment group were higher than those in the control group,while the RI value of renal aorta,and PSV and RI values of segmental arteries were lower than those in the control group.The number of patients with strong plane wave supersensitive blood flow imaging in the treatment group was more than the control group,and the difference between the groups was statistically significant(P<0.05).There was no significant difference in PSV and SWE values of aorta in the treatment group(P>0.05).Conclusion:The Shenqi Yanshen prescription can improve the renal aortic EDV value,segmental artery PSV and EDV values,and renal plane wave supersensitive blood flow imaging level in patients with chronic kidney disease(stage 1~4),and reduce RI value of aorta and segmental artery,thereby ameliorating renal blood flow perfusion.

关 键 词：参芪延肾方 慢性肾脏病 超声检查 弹性值 

分 类 号：R256.5[医药卫生—中医内科学]