基于“醇正和缓”理论自拟方剂治疗脾肾气虚型慢性肾脏病2~3期的临床研究  

Clinical study on the treatment of Stage 2-3 chronic kidney disease with syndrome of qi deficiency of spleen and kidney by self-prepared prescription based on the“Chunzheng Hehuan”theory

作　　者：蒋丽君[1] 薛红良 冯青 张亚琦[1] 孙正伟[1] JIANG Lijun;XUE Hongliang;FENG Qing;ZHANG Yaqi;SUN Zhengwei(Department of Nephrology,Wujin Hospital of Traditional Chinese Medicine,Jiangsu Province,Changzhou213000,China)

机构地区：[1]江苏省常州市武进中医医院肾病科,江苏常州213000

出　　处：《中国医药导报》2024年第10期64-68,共5页China Medical Herald

基　　金：江苏省科技计划青年基金项目(BK20190660);江苏省常州市武进区科技支撑计划(社会发展)项目(WS202108)。

摘　　要：目的探究基于“醇正和缓”理论自拟方剂治疗脾肾气虚型慢性肾脏病(CKD)2~3期的临床效果。方法选取江苏省常州市武进中医医院2021年11月至2023年4月收治的2~3期CKD患者88例,采用随机数字表法将其分成对照组和观察组,各44例。对照组予以复方α-酮酸片治疗,观察组予以复方α-酮酸片联合自拟方剂和缓养肾方治疗,两组均以2个月为1个疗程,共治疗2个疗程。比较两组疗效及用药安全性,比较两组治疗前后的中医症状、体征积分及肾小管、肾功能。结果观察组疗效优于对照组(P<0.05)。治疗后,两组中医症状、体征积分均低于治疗前,且观察组低于对照组(P<0.05)。治疗后,两组N-乙酰-β-D-葡萄糖苷酶、α_(1)-微球蛋白、β_(2)-微球蛋白、视黄醇结合蛋白、血尿素氮、血肌酐、血尿酸、半胱氨酸蛋白酶抑制剂C、24 h尿蛋白定量均低于治疗前,且观察组α_(1)-微球蛋白、视黄醇结合蛋白、血尿素氮、血肌酐、血尿酸、半胱氨酸蛋白酶抑制剂C、24 h尿蛋白定量均低于对照组(P<0.05)。两组治疗期间均未发生不良反应,两组治疗前后谷丙转氨酶、总胆红素比较,差异无统计学意义(P>0.05)。结论基于“醇正和缓”理论的自拟中药和缓养肾方用于2~3期CKD患者临床治疗,可明显提升效果,改善患者临床中医症状,提升肾小管功能,促进肾功能恢复,且用药安全可控。Objective To explore the clinical effect of self-made prescription based on the theory of“Chunzheng Hehuan”on the treatment of Stage 2-3 chronic kidney disease(CKD)with syndrome of qi deficiency of spleen and kidney.Methods A total of 88 patients with Stage 2-3 CKD admitted to Wujin Hospital of Traditional Chinese Medicine,Jiangsu Province from November 2021 to April 2023 were selected and divided into control group and observation group by random number table method,with 44 cases in each group.The control group was treated with Compoundα-Ketoacid Tablets,and the observation group was treated with Compoundα-Ketoacid Tablets combined with Hehuan Yangshen Prescription which was the self-made prescription.Both groups were treated with one course of treatment for two months,with a total of two courses.The efficacy and drug safety of the two groups were compared,and the scores of traditional Chinese medicine symptoms,signs,renal tubules and renal function before and after treatment were compared.Results The curative effect of observation group was better than that of control group(P<0.05).After treatment,the scores of traditional Chinese medicine symptoms and signs in both groups were lower than before treatment,and those of observation group were lower than those of control group(P<0.05).After treatment,the levels of N-acetyl-β-D-glucosidase,α_(1)-microglobulin,β_(2)-microglobulin,retinol-binding protein,blood urea nitrogen,serum creatinine,blood uric acid,cysteine proteinase inhibitor C,and 24 h urinary protein in both groups were lower than before treatment,the levels ofα_(1)-microglobulin,retinol binding protein,blood urea nitrogen,blood creatinine,blood uric acid,cysteine proteinase inhibitor C,and 24 h urinary protein in observation group were lower than those in control group(P<0.05).There was no adverse reaction between the two groups during treatment,and there were no significant differences in alanine transaminase and total bilirubin between the two groups before and after treatment(P>0.05).Conclus

关 键 词：慢性肾脏病 复方Α-酮酸片 和缓养肾方 肾功能 

分 类 号：R651.1[医药卫生—外科学]