培本清利通络方治疗慢性肾脏病3~5期伴CKD-MBD脾肾两虚兼湿瘀证的临床研究  

Clinical Study of Peiben Qingli Tongluo Formula in the Treatment of Chronic Kidney Disease Stage 3-5 Complicated with CKD-MBD with Spleen-Kidney Deficiency and Dampness-Stasis Syndrome

作　　者：郭建红[1] 任燕[1] GUO Jianhong;REN Yan(Department of Nephrology,Suzhou Hospital of Traditional Chinese Medicine Affiliated to Nanjing University of Chinese Medicine,Suzhou 215009,China;不详)

机构地区：[1]南京中医药大学附属苏州市中医医院肾内科,江苏苏州215009

出　　处：《中国医学创新》2024年第18期93-98,共6页Medical Innovation of China

基　　金：江苏省老年医学学会老年医学科技发展基金(医养结合)专项项目(JGS2019ZXYY019);苏州市科技发展计划项目(SKYXD2022060,SYSD2019156);苏州市中医医院院内课题(YQN2021013)。

摘　　要：目的:观察基于吴门医派“络病理论”创立的培本清利通络方联合骨化三醇胶丸治疗慢性肾脏病(CKD)3~5期伴CKD-矿物质及骨代谢紊乱(CKD-MBD)脾肾两虚兼湿瘀证患者的效果。方法:选择2022年7月—2023年6月于南京中医药大学附属苏州市中医医院就诊的脾肾两虚兼湿瘀证CKD 3~5期合并有CKD-MBD的患者60例,随机分为治疗组和对照组,每组30例。对照组予控制血压、控制血糖、改善贫血等基础治疗,同时口服骨化三醇胶丸;治疗组在对照组治疗基础上加服培本清利通络方,两组疗程均为12周。比较两组患者治疗前后肾功能[血肌酐(Scr)、血尿素氮(BUN)、尿酸(UA)]、矿物质及骨代谢[钙(Ca)、磷(P)、全段甲状旁腺激素(iPTH)、碱性磷酸酶(ALP)]、中医症候积分、生活质量评分,并评估临床疗效;治疗前后检测两组血常规、肝功能、血钾,以评估用药安全性。结果:两组治疗后中医症候积分均较治疗前降低,且治疗组低于对照组(P<0.05);治疗组总有效率为93.33%,明显高于对照组的73.33%(P<0.05);治疗后,治疗组BUN、UA均明显低于治疗前,且Scr、BUN均明显低于对照组,差异均有统计学意义(P<0.05);治疗后,治疗组P、iPTH均明显低于治疗前,Ca明显高于治疗前,且治疗组Ca高于对照组,iPTH低于对照组,差异均有统计学意义(P<0.05);治疗后,治疗组生活质量评分较治疗前明显下降,且治疗组低于对照组(P<0.05);两组治疗后安全性指标比较,差异均无统计学意义(P>0.05)。结论:培本清利通络方可改善CKD 3~5期合并CKD-MBD脾肾两虚兼湿瘀证患者Ca、P、iPTH指标,延缓肾功能减退,减轻患者腰脊酸痛、皮肤瘙痒、倦怠乏力等症状,并可提高患者生活质量。Objective:To observe the effect of Peiben Qingli Tongluo Formula based on Wumen medicine school's"collateral pathology theory"combined with Calcitriol Capsules in the treatment of patients with chronic kidney disease(CKD)stage 3-5 complicated with CKD-mineral and bone disorder(CKD-MBD)with spleen-kidney deficiency and dampness-stasis syndrome.Method:A total of 60 patients with CKD stage 3-5 complicated with CKD-MBD with spleen-kidney deficiency and dampness-stasis syndrome who were treated in Suzhou Hospital of Traditional Chinese Medicine Affiliated to Nanjing University of Chinese Medicine from July 2022 to June 2023 were selected and randomly divided into treatment group and control group,with 30 cases in each group.The control group was treated with blood pressure control,blood glucose control,anemia improvement and other basic treatments,along with oral Calcitriol Capsules.The treatment group was supplemented with Peiben Qingli Tongluo Formula on the basis of the control group.The treatment duration for both groups was 12 weeks.Renal function[serum creatinine(Scr),blood urea nitrogen(BUN),uric acid(UA)],mineral and bone metabolism[calcium(Ca),phosphorus(P),intact parathyroid hormone(iPTH),alkaline phosphatase(ALP)],traditional Chinese medicine syndrome scores and quality of life scores of the two groups were compared before and after treatment,and clinical efficacy was evaluated.Blood routine,liver function and blood potassium were measured before and after treatment to evaluate the medication safety.Result:After treatment,traditional Chinese medicine syndrome scores of both groups were lower than those before treatment,and that in the treatment group was lower than that in the control group(P<0.05).The total effective rate of the treatment group was 93.33%,which was significantly higher than 73.33%of the control group(P<0.05).After treatment,BUN and UA in treatment group were significantly lower than those before treatment,and Scr and BUN were significantly lower than those in the control group,the differen

关 键 词：吴门医派 络病理论 培本清利通络方 慢性肾脏病3~5期 慢性肾脏病-矿物质及骨代谢紊乱 脾肾两虚兼湿瘀证 

分 类 号：R277.5[医药卫生—中医学]