陈氏肾复汤对脾肾气虚、湿浊瘀阻型慢性肾脏病3a期患者的疗效观察及对血清胎球蛋白A的影响  

Clinical observation on the CHEN’s Shenfu decoction on chronic kidney disease stage 3a patients with spleen-kidney Qi deficiency,and damp turbidity and blood stasis and its influence on serum fetuin A

作　　者：马筱璠 吴竞[2] MA Xiaofan

机构地区：[1]福建中医药大学附属福州中医院,福建福州350001 [2]福建中医药大学附属人民医院,福建福州350004

出　　处：《中医临床研究》2024年第19期67-73,共7页Clinical Journal Of Chinese Medicine

基　　金：国家中医临床研究基地专项课题(JDZX201930)。

摘　　要：目的:观察陈氏肾复汤对脾肾气虚、湿浊瘀阻型慢性肾脏病(Chronic Kidney Disease,CKD)3a期患者的临床疗效,并初步探讨该方防治慢性肾脏病血管钙化的可能性。方法:选取符合入选标准的患者70例,依据简单随机法分为对照组和试验组,每组35例。对照组予以西医常规治疗,试验组在西医常规治疗的基础上加用陈氏肾复汤,疗程均为8周。观察两组治疗前后血肌酐(Serum Creatinine,Scr)、肾小球滤过率(Estimate Glomerular Filtration Rate,eGFR)、24小时尿蛋白定量(Urinary Protein Quantity,UP)、血钙(Ca)、血磷(P)、钙磷乘积(Ca×P)、甲状旁腺激素(Parathyroid Hormone,PTH)、超敏C反应蛋白(Hypersensitive C-reactive Protein,hs-CRP)、血清胎球蛋白A(Fetuin-A)及中医证候积分的变化。结果:与治疗前相比,试验组在降低24 h UP、升高eGFR方面的疗效优于对照组(P <0.05),而在降低Scr方面的疗效与对照组无明显差异(P>0.05);两组患者P、Ca×P、hs-CRP均较治疗前降低(P <0.05),且试验组疗效优于对照组(P <0.05);两组患者Fetuin-A均较治疗前升高(P <0.05),且试验组升高程度优于对照组(P <0.05);两组患者中医证候积分均较治疗前降低(P <0.05),且试验组降低程度优于对照组(P <0.05);试验组的总有效率高于对照组(P <0.05)。结论:在西医常规治疗的基础上加用陈氏肾复汤能更好地改善脾肾气虚、湿浊瘀阻型慢性肾脏病3α期患者的临床症状,减少尿蛋白排泄,保护肾功能,并可通过升高钙化抑制因子血清Fetuin-A水平改善钙磷代谢紊乱和微炎症状态,从而对慢性肾脏病血管钙化起到一定的防治作用。Objective:To evaluate the clinical effect of the CHEN’s Shenfu decoction(陈氏肾复汤)on patients with chronic kidney disease(stage 3a)of spleen-kidney Qi(气)deficiency,and damp turbidity and blood stasis,and preliminarily explore the possibility of using this prescription to control vascular calcification in chronic kidney disease.Methods:Totally 70 patients who met the inclusion criteria were enrolled,and were randomly divided into the control group and the trial group,35 cases in each group.The control group was treated by western routine therapy,while the trial group was treated with the CHEN’s Shenfu decoction more.The course of treatment was 8 weeks.The changes of serum creatinine(Scr),estimate glomerular filtration rate(eGFR),24-hour urinary protein quantity(24 h UP),blood calcium(Ca),blood phosphorus(P),calcium-phosphorus product(Ca×P),parathyroid hormone(PTH),hyper sensitive C-reactive protein(hs-CRP),serum Fetuin-A and TCM syndrome scores were observed before and after the treatment in the two groups.Results:After treatment,the Scr and 24 hUP in the two groups were decreased while eGFR was increased(P<0.05),and the efficacy in the trial group in reducing 24 h UP and increasing eGFR was better than the control group(P<0.05),but there was no significant difference in the decrease of Scr between the two groups(P>0.05).After treatment,the P,Ca×P and hs-CRP in the two groups were decreased(P<0.05),and those in the trial group was better than the control group(P<0.05).After treatment,the serum fetuin-A in the two groups was increased(P<0.05),and the effect in the trial group was superior to the control group(P<0.05).After treatment,TCM syndrome scores in the two groups were decreased(P<0.05),and the trial group had better efficacy than the control group(P<0.05).The total effective rate in the trial group was higher than the control group(P<0.05).Conclusion:The CHEN’s Shenfu decoction with western routine therapy has a significant curative effect on chronic kidney disease(stage 3a)of spleen-kidney

关 键 词：慢性肾脏病 陈氏肾复汤 脾肾气虚 湿浊瘀阻 血管钙化 胎球蛋白A 

分 类 号：R256.5[医药卫生—中医内科学]