温肾方联合脐疗治疗脾肾阳虚型慢性肾脏病临床疗效研究  

Clinical Efficacy Study of Wenshen Prescription Combined with Umbilical Therapy in Treating Chronic Kidney Disease of Spleen-kidney Yang Deficiency Type

作　　者：刘晓霞 刘婷婷 钟平莉 李霞 岑洁 LIU Xiaoxia;LIU Tingting;ZHONG Pingli(Shanghai Minhang Hospital of Integrated Traditional Chinese and Western Medicine,Shanghai,201100)

机构地区：[1]上海市闵行区中西结合医院,上海201100 [2]上海市监狱总医院,上海200120 [3]上海市闵行区妇幼保健院,上海201100

出　　处：《中国中西医结合肾病杂志》2024年第12期1059-1062,共4页Chinese Journal of Integrated Traditional and Western Nephrology

基　　金：上海市闵行区自然科学研究项目(No.2022MHZ032);上海市中医药高层次人才引领计划项目(No.ZY(2021-2023)-0403);“十四五”中医特色专科建设计划项目(No.ZYTSZK2-3);上海市卫生健康委员会科研项目(No.202240169);第二批上海市闵行区名中医工作室建设项目(No.mhmzy2024-02)。

摘　　要：目的:探讨温肾方联合脐疗治疗脾肾阳虚型慢性肾脏病的临床疗效研究。方法:按随机数字表法将纳入的60例脾肾阳虚型慢性肾脏病患者平均分为对照组和治疗组各30例。两组均采用一般治疗及常规西医治疗;一般治疗包括优质低蛋白、低脂饮食、低盐、低磷、补充必需氨基酸等支持疗法,以及降压降糖、纠正贫血、调节钙磷代谢、降血脂等常规治疗。对照组患者每日口服中药治疗,治疗组患者在对照组基础上每月连续脐疗治疗14 d,3个月为1个疗程,观察2个疗程。比较两组患者肾功能、eGFR以及中医证候积分治疗前后变化情况。结果:治疗组总有效率为90%,高于对照组66.67%,差异有统计学意义(P<0.05);治疗组患者治疗后中医临床症状积分较对照组改善明显,特别是畏寒肢冷、神疲乏力、食少纳呆等症状(P<0.05);两组治疗后血肌酐、尿素氮、尿酸、胱抑素C下降、eGFR升高,组间比较血肌酐、尿素氮、尿酸、胱抑素C下降更明显(P<0.05)。结论:温肾方联合脐疗可显著改善脾肾阳虚型慢性肾脏病患者中医临床症状,降低血肌酐,延缓肾衰竭进展。Objective:To explore the clinical efficacy of Wenshen Prescription combined with umbilical therapy in the treatment of chronic kidney disease of spleen-kidney yang deficiency type.Methods:According to the random number table method,60 patients with chronic kidney disease of spleen-kidney yang deficiency type were equally divided into a control group of 30 cases and a treatment group of 30 cases.Both groups received general treatment and conventional Western medicine treatment;general treatment included high-quality low-protein,low-fat diet,low-salt,low-phosphorus,supplementing essential amino acids and other supportive therapies,as well as routine treatments such as lowering blood pressure and blood sugar,correcting anemia,regulating calcium and phosphorus metabolism,and lowering blood lipids.The patients in the control group were treated with traditional Chinese medicine orally every day,and the patients in the treatment group received continuous umbilical therapy for 14 consecutive days every month on the basis of the treatment for the control group.Three months constituted one course of treatment,and two courses of treatment were observed.Compare the changes in renal function,eGFR,and TCM syndrome scores of the patients in the two groups before and after treatment.Results:The total effective rate in the treatment group was 90%,which was higher than that of 66.67%in the control group,and the difference was statistically significant(P<0.05).After treatment,the scores of TCM clinical syndrome of the patients in the treatment group improved significantly compared with the control group,especially the symptoms such as aversion to cold with cold limbs,fatigue and weakness,and poor appetite(P<0.05).After treatment,both groups showed decreases in serum creatinine,urea nitrogen,uric acid,and cystatin C,as well as an increase in eGFR.When compared with the control group,the decreases in serum creatinine,urea nitrogen,uric acid,and cystatin C were more significant(P<0.05).Conclusion:Wenshen Prescription combined with umb

关 键 词：慢性肾脏病 温肾方 脐疗 外敷 

分 类 号：R73[医药卫生—肿瘤]