六君子汤合肾气丸化裁治疗脾肾气虚证慢性肾小球肾炎的临床效果观察  

Observation on the Clinical Effect of Liujunzi Decoction Combined with Shenqi Pills in the Treatment of Chronic Glomerulonephritis with Spleen-kidney Qi Deficiency Syndrome

作　　者：张韧[1] 苗悦 倪国忠 ZHANG Ren;MIAO Yue;NI Guozhong(The First Department of Acupuncture,the First Affiliated Hospital of Heilongjiang University of Traditional Chinese Medicine,Harbin 150000,China;the Fifth Department of Acupuncture,the First Affiliated Hospital of Heilongjiang University of Traditional Chinese Medicine,Harbin 150000,China;Department of Rehabilitation Medicine,the First Hospital of Qiqihar City,Qiqihar,Heilongjiang 161000,China)

机构地区：[1]黑龙江中医药大学附属第一医院针灸一科,哈尔滨150000 [2]黑龙江中医药大学附属第一医院针灸五科,哈尔滨150000 [3]齐齐哈尔市第一医院康复医学科,黑龙江齐齐哈尔161000

出　　处：《临床误诊误治》2025年第4期88-93,共6页Clinical Misdiagnosis & Mistherapy

基　　金：黑龙江省中医药管理局项目(ZHY2023-076)。

摘　　要：目的评价六君子汤合肾气丸化裁治疗脾肾气虚证慢性肾小球肾炎(CGN)的临床效果。方法选取2021年12月至2024年1月收治的脾肾气虚证CGN患者116例,根据随机数字表法分为对照组和观察组,每组58例。对照组根据患者临床表现予以控制血压、血脂、蛋白尿等常规治疗,观察组在对照组基础上予以六君子汤合肾气丸化裁治疗,2组持续治疗8周。观察2组的临床疗效,以及治疗前后中医证候积分、肾功能指标[血尿素(BUN)、血肌酐(Scr)、24 h尿蛋白定量(24 h-Upro)]和炎性因子指标[血清肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、超敏C反应蛋白(hs-CRP)]水平。并记录2组治疗期间不良反应发生情况。结果观察组总有效率为94.83%(55/58),高于对照组的75.86%(44/58,P<0.05)。治疗后,2组各中医证候积分、BUN、Scr、24 h-Upro以及血清hs-CRP、IL-6、TNF-α水平均较治疗前降低,且观察组低于对照组(P<0.05)。2组治疗期间均无明显不良反应发生。结论六君子汤合肾气丸化裁治疗脾肾气虚证CGN患者具有良好的临床效果,能在一定程度上改善临床症状、肾功能和炎症反应,并具有一定的安全性。Objective To evaluate the clinical effect of Liujunzi decoction combined with Shenqi pills in the treatment of chronic glomerulonephritis(CGN)with spleen-kidney qi deficiency syndrome.Methods A total of 116 CGN patients with spleen-kidney qi deficiency syndrome treated from December 2021 to January 2024 were selected and divided into the observation group(n=58)and the control group(n=58)according to random number table method.The control group was given routine treatment to control blood pressure,blood lipids and proteinuria according to clinical manifestations,and the observation group was given the treatment of Liujunzi decoction combined with Shenqi pills on the basis of the control group.The two groups were treated consecutively for 8 weeks.The clinical efficacy,traditional Chinese medicine(TCM)syndrome score,renal function indexes[blood urea nitrogen(BUN),serum creatinine(Scr),24 h urinary protein quantity(24 h-Upro)]and inflammatory factor indexes[serum tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),hypersensitive C reactive protein(hs-CRP)]levels of the two groups before and after treatment were observed,and the occurrence of adverse reactions during treatment in the two groups was recorded.Results The total effective rate of the observation group was 94.83%(55/58),which was higher than that of the control group 75.86%(44/58,P<0.05).After treatment,the TCM syndrome score,BUN,Scr,24 h-Upro and serum hs-CRP,IL-6 and TNF-αlevels in the two groups were lower than those before treatment,and lower in the observation group than in the control group(P<0.05).There were no obvious adverse reactions during treatment in both groups.Conclusion Liujunzi decoction combined with Shenqi pills has good clinical effect in the treatment of CGN patients with spleen-kidney qi deficiency syndrome,which can improve clinical symptoms,renal function and inflammatory response to a certain extent,and has certain safety.

关 键 词：慢性肾小球肾炎 六君子汤 肾气丸 中医证候 血尿素 尿蛋白 肿瘤坏死因子-α 白细胞介素-6 

分 类 号：R692.31[医药卫生—泌尿科学]