固本通络汤联合血液透析治疗急性肾衰竭临床研究  

The effects of Guben Tongluo decoction combined with hemodialysis in treatment of patients with acute renal failure

作　　者：林玉洁 张成亮[1] 王林琳 王晴岚 李剑恺 吴卿[1] LIN Yujie;ZHANG Chengliang;WANG Linlin;WANG Qinglan;LI Jiankai;WU Qing(Shuguang Hospital Affiliated with Shanghai University of Chinese Medicine,Shanghai 200021,China)

机构地区：[1]上海中医药大学附属曙光医院,上海200021

出　　处：《陕西中医》2025年第4期467-471,共5页Shaanxi Journal of Traditional Chinese Medicine

基　　金：国家自然科学基金青年基金资助项目(81904124)。

摘　　要：目的:评价固本通络汤联合血液透析治疗急性肾衰竭的临床疗效。方法:将80例患者以随机数字表法分为对照组(40例)和治疗组(40例)。对照组给予西医常规处理,治疗组在对照组的基础上给予固本通络汤内服。治疗前后检测肾功能指标、血液流变学指标和肾血流指标;检测治疗前后自噬相关蛋白;检测治疗前后微炎症因子;进行治疗前后中医证候评分;比较治疗后的疾病愈显率。结果:治疗后,两组尿素氮(BUN)、血肌酐(Scr)水平下降,胆碱酯酶(CHE)、肌酐清除率(Ccr)水平升高(均P<0.05);且治疗组BUN、Scr水平低于对照组,CHE、Ccr水平高于对照组(均P<0.05)。治疗后,两组患者血液流变学指标、肾动脉内径、肾血流阻力指数、自噬效应蛋白、微炎症状态指标、中医各证候评分及总分下降(均P<0.05),且治疗组低于对照组(均P<0.05)。治疗组疾病愈显效率高于对照组(P<0.05)。结论:固本通络汤联合血液透析能改善急性肾衰竭患者血液流变学和肾血流动力学,抑制微炎症状态及自噬相关蛋白,改善肾功能,减轻临床症状,提高疾病愈显率。Objective:To evaluate the clinical efficacy of Guben Tongluo decoction combined with hemodialysis in the treatment of acute renal failure.Methods:80 eligible patients were randomly divided into control group(40 cases)and treatment group(40 cases)using random number table method.The control group was given comprehensive western medicine routine treatment measures,while the treatment group was given Guben Tongluo decoction orally on the basis of the control group.The renal function indicators,hemorheological indicators,and renal blood flow indicators before treatment and after treatment were recorded.The autophagy related proteins,micro inflammatory factors,TCM symptoms before and after treatment and the disease recovery rate after treatment were compared.Results:After treatment,the levels of urea nitrogen(BUN)and blood creatinine(Scr)in both groups decreased,while the levels of cholinesterase(CHE)and creatinine clearance rate(Ccr)increased(all P<0.05).After treatment,the levels of BUN and Scr in the study group were lower than those in the control group,while the levels of CHE and Ccr were higher than those in the control group(all P<0.05).After treatment,hemorheology indexes,renal artery diameter,renal blood flow resistance index,autophagy effector protein,microinflammatory status indexes,TCM syndrome scores and total scores of both groups decreased(all P<0.05),and the study group were lower than the control group(all P<0.05).The disease recovery rate in the study group was higher than that in the control group(P<0.05).Conclusion:The combination of Guben Tongluo decoction and hemodialysis can improve renal hemorheology and hemodynamics,inhibit micro inflammatory status and autophagy related proteins,improve renal function,alleviate clinical symptoms,and increase disease recovery rate in patients with acute renal failure.

关 键 词：急性肾衰竭 固本通络汤 血液流变学 肾血流动力学 微炎症状态 自噬相关蛋白 

分 类 号：R692.5[医药卫生—泌尿科学]