肾安方联合西医常规治疗早中期慢性肾功能不全临床研究
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摘要
目的探讨肾安方联合西药常规治疗早中期慢性肾功能不全(CRF)的临床疗效。方法采用随机数字表法将60例CRF患者分为2组。对照组予西医常规治疗(抗感染、纠正酸中毒、降压、纠正电解质紊乱),治疗组在对照组治疗基础上予肾安方,每日1剂,分早晚口服。2组均14 d为1个疗程,连续治疗2个疗程。于治疗前后检测血肌酐(SCr)、血尿素氮(BUN)、胱抑素C(Cys-C)、尿κ轻链、尿λ轻链、β2-微球蛋白(β2-MG)、甲状旁腺激素(PTH)、24h尿总蛋白定量、24h尿白蛋白定量、尿微量总蛋白、总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、脂蛋白(A)[Lp(A)]、血红蛋白(Hb),比较2组临床疗效及中医疗效。结果治疗组临床疗效、中医疗效均显著优于对照组(P<0.05)。与本组治疗前比较,治疗组治疗后24h尿总蛋白定量、24h尿白蛋白定量、尿微量总蛋白、PTH、β2-MG、SCr、BUN、Cys-C、尿κ轻链及尿λ轻链水平明显降低(P<0.05);2组治疗后比较,治疗组上述指标均低于对照组(P<0.05)。与本组治疗前比较,治疗组治疗后Lp(A)水平明显降低,Hb显著升高(P<0.05);2组治疗后比较,治疗组Lp(A)水平明显低于对照组(P<0.05)。与本组治疗前比较,2组治疗后中医症状积分显著降低(P<0.05);2组治疗后比较,治疗组中医症状积分明显低于对照组,积分减少率明显高于对照组(P<0.05)。结论肾安方联合西医常规治疗早中期CRF可有效改善患者肾功能,降低蛋白尿,显著抑制CRF病情进展,疗效显著。
Objective To investigate the clinical efficacy of Shen'an Prescription combined with Western medicine in the treatment of chronic renal insufficiency(CRF). Methods Totally 60 CRF patients were randomly divided into two groups. The control group was given routine Western medicine, including anti-infective treatment, correcting acidosis, anti-hypertension and correcting electrolyte imbalance, while the treatment group was treated withShen'an Prescription on the basis of the control group, one dosage per day, orally taken in the morning and evening. 14 d were set as one treatment course for both groups. The treatment for both groups lasted for two treatment courses. Serum creatinine(SCr), blood urea nitrogen(BUN), cystatin C(Cys-C), urinary κ light chain, urinary λ light chain, β2-microglobulin(β2-MG), parathyroid hormone(PTH), 24-hour total urinary protein quantitation, 24-hour urinary albumin quantification, total urinary microprotein, total cholesterol(TC), triglyceride(TG), low-density lipoprotein cholesterol(LDL-C), high density lipoprotein cholesterol(HDL-C), lipoprotein(A) [Lp(A)] and hemoglobin(Hb) before and after treatment were detected. Clinical efficacy and TCM efficacy of both groups were compared. Results The clinical efficacy and TCM efficacy of the treatment group were significantly better than the control group(P<0.05). Compared with before treatment, the 24 h total urinary protein quantification, 24 h urinary albumin quantitation, urinary total protein, PTH, β2-MG, SCr, BUN, Cys-C, urinary κ light chain and urinary λ light chain in the treatment group decreased significantly(P<0.05). After treatment, the above indexes in the treatment group were lower than those in the treatment group(P<0.05). Compared with before treatment, the Lp(A) level significantly decreased and the Hb significantly increased in the control group(P<0.05). The level of Lp(A) in the treatment group was significantly lower than that in the control group(P<0.05). Compared with before treatment, the scores of TCM symptoms in the two groups were significantly lower(P<0.05). After treatment, the scores of TCM symptoms in the treatment group were significantly lower than those in the control group, and the reduction rate of the score was significantly higher than that in the control group(P<0.05). Conclusion Shen'an Prescription combined with routine Western medicine can effectively improve renal function and reduce proteinuria in patients with CRF, and can significantly inhibit the progress of CRF, with obvious efficacy.
Objective To investigate the clinical efficacy of Shen'an Prescription combined with Western medicine in the treatment of chronic renal insufficiency(CRF). Methods Totally 60 CRF patients were randomly divided into two groups. The control group was given routine Western medicine, including anti-infective treatment, correcting acidosis, anti-hypertension and correcting electrolyte imbalance, while the treatment group was treated withShen'an Prescription on the basis of the control group, one dosage per day, orally taken in the morning and evening. 14 d were set as one treatment course for both groups. The treatment for both groups lasted for two treatment courses. Serum creatinine(SCr), blood urea nitrogen(BUN), cystatin C(Cys-C), urinary κ light chain, urinary λ light chain, β2-microglobulin(β2-MG), parathyroid hormone(PTH), 24-hour total urinary protein quantitation, 24-hour urinary albumin quantification, total urinary microprotein, total cholesterol(TC), triglyceride(TG), low-density lipoprotein cholesterol(LDL-C), high density lipoprotein cholesterol(HDL-C), lipoprotein(A) [Lp(A)] and hemoglobin(Hb) before and after treatment were detected. Clinical efficacy and TCM efficacy of both groups were compared. Results The clinical efficacy and TCM efficacy of the treatment group were significantly better than the control group(P<0.05). Compared with before treatment, the 24 h total urinary protein quantification, 24 h urinary albumin quantitation, urinary total protein, PTH, β2-MG, SCr, BUN, Cys-C, urinary κ light chain and urinary λ light chain in the treatment group decreased significantly(P<0.05). After treatment, the above indexes in the treatment group were lower than those in the treatment group(P<0.05). Compared with before treatment, the Lp(A) level significantly decreased and the Hb significantly increased in the control group(P<0.05). The level of Lp(A) in the treatment group was significantly lower than that in the control group(P<0.05). Compared with before treatment, the scores of TCM symptoms in the two groups were significantly lower(P<0.05). After treatment, the scores of TCM symptoms in the treatment group were significantly lower than those in the control group, and the reduction rate of the score was significantly higher than that in the control group(P<0.05). Conclusion Shen'an Prescription combined with routine Western medicine can effectively improve renal function and reduce proteinuria in patients with CRF, and can significantly inhibit the progress of CRF, with obvious efficacy.
引文
[1]葛均波,徐永健.内科学[M].北京:人民卫生出版社,2013:526.
[2]周黎明.三种不同血液透析方法治疗慢性肾功能衰竭疗效观察[J].中国实用医刊,2015,42(12):98-99.
[3]HANCOCKWW.Thepast,present,andfutureofrenal xenotransplantation[J]. Kidney Int,1997,51(3):932-944.
[4]SAMSTEINB,PLATTJ.Physiologicandimmunologichurdles toxenotransplantation[J]. J Am Soc Nephrol,2001,12(1):182-193.
[5]齐长友.血液透析联合血液灌流治疗慢性肾功能衰竭的效果分析[J].河南医学研究,2018,27(9):1638-1639.
[6]孙文忠.血液灌流联合血液透析治疗慢性肾衰竭神经系统并发症的疗效[J].当代医学,2018,24(15):73-75.
[7]梁丽.中医治疗慢性肾功能不全进展[J].世界最新医学信息文摘,2015,15(57):46-47.
[8]陆再英,钟南山.内科学[M].北京:人民卫生出版社,2009:549.
[9]郑筱萸.中药新药临床研究指导原则(试行)[M].北京:中国医药科技出版社,2002:163-167.
[10]中华中医药学会肾病分会.慢性肾衰竭的诊断、辨证分型及疗效评定(试行方案)[J].上海中医药杂志,2006,40(8):8-9.
[11]王静.肾衰宁片治疗慢性肾功能不全的临床探讨[J].中国医药指南,2017,15(14):199.
[12]李兆华,钟巧诗,陈婉嫦,等.厄贝沙坦联合小柴胡颗粒在慢性肾功能不全患者中治疗对尿蛋白水平影响[J].中国医药科学,2017,7(5):48-51.
[13]林金松,卓宇苗,张文华.尿毒清颗粒联合还原型谷胱甘肽治疗慢性肾功能不全临床疗效及安全评价[J].青岛医药卫生,2017,49(1):46-47.
[14]高琛,赵刚.扶正祛邪法治疗慢性肾功能不全临床研究[J].辽宁中医药大学学报,2015,17(12):107-109.
[15]梁秀军.黄芪颗粒的药理作用及其在肾脏疾病中的临床应用[J].河北医药,2012,34(6):914-916.
[16]董春桃.丹参的药理作用与临床应用进展[J].山西医药杂志(下半月刊),2007,36(1):54-55.
[17]万贞元,王造昌,温月红,等.血尿素氮与肌酐联合血清胱抑素C与β2微球蛋白检测在肾功能损伤中的诊断应用[J].实验与检验医学,2014,32(5):595-596,605.
[18]付玉华,菅建国.血尿素氮、血肌酐与血清胱抑素C联合检测对肾功能损害程度的诊断价值研究[J].中国疗养医学,2017,26(5):466-468.
[19]向代军,张洪瑞,白洁,等.尿α1微球蛋白和β2微球蛋白对2~4期慢性肾病患者的诊断价值[J].检验医学与临床,2014,11(8):1011-1012,1015.
[20]刘红,马晶,王昌敏.尿轻链、尿微量清蛋白和尿α1-微量球蛋白联合检测在糖尿病早期肾损害中的临床意义[J].国际检验医学杂志,2017,38(21):2966-2967,2971.
[21]郭德明.慢性肾功能不全患者血清甲状旁腺激素水平的变化分析[J].中国临床新医学,2016,9(9):811-812.
[22]贾彦诺,高志华,徐然东,等.慢性肾衰竭继发性甲状旁腺功能亢进的相关因素分析及治疗[J].中国老年学杂志,2015,35(11):3182-3184.
[23]戴芳,董小伟,肖艳美.血清CysC, Hcy及PTH水平对慢性肾衰竭患者的临床作用[J].北华大学学报:自然科学版,2017,18(5):637-640.
[2]周黎明.三种不同血液透析方法治疗慢性肾功能衰竭疗效观察[J].中国实用医刊,2015,42(12):98-99.
[3]HANCOCKWW.Thepast,present,andfutureofrenal xenotransplantation[J]. Kidney Int,1997,51(3):932-944.
[4]SAMSTEINB,PLATTJ.Physiologicandimmunologichurdles toxenotransplantation[J]. J Am Soc Nephrol,2001,12(1):182-193.
[5]齐长友.血液透析联合血液灌流治疗慢性肾功能衰竭的效果分析[J].河南医学研究,2018,27(9):1638-1639.
[6]孙文忠.血液灌流联合血液透析治疗慢性肾衰竭神经系统并发症的疗效[J].当代医学,2018,24(15):73-75.
[7]梁丽.中医治疗慢性肾功能不全进展[J].世界最新医学信息文摘,2015,15(57):46-47.
[8]陆再英,钟南山.内科学[M].北京:人民卫生出版社,2009:549.
[9]郑筱萸.中药新药临床研究指导原则(试行)[M].北京:中国医药科技出版社,2002:163-167.
[10]中华中医药学会肾病分会.慢性肾衰竭的诊断、辨证分型及疗效评定(试行方案)[J].上海中医药杂志,2006,40(8):8-9.
[11]王静.肾衰宁片治疗慢性肾功能不全的临床探讨[J].中国医药指南,2017,15(14):199.
[12]李兆华,钟巧诗,陈婉嫦,等.厄贝沙坦联合小柴胡颗粒在慢性肾功能不全患者中治疗对尿蛋白水平影响[J].中国医药科学,2017,7(5):48-51.
[13]林金松,卓宇苗,张文华.尿毒清颗粒联合还原型谷胱甘肽治疗慢性肾功能不全临床疗效及安全评价[J].青岛医药卫生,2017,49(1):46-47.
[14]高琛,赵刚.扶正祛邪法治疗慢性肾功能不全临床研究[J].辽宁中医药大学学报,2015,17(12):107-109.
[15]梁秀军.黄芪颗粒的药理作用及其在肾脏疾病中的临床应用[J].河北医药,2012,34(6):914-916.
[16]董春桃.丹参的药理作用与临床应用进展[J].山西医药杂志(下半月刊),2007,36(1):54-55.
[17]万贞元,王造昌,温月红,等.血尿素氮与肌酐联合血清胱抑素C与β2微球蛋白检测在肾功能损伤中的诊断应用[J].实验与检验医学,2014,32(5):595-596,605.
[18]付玉华,菅建国.血尿素氮、血肌酐与血清胱抑素C联合检测对肾功能损害程度的诊断价值研究[J].中国疗养医学,2017,26(5):466-468.
[19]向代军,张洪瑞,白洁,等.尿α1微球蛋白和β2微球蛋白对2~4期慢性肾病患者的诊断价值[J].检验医学与临床,2014,11(8):1011-1012,1015.
[20]刘红,马晶,王昌敏.尿轻链、尿微量清蛋白和尿α1-微量球蛋白联合检测在糖尿病早期肾损害中的临床意义[J].国际检验医学杂志,2017,38(21):2966-2967,2971.
[21]郭德明.慢性肾功能不全患者血清甲状旁腺激素水平的变化分析[J].中国临床新医学,2016,9(9):811-812.
[22]贾彦诺,高志华,徐然东,等.慢性肾衰竭继发性甲状旁腺功能亢进的相关因素分析及治疗[J].中国老年学杂志,2015,35(11):3182-3184.
[23]戴芳,董小伟,肖艳美.血清CysC, Hcy及PTH水平对慢性肾衰竭患者的临床作用[J].北华大学学报:自然科学版,2017,18(5):637-640.