丹参和黄芪注射液联用对慢性肾脏病基础上急性肾损伤的影响

Effect of salvia miltiorrhiza and astragalus membranaceus for auxiliary treatment of patients with acute kidney injury on chronic kidney disease

目的观察丹参和黄芪注射液联用对慢性肾脏病(CKD)基础上急性肾损伤(AKI)(A/C)的影响。方法将75例A/C患者随机分为试验组39例和对照组36例,在常规治疗基础上,治疗组加用丹参注射液及黄芪注射液治疗,而对照组仅予常规治疗,两组均动态观察患者治疗前及治疗后肾功能、血红蛋白、血清白蛋白、肝功能及电解质等的变化,并动态监测尿量,比较两组患者临床疗效。结果两组肾功能均有一定改善,治疗组总有效率达69.23%,而对照组为44.45%,两组比较差异有统计学意义(P<0.05)。治疗组治疗后血肌酐(Scr)的水平均明显下降,治疗前后比较差异具有统计学意义(P<0.01),而对照组治疗前后Scr的水平则无明显变化,差异无统计学意义(P>0.05);肾功能开始恢复时间治疗组为(8.3±2.3)d,对照组为(13.2±3.4)d,两组比较差异有统计学意义(P<0.05)。但两组治疗前后血常规、电解质、尿蛋白、肝功能、血脂、C反应蛋白(CRP)指标无明显改变(P>0.05)。结论丹参和黄芪注射液联用可能更有利于改善CKD基础上出现AKI的微循环,减轻肾脏损害,争取在短时间内改善肾功能,对延缓CKD的进展和改善预后有重要意义。

Objective To evaluate the effect of salvia miltiorrhiza and astragalus membranaceus for auxiliary treatment of patients with acute kidney injury (AKI) on chronic kidney disease (CKD).Methods A randomized study was performed in patients with AKI on CKD from Shanghai 8th People′s Hospital from July 2008 to April 2011.To receive salvia miltiorrhiza and astragalus membranaceus combined with regular treatment in the treatment group or regular treatment alone in the control group.The proteinuria,kidney function,liver function and others index of laboratory tests in the patients were examined and compared before and after 2 weeks treatment.Results The kidney function were improved after treatment in both groups,The total effective rate was 69.23% in treatment group,which were higher than those in control group(P<0.05).The levels of serum creatinine (Scr) from treatment group obviously decreased after the treatment(P<0.05).The renal function recovery time in treatment group was markedly earlier than that in control group(P<0.05),while the levels of hemoglobin (Hb),white blood cell count (WBC) and serum electrolytes showed no significant changes after the treatment in both groups(P>0.05).Conclusions Salvia miltiorrhiza and astragalus membranaceus have obvious effect on improvement of kidney function in patients with AKI on CKD,they can effectively delay the deterioration of kidney functions.