活血化瘀法对肾移植术后急性肾小管坏死临床疗效影响的初步探索

Effect of Blood-activating and Stasis-removing Method for Acute Tubular Necrosis After Kidney Transplantation

[目的]探讨活血化瘀针剂香丹注射液对肾移植术后急性肾小管坏死(ATN)的影响。[方法]将肾移植术后发生ATN的26例患者分为治疗组(16例)和对照组(10例),两组均使用环孢素A、泼尼松、霉酚酸酯三联免疫抑制治疗和血液透析治疗,并根据需要采用护肝、保护胃粘膜及预防感染等治疗措施,治疗组在此基础上加用香丹注射液静脉滴注治疗,对照组不加用香丹注射液治疗。比较两组在出现急性肾小管坏死后的透析治疗时间、肾功能恢复情况、移植肾血流阻力指数(RI)等指标。[结果]与对照组比较,治疗组透析治疗时间明显缩短(P<0.05),移植肾的血清肌酐下降速度快(P <0.05),血流阻力指数较低(P<0.05)。治疗组在3个月内发生2例次急性排斥反应(AR),对照组发生1例次AR,两者比较差异无显著性意义(P>0.05)。[结论]活血化瘀针剂香丹注射液能促进肾移植术后急性肾小管坏死的早期恢复。

[ Objective] To observe the effect of Xiangdan injection with the actions of activating blood and removing stasis for the treatment of acute tubular necrosis （ATN） after kidney transplantation. [Methods] Twenty-six patients with ATN after kidney transplantation were randomized into groups A and B. The two groups were treated with triple immunosuppressive agents of cyclosporin A, prednisone and mycophenolic acid, with medicines for protecting liver function and gastric mucosa, and with preventive measures from infection. Additionally, group A （n = 16） was treated with Xiangdan injection, while group B （ n = 10） was not. After treatment, time for hemodialysis, renal function and renal flow resistance index of the transplanted kidney were compared between the two groups after the occurrence of ATN. [Results] Compared with group B, time for hemodialysis was shortened, the decrease of serum creatine （SCr） in the transplanted kidney quickened, and renal flow resistance index （RI） of the transplanted kidney decreased （P 〈 0.05）. Three months after treatment, acute rejection occurred in 2 patients in group A, and 1 in group B, the difference being insignificant （ P 〉 0.05）. [Conclusion] Xiangdan injection with the actions of activating blood and removing stasis can promote the early recovery of ATN after kidney transplantation.