肾济方治疗慢性肾衰竭的临床观察和疗效机制研究

Clinical Observation and Research of Shenji Prescription′s Effective Mechanism for Treating Chronic Renal Failure

目的:通过观察肾济方对慢性肾衰竭(CRF)的治疗效果,来探讨其作用机制,为慢性肾衰竭的临床治疗提供理论基础。方法:将100例符合标准的脾肾阳虚、浊瘀毒结型CRF患者随机分为治疗组和对照组各50例,对照组采用西医常规治疗,治疗组在对照组治疗基础上加服肾济方,对两组临床治疗效果进行比较,并观察两组治疗前后中医证候积分、生存质量评分、肾功能及血清ADM、TGF-β1、IL-6、ET-1水平的变化。结果:治疗组总有效率占90.0%,对照组总有效率占76.0%,两组比较有显著性差异(P<0.05);两组均能显著降低中医证候积分,提高生存质量评分,改善肾功能,且治疗组优于对照组(P<0.05或P<0.01),两组均能显著降低血清ADM、TGF-β1、IL-6、ET-1水平,且治疗组优于对照组(P<0.05或P<0.01)。结论:肾济方能显著改善患者的肾功能和临床症状,提高患者的生存质量,值得临床推广应用。

Objective：To study the mechanism of Shenji Prescription and supply theoretical basis of clinical treatment for CRF according to observe the therapeutic effect of Shenji Prescription for treating CRF. Methods ： 100 CRF patients with deficiency of spleen and kidney and blood-stasis and toxin, randomly divided into 50 cases of the treatment group, treated by routine western medicine and 50 cases of the control group, taken Shenji Prescription orally in addition to the standard treatment to compare the therapeutic effect of the two groups and observe the scores of TCM syndrome and the quality of life , renal function and the changes of the levels of serum ADM ,TGF-β1, IL-6 ,ET-1 before and after treatment. Results：The total effect of the treatment group is 90. 0% ,the total effect of the control group is 76. 0%, there is significant difference between the two groups （ P 〈 0.05 ）. Both groups can significantly reduce the scores of TCM syndrome and boost the scores of the quality of llfe, improve the kidney functions,the effect in the treatment group is superior to that in the control group （P 〈0. 05 or P 〈0. 01 ）. Both groups can signifi- cantly reduce the levels of serum ADM,TGF-β1, IL-6,ET-1 ;The effect in the treatment group is superior to that in the control group （P 〈 0.05 or P 〈 0. 01 ）. Conclusion：Shenji Prescription can significantly improve renal functions and clinical symptoms and the life quality of CRF patients,it can be used extensively in clinic.