肾衰颗粒治疗CKD4期临床疗效观察

Clinical Observation of Using Shenshuai Granule to Treat CKD Phase 4

目的:评价肾衰颗粒治疗慢性肾脏病4期(chronic kidney disease,CKD4)脾肾阳虚、湿热互结证的临床疗效与安全性。方法:将60例CKD4期辨证为脾肾阳虚、湿热互结证患者随机分为对照组(西医基础治疗)30例及试验组(在对照组治疗的基础上,服用肾衰颗粒)30例,连续治疗8个月,观察两组肾功能(eGFR、Scr、Ccr、BUN)、24h尿蛋白定量(24hpro)、血红蛋白(Hb)、血清白蛋白(Alb)、二氧化碳结合率(CO2CP)、肝功能(ALT、AST)、电解质(K、Na、Cl、Ca、P)、血清胱抑素C(Cys c)的变化及中医症候、体征的变化等指标。结果:试验组治疗后肾功能、血清胱抑素C、血红蛋白、血清白蛋白与治疗前相比,呈好转趋势(P<0.05);试验组eG-FR、Scr、Ccr治疗前后差值同对照组相比有显著差异(P<0.01)。两组治疗后24h尿蛋白定量较治疗前均明显下降(P<0.05);两组肝功能、二氧化碳结合率、电解质等指标较治疗前差值无统计学意义(P>0.05);试验组较对照组能够明显减少各症状积分。结论:肾衰颗粒可以改善CKD4期脾肾阳虚、湿热互结证患者的肾功能、24h尿蛋白定量、血红蛋白、血清白蛋白、血清胱抑素C,减轻中医症候、体征,最终延缓慢性肾脏病进展、提高生活质量,减少纯西药治疗带来的不良反应。

Objective： To evaluate the clinical efficacy and safety of shenshuai granule in treating chronic kidney disease（CKD） 4 period with Yang asthenia and damp heat of both spleen and kidney.Methods： 60 patients of CKD4 with Yang asthenia and damp heat of both spleen and kidney,were randomly divided into two guoups.30 cases in the control group were only accept Western-based treatment,the experimental group（n=30） were treated with shenshuai granule based on Western-based treatment,both groups treat continuously for 8 months.The clinical effect included the changes of eGFR,Scr,BUN,24hpro,Hb,Alb,CO2CP,K、 Na、Cl、 Ca、P,cystatin C,and the symptoms,signs of traditional Chinese medicine.Results： The renal function,cystatin C,Hb,Alb were significantly improved in comparison with that before treatment in experimental group（P0.05）;The eGFR,Scr,Ccr of treatment group had significant difference compared with the control group before and after treatment（P0.01）;24hpro after treatment was decrease than that before treatment in both groups;The liver function,CO2CP,electrolyte（K、 Na、Cl、 Ca、P） of Two groups was not statistically significant（P0.05） than that before treatment;test group significantly reduced compared with the control group to the symptom score.Conclusion： The shenshuai granule can improve eGFR,Scr,BUN,24hpro,Hb,Alb,cystatin C and the symptoms of the traditional Chinese medicine in CKD4 with Yang asthenia and damp heat of both spleen and kidney.It not only can delay progression of CKD and improve the quality of life,but also reduce the adverse reactions of single western medicine treatment ultimately.