中药对慢性肾衰竭氮质血症及肾血流参数的影响

The Effect of Chinese Herbs on Renal Function and Renal Blood Flow Prameter in Chronic Renal Failure

目的 :探讨中药参麦注射液及复方丹参注射液对慢性肾衰 (CRF)病人血尿素氮、肌酐的治疗作用及其延缓CRF的机制。方法 :1992年～ 1999年本院肾科住院病人 148例 ,BUN11～ 42mmol/L ,Scrl177～ 44 2 μmol/L ,Ccr10～ 2 5ml/min之间。入院后随机分为两组 ,参麦组 (SMI) 76例 ,复方丹参组 (FDI) 72例 ,分别使用参麦注射液或复方丹参注射液 2 0ml,加入 5 %葡萄糖液中静脉滴注 ,每日 1次 ,15d为一疗程。定期复查血象、肝肾功能、彩色多普勒能量图 (CDPI) ,检测肾血流参数、收缩期峰值 (Vmax)、舒张末期流速 (Vmin)、肾血管阻力指数 (RI) ,随访 3年 ,并作相关分析。结果 :治疗后两组病人临床症状均有明显改善 ,BUN、Scr均有降低 ,但参麦组更为明显 ,总有效率 93.4% ;RI与BUN相关系数分别为 0 .78,0 .6 1;Vmin与BUN、Scr的相关系数分别为 - 0 .91、- 0 .75 ;3年后 ,SMI组 86 .4%的病人病情稳定 ,未进入尿毒症期 ;FDI组有 6 2 .4%的病人Scr稳定在 177～ 44 2 μmol/L之间。 结论 :中药SMI、FDI均是治疗CRF有效药物 ,SMI更为明显 ,其改善氮质血症及延缓CRF的进展机制与改善肾动脉血流参数Vmax、Vmin及RI有关。彩色多普勒能量图不仅对肾血流参数的诊断很有价值 ,而且对治疗效果的监测和指导用药也很有意义。

Objective: To investigate the therapeutic effect of Shen Mai and Compound Danshen Injections on the renal function and renal blood flow parameter in patients with chronic renal failure.Methods:Out of the 148 hospitalized cases,76 cases were treated with Shen Mai Injection and 72 with Compound Danshen Injection from 1992 to 1999.The treatment was provided once daily for 15 days(one therapeutic course).The blood picture,hepatic and renal functions,and color Doppler power imaging (CDPI) were tested or performed regularly.A follow-up of three years was made and the related data were analyzed.Results:After the treatment,clinical symptoms were found improved in both groups.BUN and Scr were found both lower than before.However,the effect was more marked in the Shen Mai group with a therapeutic effect rate of 93.4%.Three years later,86.4% of the patients in the Shen Mai group were found still stable in disease condition,while 62.4% of the patients in Danshen group had a Scr level between 177-442 μmol/L.Conclusion:Both Shen Mai and Dan Shen are effective drugs in the treatment of chronic renal failure.However the former was found more efficient.Color Doppler power imaging (CDPI) was not only valuable to the diagnosis of renal blood flow parameter in patients with chronic renal failure,but also very significant in monitoring the therapeutic effect and in guiding the drug administration.