罗氏肾病三号方对慢性肾脏病4期患者的临床疗效

Clinical Observation of Using LUO′s Kidney Disease Decoction Ⅲ to Treat CKD Phase 4

目的:评价广东省名中医罗仁教授临床经验方罗氏肾病三号方治疗中医辨证为脾肾两虚、瘀热互结型的慢性肾脏病4期患者的有效性及安全性。方法:在2015年3月—2016年6月随师罗仁教授门诊期间收集慢性肾脏病4期且中医证型符合脾肾两虚、瘀热互结病例60例,收集患者临床资料,观察患者治疗前后24 h尿蛋白定量(24 hpro)、血尿素氮(BUN)、血清肌酐(Scr)、血尿酸(UA)、胱抑素C(Cys-C)的变化及中医证候、体征的变化等指标,对临床安全性及疗效、用药规律进行总结。结果:共收集慢性肾脏病4期患者60例,患者服用罗氏肾病三号方3～4周,与治疗前相比,治疗后患者血肌酐和血尿素氮得到明显改善(P<0.05),24 h尿蛋白定量及胱抑素C较治疗前均明显下降(P<0.05),总有效率为78.3%。随访患者的肌酐清除率和血肌酐水平基本保持稳定。结论:罗氏肾病三号方治疗慢性肾脏病4期患者具有较好的有效性和安全性。

Objective:To evaluate the efficacy and safety of Kidney Disease Decoction Ⅲ from LUO Ren who is a clinical professor of Guangdong Province in treating chronic kidney disease(CKD) at phase 4 with spleen and kidney deficiency and blood stasis type.Methods:From March 2015 to June 2016,60 CKD4 patients with spleen and kidney deficiency and blood stasis type were collected during the outpatient department.The clinical data was collected before and after treatment including the 24 h urinary protein(24 hpro),blood urea nitrogen(BUN),serum creatinine(Scr),serum uric acid(UA),cysteine C(Cys-C) and changes of symptoms to summarize the clinical safety and efficacy of this drug.Results:A total of 60 patients with chronic kidney disease were enrolled in this study.The patients were treated with LUO′s Kidney Disease Decoction Ⅲ for 3 to 4 weeks.We compared serum creatinine and blood urea nitrogen with those before treatment and they were significantly improved(P<0.05).Urine protein quantification and cystatin C were significantly decreased(P<0.05).The total effective rate was 78.3%.Patients creatinine clearance and serum creatinine levels in the follow-up period remained stable.Conclusion:LUO′s Kidney Disease Decoction Ⅲ had obvious clinical curative effect in the treatment of spleen and kidney deficiency and blood stasis type in patients with CKD4.It has a certain clinical significance in reducing proteinuria and improving renal function.It can delay chronic renal failure.