益气活血化痰方预防冠脉造影后造影剂肾病的临床研究

Clinical study on qi-benefiting blood-activating phlegm-resolving prescriptions for the prevention of contrast-induced nephropathy after coronary angiography

目的探讨中药益气活血化痰方对冠状动脉介入治疗术(PCI)患者造影剂肾病(CIN)的防治作用。方法选择100例接受冠脉造影及PCI治疗的患者,随机分为中药治疗组和对照组各50例,所有行冠脉造影及PCI术患者术前及术后10 h均进行围术期肾功能保护,包括抗血小板、抗凝、调脂、水化治疗,中药治疗组在此基础上加服益气活血化痰中药汤剂。检测所有患者术前以及术后48 h血肌酐(SCr)水平。结果术后48 h及1周后,2组患者SCr比较差异无统计学意义,但差异逐渐增大。100例患者中11例发生CIN,其中中药治疗组2例(4.67%),对照组9例(18.00%)。中药治疗组发病率低于对照组,2组比较差异有统计学意义(P=0.05)。结论中药益气活血化痰方能降低造影患者SCr水平以及CIN发病率。

Objective To study the prevention and treatment of qi-benefiting blood-activating phlegm-resolving prescriptions for contrast-induced nephropathy（ CIN） in patients after percutaneous coronary intervention（ PCI）. Methods 100 patients who had received coronary angiography and PCI were randomly divided into two groups： Chinese herbal medicine group and the control group of50 each. All of them were given perioperative kidney protection before and 10 hours after the operation, including antiplatelet aggregation,the Chinese herbal medicine group was also given qi-benefiting blood-activating phlegm-resolving prescriptions. The serum creatinine（ SCr） levels were measured before,48 hours after percutaneous coronary intervention. Results The differences of SCr between the two groups 48 h and one week after the operation had no statistical significance,but it became gradually enlarged. Among100 cases of patients,CIN occurred in 11 cases,of them,2 from the Chinese herbal medicine group（ 4. 67%）,9 from the control group（ 18. 00%）. The incidence of CIN in the Chinese herbal medicine group was significantly lower than that in the control group,the difference between the two groups was statistically significant（ P = 0. 05）. Conclusion Qi-benefiting blood-activating phlegmresolving prescriptions can reduce SCr level and CIN incidence for patients with radiography