黄葵胶囊联合健脾益肾方对慢性肾脏病脾肾阳虚型患者的疗效观察

Effect of Huangkui capsule combined with Jianpiyishen decoction on CKD patients with Pishengyangxu syndrome

目的观察黄葵胶囊联合健脾益肾方对慢性肾脏病(CKD3-4期)脾肾阳虚型的临床疗效。方法 58例患者随机分为治疗组(28例)和对照组(30例),两组患者均接受西医基础治疗及自拟健脾益肾方治疗,方剂1剂/d,100 ml/次煎服,2次/d,连用3个月,治疗组在此基础上加黄葵胶囊治疗,5粒/次口服,3次/d,连用3个月。于治疗前、治疗3个月时检测血液相关指标:Hb、Alb、TC、TG、BUN、Cr、UA、eGFR、CRP及β2微球蛋白(β2-MG)、血清超氧化物歧化酶(SOD)、丙二醛(MDA)、内皮素(ET)、一氧化氮(NO)。结果治疗前以上两组相关指标差异无统计学意义(P﹥0.05);治疗后两组收缩压、舒张压、TC、TG、BUN、Cr、UA、β2-MG、CRP、MDA、ET显著降低,Hb、Alb、NO、SOD、eGFR显著升高,差异均有统计学意义(P<0.05);与对照组比较,治疗组于治疗3个月后舒张压、TC、TG、BUN、Cr、UA、β2-MG、CRP、MDA、ET降低更明显,Hb、Alb、NO、SOD、eGFR升高更明显,差异均有统计学意义(P<0.05)。治疗3个月后,治疗组中医脾肾阳虚型主证表现消失,标实证表现明显减少,尤以湿热证减少明显;对照组脾肾阳虚型主证及标实证表现减少。结论黄葵胶囊联合健脾益肾方治疗慢性肾脏病(CKD3-4期)脾肾阳虚型合并湿热的临床疗效优于单纯使用健脾益肾方。

Objective To observe the clinical effect of Huangkui capsule combined with Jianpiyishen decoction on chronic kidney disease（ CKD stage 3-4） patients with Pishengyangxu syndrome.Methods 58 patients were randomly divided into treatment group（ 28 cases） and control group（ 30 cases）.Both groups received the basic treatment of western medicine and the Jianpiyishen recipe（ 1 dose / day,decoction 100 ml / time,twice a day for 3 months）. The treatment group was added with oral Huangkui capsule,5 capsules / time,thrice a day for 3 months. Before treatment,and 3 months after the treatment,the following were detected： Hb,Alb,TC,TG,BUN,Cr,UA,e GFR,C-reactive protein（ CRP）,beta2 microglobulin（ β2-MG）,serum superoxide dismutase（ SOD）,malondialdehyde（ MDA）,endothelin（ ET）,and nitric oxide（ NO）. Results Compared with the control group,the treatment group showed significantly higher levels of Hb,Alb,NO,SOD,and e GFR（ P〈0. 05） 3 months after the treatment,but showed significantly lower levels of TC,TG,BUN,Cr,UA,CRP,MDA,β2-MG,ET,and DBP（ P〈0. 05）,with all the differences being statistically significant. Both the primary and secondary manifestations of TCM Pishengyangxu syndrome disappeared,and the secondary sthenia syndrome manifestations were reduced.Conclusion The effect of Huangkui capsule combined with Jianpiyishen formula on CKD（ stage 3-4） patients with Pishengyangxu syndrome was better than that of Jianpiyishen recipe alone.