肾衰方对CKD4期慢性肾衰患者肾功能及钙磷代谢的影响

Effect of Renal Failure Recipe on Renal Function and Calcium and Phosphorus Metabolism in Patients with CKD4 Chronic Renal Failure

目的:评价肾衰方改善CKD4期慢性肾衰患者肾功能及钙磷代谢的临床疗效。方法:选取慢性肾脏病4期(脾肾气虚、瘀血阻滞型)患者60例,随机分为两组:对照组和治疗组,前者给予西医一体化治疗,后者在前者的基础上加用肾衰方,治疗6个月后,观察两组患者临床疗效、中医证候积分、肾功能、24 h尿蛋白定量、钙、磷、1,25(OH)2D3、甲状旁腺、血清FGF-23的变化。结果:治疗后,治疗组临床疗效明显优于对照组(P<0.05),在降低中医证候积分、减少24h尿蛋白定量、降低尿素氮、肌酐、提高肾小球滤过率方面优于对照组(P<0.05)。治疗组在降低血磷、改善继发性甲状旁腺功能亢进方面优于对照组(P<0.05)。结论:肾衰方在治疗脾肾亏虚、瘀血阻滞型CKD4期患者较对照组有明显的临床疗效,能减少蛋白尿、改善肾功能、降低血磷,改善甲状旁腺功能亢进,能延缓慢性肾功能衰竭,具有一定的临床意义。

Objective：To evaluate renal function and calcium phosphate metabolism in patients with CKD4 chronic renal fail- ure. Methods：We selected （spleen and kidney deficiency, blood stasis type） 60 cases of patients with No. 4 chronic kidney disease and divided into 2 groups ： control group and treatment group. The former were given the integration treatment of Western Medicine and the latter on the basis of the former used Renal Failure Recipe. After 6 months treatment,we observed changes in two groups＇ clinical curative effect, TCM syndrome integral, renal function, 24 hours urinary protein quantity, calcium, phosphorus, 1,25 （OH） 2 D3, parathyroid and serum FGF - 23. Results ： After treatment, the clinical efficacy of the treatment group was significantly better than the control group （ P 〈 0. 05 ）. Compared with the control group （ P 〈 0. 05 ）, treatment group＇ s reduction of TCM syn- drome score, urinary protein in 24 hours, urea nitrogen, creatinine and increasion of glomerular fihration rate were significant. The treatment group was better than the control group（P 〈 0. 05 ） in reducing blood phosphorus and improving parathyroid function. Conclusion：Renal Failure Recipe had obvious clinical curative effect in the treatment of spleen and kidney deficiency and blood stasis type in patients with CKD4 than the control group. It has a certain clinical significance in reducing proteinuria, improving renal function, decreasing serum phosphorus and increasing the parathyroid function. It can delay chronic renal failure.