健脾补肾方联合西药治疗1～2期慢性肾脏病脾肾气虚蛋白尿多中心随机平行对照研究

The Cursive Effect of in the Treatment of Jianpi Bushen Decoction for the of Stage CKD1～2

[目的]观察健脾补肾方辨治1~2期慢性肾脏病脾肾气虚蛋白尿疗效。[方法]使用多中心随机平行对照方法,将236例门诊患者按随机数字表法随机分两组;注意休息,避免重体力劳动,清淡饮食等。对照组108例缬沙坦,80mg/d,口服。治疗组128例健脾补肾方(黄芪30g,党参、白术各20g,茯苓、猪苓、黄柏、山茱萸各15g,山药、淫羊藿各20g,菟丝子、丹参、川芎各15g,益母草、牡丹皮各12g,甘草9g;贫血加当归、阿胶各15g;水肿加薏苡仁30g,泽泻15g;血尿加茜草、大小蓟各12g;湿热盛加车前草、通草各15g),1剂/d,水煎400mL,早晚口服。连续治疗3个月为1疗程。观测临床症状、24h尿蛋白定量、eGFR、不良反应。治疗1疗程,判定疗效。[结果]治疗组临床控制47例,显效35例,有效26例,无效20例,总有效率84.40%;对照组临床控制24例,显效19例,有效22例,无效43例,总有效率60.20%;治疗组疗效优于对照组(P<0.05)。中医证候疗效治疗组优于对照组(P<0.05)。24h尿蛋白水平、eGFR治疗组降低优于对照组(P<0.01)。[结论]健脾补肾方辨治1~2期慢性肾脏病脾肾气虚蛋白尿,疗效满意,无严重不良反应,值得推广。

[Objective] To observe the cursive effect of in the treatment of Jianpi Bushen decoction for the of stage CKDl-2.[Method] Used the method of multicenter randomized parallel-group, according to random number table method, 236 cases of patients randomly divided into two groups; The control group of 108 cases, used valsartan, 80 mg/dl. Treatment group, 128 cases, used of Jianpi Bushen decoction （Radix astragali 30g, Dangshen, Atractylodes, Poria cocos, Grifola, Cortex Phellodendri ware each 20g, Fructus and Corni ware each 15g, Chinese yam and Epimedium ware each 20g, Dodder, salvia Miltiorrhiza, Rhizoma ligustici wallichii ware each 15g, Motherwort, Cortex moutan, Radix glycyrrhizae 9g, Anemia and angelica, Donkey-hide gelatin each 15g, Edema and Semen coicis 30g, Alisma 15g; Hematuria with madder, Big field thistle every 12g; Damp and Hot filled with plantain,Ricepaperplant pith each 15g）, 1/d, boiling water 400 ml, oral sooner or later. Treatment for 3 months ,Observation of clinical symptoms, 24h urine protein quantitative, eGFR, adverse reactions. As a course treatment, judge curative effect. [Result] The treatment group clinical control of 47 cases, 35 cases were markedly effective, effective 26 cases, 20 cases, total effective rate was 84.40%; 24 cases of control group in clinical control, 19 cases were markedly effective, 22 cases effectively, invalid 43 cases, total effective rate was 60.20%; The treatment group curative effect is better than that of control group （P〈0.05）. TCM syndrome curative effect of treatment group is better than that of control group （P 〈0.05）. 24h urine protein levels, eGFR treatment group lower than the control group （P〈0.01）. [Conclusion] The effect of in the treatment of Jianpi Bushen decoction for the of stage CKD1-2 was very dood, and no serious adverse reactions, it wasworthy of promotion.