中医综合方案治疗老年慢性肾衰竭的疗效研究

Clinical Research on Synthesized Traditional Chinese Medicine Treatment for Elderly Chronic Renal Failure

目的:对本中心750例老年慢性肾衰患者进行回顾性分析,以评价中医综合治疗对老年肾衰竭的疗效。方法:对本中心慢性肾病数据库进行检索,筛选2009年10月1日~2010年9月30日间eGFR≤60ml·min^(-1)·1.73 m-2的老年患者。对纳入患者进行分组,计算eGFR的年变化率、替代治疗及死亡的发生情况。结果:随访的中位数时间为3.64年,随访结束时eGFR水平为44.21 ml·min^(-1)·1.73 m-2(24.35,59.85),较入组时45.82 ml·min^(-1)·1.73 m-2(33.74,52.76)有轻微的下降,但差异无统计学意义;但血清肌酐、尿素氮、胱抑素C、白蛋白的差异均有统计学意义。eGFR的年变化率为-0.48 ml·min^(-1)·1.73 m-2/a,其中201例(26.80%)患者的eGFR年变化率>3 ml·min^(-1)·1.73 m-2/a。共24例(3.2%)进入肾脏替代治疗、死亡87例(11.6%)。结论:中医药综合治疗可以改善肾功损害的发展趋势,延缓病情进展、提高肾存活率,延长达到肾脏替代治疗的时间。

Objective： A retrospective analysis of 750 cases of elderly patients with chronic renal failure, in order to evalu- ate the efficacy of Synthesized TCM treatment for the elderly renal failure. Methods： We examined the change in estimated glomerular filtration rate （eGFR） , incidence of Renal replacement therapy and deathamongcases from our Chronic Kidney Disease Database with eGFR≤60 ml·min^-1 followed for a mean of 3.64 years. Results：At the end of follow - up, the level of eGFR was 44.21 ml·min^-1 · 1.73 m -2 （24.35, 59.85 ） , compared with 45.82 ml·min^-1 . 1.73 m-2 at beginning, which was slightly decreased, but not statistically significant. There were significantdifferences of serum creatinine, urea nitrogen, albumin, Cystatin C before and after treatment. The annual change rate of eGFR was -0.48 ml·min^-1 . 1.73 m-2 , of which 201 patients （26.80%） had a change more than 3 ml·min^-1 · 1.73 m^-2/a. A total of 24 patients （3.2%） were treated with renal replacement therapy and 87 cases （11.6% ） died. Conclusion ：Combined treatment of TCM can improve the development trend of renal damage, delay the pro- gress of the disease, improve the survival rate, and prolong the time of renal replacement therapy.