健脾补肾地龟汤治疗慢性肾脏病3～4期营养不良的临床研究

Clinicalstudy on Jianpi Bushen Digui Decoction for the treatment of malnutrition in stage 3-4 of chronic kidney disease and the effects of CRP

目的观察健脾补肾地龟汤治疗慢性肾脏病(CKD)3~4期营养不良患者的疗效。方法选取CKD 3~4期营养不良患者90例,按随机数字表法分为对照组和治疗组各45例。2组均给予基础治疗。对照组加用复方α酮酸片治疗,每次4粒,每日3次;治疗组加用健脾补肾地龟汤,治疗2个月。观察治疗前后2组临床症状、SGA评分、肾功能、血清白蛋白(Alb)、血红蛋白(Hb)、C反应蛋白(CRP)、转铁蛋白(TF)、前白蛋白(PA)、红细胞(RBC)计数、网织红细胞(RET)绝对值等指标变化。结果与对照组相比,治疗组血肌酐(Scr)、24 h尿蛋白(24 h Upr)明显下降(P<0.01);营养不良状态明显改善;血清Alb、Hb明显升高(P<0.05);症状评分及SGA评分显著降低(P<0.05);CRP明显下降(P<0.05)。结论健脾补肾地龟汤能改善患者营养不良状况,保护肾功能,下调CRP水平。

Objective To observe the curative effect of Jianpi Bushen Degui Decoction on malnutrition in chronic kidney disease（CKD） of stage 3-4.Methods 90 CKD patients of stage 3-4 with malnutrition were randomly divided into the control group and treatment group according to random number table,each with 45 cases.Both of two groups were given basic treatment.The control group was added with compound alpha keto acid tablets,4 tablets each time,3 times a day;the treatment group was added with Jianpi Bushen Digui Decoction for 2 months.The changes of clinical symptoms,SGA scores,renal function,serum albumin（Alb）,hemoglobin（Hb）,CRP,transferrin（TF）,prealbumin（PA）,red blood cell count（RBC）,reticulocyte（absolute value of RET）were observed before and after the treatment.Results Compared with the control group,serum creatinine（Scr）,24 h Upr were decreased significantly（P〈0.01）,the malnutrition status improved significantly,serum Alb and Hb increased significantly（P〈0.05）,the symptom scores and SGA scores reduced（P〈0.05）,CRP decreased significantly（P〈0.05） in the treatment group.Conclusion Jianpi Bushen Digui Decoction can improve the malnutrition of patients,protect the renal function,and reduce the level of CRP.