桂蓉汤辅助西药治疗慢性肾衰竭的临床研究

A Clinical Study of Guirong Decoction Adjuvant to Western Medicine in Treatment of Chronic Renal Failure

目的观察桂蓉汤辅助西药治疗慢性肾衰竭的临床疗效。方法选取86例慢性肾功能衰竭患者,按随机数字表法分为观察组与对照组,每组各43例。对照组采取西药对症治疗,观察组在对照组基础上联合桂蓉汤治疗,两组均治疗6个月。比较两组治疗总有效率、治疗前后的中医证候积分(主症积分、次症积分和总积分)、肾功能指标[内生肌酐清除率(Ccr)、血肌酐(Scr)及血尿素氮(BUN)]、随访终点时的终末期肾衰竭(ESRD)发生率并观察不良反应发生情况。结果治疗后两组中医证候各项积分、血清BUN、Scr水平均较治疗前下降,血清Ccr水平较治疗前升高,差异有统计学意义(P<0.05)。观察组治疗后的中医证候各项积分、血清BUN、Scr水平均低于对照组,血清Ccr水平高于对照组,差异有统计学意义(P<0.05或P<0.01)。观察组治疗总有效率高于对照组,差异有统计学意义(P<0.05)。观察组ESRD发生率低于对照组,差异有统计学意义(P<0.05)。两组患者治疗期间均未发生严重不良反应。结论桂蓉汤辅助西药治疗慢性肾衰竭可有效改善患者肾功能,缓解病情,并延缓病理进展,效果理想,值得推广。

Objective To observe the clinical efficacy of Guirong Decoction adjuvant to Western medicine in the treatment of chronic renal failure. Methods A total of 86 patients with chronic renal failure were equally divided into observation group and control group using a random number table. Both the control group and the observation group were treated with Western medicine for 6 months, while the observation group received Guirong Decoction in addition. The overall response rate, traditional Chinese medicine （TCM） syndrome scores （main syndrome score, secondary syndrome score, and total score）, renal function indices （creatinine clearance rate （Ccr）, serum creatinine （SCr）, blood urea nitrogen （BUN）） before and after treatment, and incidence of end-stage renal disease （ESRD） at the end of follow-up were compared between the two groups. The incidence of adverse reactions was observed. Results After treatment, both groups had significantly lower TCM syndrome scores, serum BUN levels, and SCr levels and significantly higher serum Ccr levels （P〈0.05）. The observation group had significantly lower TCM syndrome scores, serum BUN level, and Scr level and a significantly higher serum Ccr level than the control group （P〈0.05 or P〈0.01）. The overall response rate was significantly higher in the observation group than in the control group （P〈0.05）, while the incidence of ESRD was significantly lower in the observation group than in the control group （P〈0.05）. No severe adverse reactions were observed in either group. Conclusion In the treatment of chronic renal failure, the Guirong Decoction adjuvant to Western medicine can effectively improve the patients＇ renal function, relieve the disease, and delay the pathological progress. The combination therapy achieves satisfactory treatment outcomes, which holds promise for clinical application.