益肾健脾活血泄浊法治疗慢性肾功能衰竭临床研究

Clinical Study on Method of Reinforcing the Kidney and Invigorating the Spleen and Method of Activating Blood and Draining Turbid Downward for Chronic Renal Failure

目的:观察益肾健脾、活血泄浊法治疗慢性肾功能衰竭的临床疗效。方法:将96例患者随机分为2组,对照组36例给予单纯西药常规治疗,治疗组60例在对照组治疗的基础上加用肾衰康口服及大黄附子灌肠方保留灌肠,2月为1疗程,共治2疗程。观察2组临床疗效,检测2组治疗前后血肌酐(SCr)、尿素氮(BUN)、内生肌酐清除率(CCr)、血红蛋白(Hb)、24 h尿蛋白定量(UTP)的变化。结果:总有效率治疗组为78.33%,对照组为69.44%,2组比较,差异有统计学意义(P <0.05)。治疗后2组患者UTP降低,Hb升高,与治疗前比较,差异均有统计学意义(P <0.05);且治疗组UTP、Hb改善较对照组更显著(P <0.05)。治疗后2组患者SCr较治疗前降低(P <0.05,P <0.01),CCr较治疗前升高(P <0.05);且治疗组SCr、CCr改善较对照组更显著(P <0.05)。治疗后治疗组BUN下降明显,与治疗前及对照组治疗后比较,差异均有统计学意义(P <0.05)。对照组治疗后BUN不降反升,与治疗前比较,差异有统计学意义(P <0.05)。结论:在常规西药治疗的基础上联合益肾健脾、活血泄浊法治疗慢性肾功能衰竭,可以延缓患者肾功能损害的进展,升高血红蛋白,疗效优于单纯西药治疗。

Objective： To observed the clinical effect of the method of reinforcing the kidney and invigorating the spleen and the method of activating blood and draining turbid downward for chronic renal failure. Methods： Divided 96 cases of patients into the control group and the treatment group randomly, 36 and 60 cases respectively in each group. The control group received routine western medicine for treatment, while the treatment group additionally was treated with the oral administration of Shenshuaikang and received retained clyster of Dahuang Fuzi clyster prescription based on the treatment of the control group. The two groups were treated for two courses, two months being a course. Observed the clinical effect, and detected the changes of serum creatinine（SCr）, blood urea nitrogen（BUN）, endogenous creatinine clearance rate（CCr）, hemoglobin（Hb） and 24 h urine total protein（UTP）before and after treatment in the two groups. Results：The total effective rate was 78.33% in the treatment group and was 69.44% in the control group, the difference being significant（P〈0.05）. After treatment, UTP was decreased and hemoglobin was increased in the two groups when respectively compared with that before treatment, differences being significant（P〈0.05）, and the improvement of UTP and Hb in the treatment group was more obvious than that in the control group（P〈0.05）. After treatment, levels of SCr in the two groups were decreased when compared with those before treatment（P〈0.05, P〈0.01）,while levels of CCr were increased when compared with those before treatment（P〈0.05）,and the improvement of SCr and CCr in the treatment group was more obvious than that in the control group（P〈0.05）. After treatment,BUN in the treatment group was decreased more obviously when compared with that before treatment and that in the control group after treatment,differences being significant（P〈0.05）. After treatment, BUN in the control group was increased when compared with that before treatment, the difference being significant（P〈0.05）. Conclusion： The therapy of basic western medicine combined with the method of reinforcing the kidney and invigorating the spleen and the method of activating blood and draining turbid downward for chronic renal failure can delay the development of kidney dysfunction and increase hemoglobin of patients,whose curative effective is better than that of simple western medicine.