中医综合疗法治疗早期慢性肾衰竭的疗效观察

Therapeutic effect of traditional Chinese medicine comprehensive therapy on early chronic renal failure

目的观察中医综合疗法治疗早期慢性肾衰竭的临床疗效。方法将160例早期慢性肾衰竭患者按照随机数字表法分为2组。治疗组80例在常规治疗基础上联合中药内服+灌肠+离子导入中医综合疗法治疗;对照组80例在常规治疗基础上联合包醛氧淀粉治疗。2组均治疗3个月后统计疗效,比较2组治疗前后中医症状疲倦乏力、腰膝痠软、纳差呕恶、夜尿清长、大便干结、脘腹胀满及水肿评分变化情况,比较2组治疗前及治疗1、2、3个月后血肌酐(Cr)、尿素氮(BUN)、尿酸(UA)、胱抑素C(Cys-C)、超敏C反应蛋白(hs-CRP)、转化生长因子-β_1(TGF-β_1)水平变化情况。结果治疗组总有效率85.00%,对照组总有效率58.75%,治疗组疗效优于对照组(P<0.05);2组治疗后中医症状疲倦乏力、腰膝痠软、纳差呕恶、夜尿清长、大便干结、脘腹胀满及水肿评分与本组治疗前比较均明显降低(P<0.05),且治疗组治疗后各中医症状评分均低于对照组(P<0.05);2组治疗1、2、3个月后Cr、BUN、UA、Cys-C、hs-CRP及TGF-β_1水平与本组治疗前比较均明显降低(P<0.05),且治疗组治疗后各指标均低于对照组同期水平(P<0.05)。结论在常规治疗基础上联合中药内服+灌肠+离子导入中医综合疗法治疗早期慢性肾衰竭可明显提高临床疗效,改善患者中医症状表现,改善患者肾功能,降低Cys-C、hs-CRP及TGF-β_1水平,延缓病情进展。

Objective To observe the clinical effects of traditional Chinese medicine comprehensive therapy on early chronic renal failure. Methods 160 patients with chronic renal failure were randomly divided into two groups. 80 cases in treatment group were treated by oral administration of Chinese medicine plus enema and iontophoresis on the basis of routine treatment. 80 cases in control group were treated by oxyamyli tectus aldehydum on the basis of routine treatment. The curative effect was evaluated after 3 months of treatment in both groups. The changes of TCM symptoms, such as fatigue, weakness of waist and knee, nausea and vomiting, clear and long night urine, dry stool, abdominal distention and edema scores before and after treatment were compared between the two groups. The levels of serum creatinine (Cr), urea nitrogen (BUN), uric acid(UA), cystatin C (Cys-C), hypersensitive C-reactive protein (hs-CRP) and transforming growth factor-β 1 (TGF-β 1) were compared before treatment and 1, 2 and 3 months after treatment in the two groups. Results The total effective rate was 85.00% in the treatment group and 58.75% in the control group. The curative effect of the treatment group was better than that of the control group ( P <0.05). After treatment, the TCM symptoms scores of fatigue, weakness of waist and knee, nausea and vomiting, clear and long night urine, dry stool, abdominal distension and edema in the two groups were significantly lower than those in the group before treatment ( P <0.05), and the scores of TCM symptoms in the treatment group were lower than those in the control group ( P <0.05). After 1, 2 and 3 months of treatment, the levels of Cr, BUN, UA, Cys-C, hs-CRP and TGF-β 1 in the two groups were significantly lower than those in the group before treatment ( P <0.05), and the indexes in treatment group were lower than those in the control group at the same time ( P <0.05). Conclusion On the basis of conventional treatment, combined with traditional Chinese medicine oral administration plus enema and iontophoresis in the treatment of early chronic renal failure can significantly improve clinical efficacy, improve the scores of TCM symptoms, improve renal function, and reduce the levels of Cys-C, hs-CRP and TGF-β 1 , and delay the progress of the disease.