中医一体化治疗慢性肾功能衰竭疗效观察

Observation of Curative Effect of Integrated Therapy of TCM on Chronic Renal Failure

目的:观察中医一体化结合西医常规疗法治疗慢性肾功能衰竭的临床疗效,并进一步探讨其可能的作用机制。方法:采用随机、平行、对照的方法,将80例病例分为对照组,中药组,中药联合针剂组及中医一体化组,各组病例均为20例。各组均予基础治疗,对照组同时加服包醛氧淀粉,中药组加用中药汤剂,中药联合针剂组加用中药及肾康注射液静脉滴注,中医一体化组加用中药汤剂、肾康注射液静脉滴注及肾病治疗仪刺激肾区特定腧穴。各组疗程均为3个月,观察相关指标变化情况。结果:4组治疗后血肌酐(serum creatinine,Scr)、尿素氮(urine urea nitrogen,BUN)水平与治疗前比较均明显降低,差异有统计学意义(P <0. 05);治疗后组间比较,中药联合针剂组、中医一体化组BUN、SCr水平与对照组、中药组比较差异有统计学意义(P <0. 05);中医一体化组治疗后尿N-乙酰-B-D氨基葡萄糖苷酶(urinary N-acetyl-B-D glucosaminidase,NAG)水平、血β2微球蛋白(blood beta 2 microglobulin,β2MG)、层黏连蛋白(laminin,LN)与治疗前比较均明显降低,差异有统计学意义(P <0. 05);中医一体化组治疗后血脂指标与治疗前比较差异无统计学意义(P> 0. 05)。结论:中医一体化治疗可以改善慢性肾功能衰竭患者肾功能,其作用机制可能与改善肾脏纤维化有关。

Objective: To observe the clinical curative effect of integrated therapy of TCM combined with conventional Western medicine therapy on chronic renal failure,and further explore its possible mechanism of action. Methods: A total of 80 cases were divided into the control group,the TCM group,the TCM combined with injection group and the integrated TCM group by randomized,parallel and controlled method,with 20 cases in each group. Each group was given basic treatment,while the control group was additionally given aldehyde-coated oxystarch,the TCM group was added TCM decoction,the TCM combined with injection group was added TCM and Shenkang Injection for intravenous drip,the traditional Chinese medicine combined injection group was given traditional Chinese medicine and Shenkang injection intravenous drip,and the integrated TCM group was added TCM decoction,Shenkang injection intravenous drip and nephropathy treatment apparatus to stimulate specific acupoints in the kidney area.The course of treatment in each group lasted 3 months,and the changes of related indicators were observed. Results: After the treatment,serum creatinine( Scr) and urea nitrogen( BUN) levels in the four groups were significantly lower than those before the treatment,and all the differences were statistically significant( P < 0. 05). After the treatment,there were significant differences in BUN and SCr levels between the TCM combined with injection group and the TCM integrated group compared with the control group and the TCM group( P < 0. 05). Urinary N-acetyl-B-D Glucosaminidase( NAG),blood beta 2 microglobulin(β2 MG) and laminin( LN) in the integrated TCM group,and all the differences were statistically significant( P < 0. 05). However,there was no significant difference in blood lipid index in the TCM integrated group before and after the treatment( P > 0. 05).Conclusion: Integrated therapy of TCM can improve renal function in patients with chronic renal failure,and its mechanism may be related to the improvement of renal fibrosis.