补肾培元汤治疗慢性肾脏病临床研究

Clinical Research on Bushen Peiyuan Decoction in Treating Chronic Kidney Disease

目的探讨补肾培元汤对慢性肾脏病(CKD)患者的临床疗效及作用机制。方法选择2017年9月—2019年7月长春中医药大学门诊及住院部就诊的慢性肾脏病患者,根据随机数字表法分为对照组和治疗组,治疗组采用基础治疗+补肾培元汤口服,对照组采用基础治疗+尿毒清颗粒口服,均给药2个月。治疗前后分别观察患者症状、体征,检测血肌酐、尿素氮、血尿酸、24 h尿蛋白定量、尿常规、血常规及血清基质金属蛋白酶-9(MMP-9),并统计分析。结果治疗2个月后,与对照组比较,治疗组尿量、体质量及水肿积分均有明显改善(P<0.05);治疗组主要症状、次要症状量化积分下降明显(P<0.05);治疗组24 h尿蛋白定量、尿红细胞计数下降明显(P<0.05);治疗组SCr、BUN、MMP-9下降明显(P<0.05)。结论补肾培元汤可以明显降低CKD患者血尿、蛋白尿,降低血清肌酐、尿素氮水平,明显降低CKD患者MMP-9,其治疗CKD的机制可能与降低血清基质金属蛋白酶-9有关。

Objective To explore the clinical effect and mechanism of Bushen Peiyuan decoction on patients with chronic kidney disease(CKD). Methods Patients with CKD admitted to the outpatient and inpatient department of Changchun university of Chinese medicine from September 2017 to July 2019 were selected and divided into the control group and the treatment group according to the random number table. The treatment group was given basic treatment and Bushen Peiyuan decoction orally, while the control group was given basic treatment and Uric poisonous clear granules orally for 2 months. Symptoms and signs of the patients were observed before and after the treatment. Serum creatinine, urea nitrogen, serum uric acid, 24-hour urine protein quantitative, urine routine, blood routine and serum matrix metalloproteinase-9(MMP-9) were detected and statistically analyzed. Results After 2 months of treatment, urine volume, body weight and edema scores in the treatment group were significantly improved compared with the control group(P<0.05). Quantitative scores of main and secondary symptoms in the treatment group decreased significantly(P<0.05). In the treatment group, 24-hour urine protein quantification and urine erythrocyte count decreased significantly(P<0.05). SCr, BUN and MMP-9 decreased in the treatment group(P<0.05). Conclusion Bushen Peiyuan decoction can significantly reduce hematuria and proteinuria, serum creatinine and urea nitrogen levels in CKD patients. Bushen Peiyuan decoction can significantly reduce MMP-9 in patients with CKD, suggesting that the mechanism of CKD treatment may be related to the reduction of serum matrix metalloproteinase-9.