健脾护肾汤减轻含顺铂化疗方案治疗患者肾毒性的临床疗效观察

Clinical Curative Effect of Jianpi Hushen Decoction on Alleviating Renal Toxicity in Patients Undergoing the Treatment with Cisplatin-Containing Chemotherapy

目的:探讨健脾护肾汤减轻含顺铂化疗方案治疗患者肾毒性的临床疗效。方法:选取2017年1月~2019年1月于我院收治的84例含顺铂化疗方案治疗引起肾损伤的恶性肿瘤患者,随机均分为对照组与观察组,观察组采取健脾护肾汤联合含顺铂化疗方案治疗,对照组采取单纯化疗,连续治疗8 w。观察两组患者近期疗效、肾功能变化、氧化因子、炎性因子、生活质量情况以及不良反应发生情况。结果:两组患者临床治疗前比较,差异无统计学意义(P>0.05)。与治疗前比较,两组治疗后尿素氮(BUN)、血肌酐(SCr)、尿酸(UA)、胱抑素C(CysC)、丙二醛(MDA)、一氧化氮(NO)、肿瘤坏死因子-α(TNF-α)、白介素-6(IL-6)、白介素-1β(IL-1β)、前列腺素(PGE2)水平以及躯体功能(PF)、躯体疼痛(BP)、生理职能(RP)、生命活力(VT)评分均明显升高(P<0.05),而估算肾小球滤过率(GFR)、超氧化物歧化酶(SOD)、还原型谷胱甘肽(GSH)活性明显降低(P<0.05);治疗后与对照组比较,观察组BUN、SCr、UA、CysC、MDA、NO、TNF-α、IL-6、IL-1β、PGE2水平明显降低(P<0.05),eGFR水平、SOD活性、GSH活性以及PF、BP、RP、VT评分明显升高(P<0.05)。两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:健脾护肾汤可以缓解顺铂化疗患者体内氧化应激及炎症反应,改善患者肾功能,有助于患者生活质量提高且安全性较好。

Objective:To explore the clinical curative effect of Jianpi Hushen Decoction on alleviating renal toxicity in patients undergoing the treatment with cisplatin-containing chemotherapy.Methods:84 patients with kidney injury and malignant tumors caused by cisplatin-containing chemotherapy who were admitted to the hospital from January 2017 to January 2019 were enrolled.Patients were randomly divided into the control group and the observation group.The patients in the observation group were treated with Jianpi Hushen Decoction combined with cisplatin-containing chemotherapy,while those in the control group were treated with chemotherapy alone for 8 weeks.The short-term curative effect,renal function changes,oxidative factors,inflammatory factors,quality of life and occurrence of adverse reactions in both groups were observed.Results:Before treatment,there was no significant difference between the two groups(P>0.05).Compared with before treatment,the levels of blood urea nitrogen(BUN),serum creatinine(SCr),uric acid(UA),cystatin C(CysC),malondialdehyde(MDA),nitric oxide(NO),tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),interleukin-1β(IL-1β)and prostaglandin(PGE2),and scores of physical function(PF),body pain(BP),role physical(RP)and vitality(VT)were increased(P<0.05),while estimated glomerular filtration rate(GFR),activities of superoxide dismutase(SOD)and reduced glutathione(GSH)were decreased in both groups(P<0.05).After treatment,compared with the control group,the levels of BUN,SCr,UA,CysC,MDA,NO,TNF-α,IL-6,IL-1βand PGE2 in the observation group were decreased(P<0.05),while eGFR level,activities of SOD and GSH,and scores of PF,BP,RP and VT were increased in the observation group(P<0.05).There was no significant difference in the adverse reaction incidence between the two groups(P>0.05).Conclusion:Jianpi Hushen Decoction can alleviate the oxidative stress and inflammatory response,and improve the renal function of patients undergoing the treatment with cisplatin containing chemotherapy,which is conducive to improving their quality of life,with high safety.