复方积雪草组方对慢性肾脏病4~5期患者肾功能及营养状况的影响

Effect of Compound Centella Asiatica on Kidney Function and Nutrition Status in Patients with Chronic Kidney Disease Stages 4~5

目的:了解复方积雪草组方对CKD4~5期患者肾功能及营养状况的影响。方法:纳入45例原发病为慢性肾小球肾炎CKD4~5期患者,随机分为两组:治疗组在基础西药治疗上加用复方积雪草组方,对照组继续基础西药治疗,疗程12周。观察患者的24 h尿蛋白定量、血肌酐、血尿酸、血尿素氮、血清白蛋白、血红蛋白、肾小球滤过率、主观全面营养评分等指标的变化。结果:(1)治疗组总有效率40%,对照组总有效率20%,两组间比较,差异有统计学意义(P<0.05)。(2)治疗组24 h尿蛋白定量、尿素氮、血肌酐、血尿酸、主观全面营养评分较治疗前下降,血清白蛋白、血红蛋白、肾小球滤过率较治疗前上升,差异有统计学意义(P<0.05)。对照组24 h尿蛋白定量、血肌酐、尿素氮、血尿酸、血清白蛋白、血红蛋白、肾小球滤过率、主观全面营养评分前后比较差异无统计学意义(P>0.05)。治疗组治疗后24 h尿蛋白定量、血肌酐、血清白蛋白、肾小球滤过率明显高于对照组,差异有统计学意义(P<0.05)。(3)对照组中有1例患者进入血液透析治疗。(4)对照组出现肺部感染1例(2.2%)、治疗组和对照组各出现2例高钾血症(8.9%),经对症治疗后改善,能继续参加研究。结论:(1)复方积雪草组方能稳定CKD4~5期患者肾功能,减少蛋白尿,改善患者的营养状况;(2)复方积雪草组方具有很好的临床疗效和安全性。

Objective:To understand the effects of the compound centella asiatica on kidney function and nutritional status in patients with Stages 4~5 chronic kidney disease(CKD4~5).Methods:A total of 45 cases of patients with primary glomerulonephritis and CKD at the 4~5 stage were randomly divided into two groups.The control group was given routine treatment,and the treatment group was additionally treated with the compound centella asiatica based on the treatment of the control group.Both groups were treated for 12 weeks.The changes of the 24-hour urinary protein(24 h UP),serum creatinine(Scr),blood uric acid(UA),blood urea nitrogen(BUN),serum albumin(Alb),Hemoglobin(Hb),estimated glomerular filtration rate(eGFR)as well as the subjective nutritional scores were observed.Results:(1)The total clinical effective rate was 40%in the treatment group,better than that of 20%in the control group,differences being significant(P<0.05).(2)The values of 24 h UP,BUN,Scr,UA and the subjective nutritional scores in the treatment group were significantly decreased;Alb,Hb and eGFR in the treatment group was significantly increased when compared with those before treatment(P<0.05).in the control group,there was no significant difference being found in the comparison of 24 h UP,Scr,BUN,UA,Alb,Hb,eGFR,and the subjective nutritional scores before and after treatment(P>0.05).After treatment,24 h UP,Scr,Alb and eGFR in the treatment group was significantly higher than that in the control group,the difference being significant(P<0.05).(3)One patient in the control group entered hemodialysis.(4)1 case(2.2%)in the control group had pulmonary infection,2 cases(8.9%)of hyperkalemia occurred in the treatment group and the control group,which improved after symptomatic treatment and the patients could continue participating in the study.Conclusion:(1)The compound centella asiatica can stabilize kidney function,reduce 24-hour urinary protein,and improve the nutrition of patients with CKD4~5;(2)The compound centella asiatica has good clinical effect and safety.