加味参芪地黄汤治疗老年慢性心肾综合征的临床研究

Clinical Research of Modified Shenqi Dihuang Decoction in the Treatment of Senile Patients with Chronic Cardiorenal Syndrome

目的观察加味参芪地黄汤治疗老年慢性心肾综合征的疗效及对炎性因子的影响。方法将符合纳入标准的诊断为慢性心肾综合征病人60例随机分为治疗组和对照组,各30例。两组均给予常规抗心力衰竭、利尿消肿、纠正水电解质、酸碱平衡等西药治疗,治疗组在常规西药治疗基础上加用加味参芪地黄汤口服,两组疗程均为2周。观察并比较两组中医证候积分疗效及炎性因子水平变化。结果治疗后,治疗组总有效率为93.3%,高于对照组的86.7%,差异有统计学意义(P<0.05)。治疗后,两组6 min步行距离、血浆N末端脑钠肽前体、肾小球滤过率、C反应蛋白、白细胞介素-6、中医证候积分较治疗前均改善,且治疗组改善程度均优于对照组(P<0.05)。结论加味参芪地黄汤治疗老年心肾综合征,可改善病人心肾功能,提高生活质量,且安全无明显副作用,其作用机制可能与抑制慢性炎症反应有关。

Objective To observe the effect of Modified Shenqi Dihuang Decoction in the treatment of senile patients with chronic cardiorenal syndrome and its effect on inflammatory factors.Methods Sixty senile patients with chronic cardiorenal syndrome were randomly divided into the treatment group and the control group,30 cases in each group.Two groups were treated with conventional anti-heart failure,diuresis and detumescence,keeping water,electrolyte,and acid-base balance,and other western medicine for 2 weeks.The treatment group was treated with Modified Shenqi Dihuang Decoction on the basis of conventional treatment of western medicine.The clinical efficacy and the changes of inflammatory factors were compared between two groups.Results The clinical efficacy in the treatment group was significantly higher than that in the control group(93.3%vs 86.7%,P<0.05).After treatment,6 min walking test,N-terminal brain natriuretic peptide precursor,glomerular filtration rate,inflammatory factor C-reactive protein,interleukin-6,traditional Chinese medicine syndrome score were improved in both groups compared with those before treatment,and those in the treatment group was better than those in the control group.Conclusion Modified Shenqi Dihuang Decoction in the treatment of senile patients with cardiorenal syndrome could improve cardiac renal function and quality of life,and it was safe without obvious side effects.Its mechanism might be related to the inhibition of chronic inflammatory response.