益气化瘀通腑法治疗早中期慢性肾脏病的临床研究

Clinical study on the method of supplementing Qi and removing stasis and unblocking organs in the treatment of chronic kidney disease at early and middle stage

目的观察益气化瘀通腑法治疗早中期慢性肾脏病的临床效果。方法将2018年7月-2019年12月秦皇岛市中医医院诊治的60例早中期慢性肾脏病患者随机分为对照组和观察组各30例,对照组患者给予肾衰宁治疗,观察组患者给予益气化瘀通腑方治疗,2组均连续治疗12周。观察2组患者治疗后肾功能指标[β_(2)微球蛋白(β_(2)-MG)、胱抑素C(Cys C)、血肌酐(SCr)、血尿素氮(BUN)、肾小球滤过率(eGFR)]、中医症状(倦怠乏力、气短懒言、腰膝酸软、食少纳呆)积分变化及治疗效果。结果治疗后2组BUN、SCr、β_(2)-MG、Cys C水平均明显降低(P均<0.05),eGFR明显升高(P均<0.05),观察组治疗后各指标变化幅度均明显高于对照组(P均<0.05);治疗后2组倦怠乏力、气短懒言、腰膝酸软、食少纳呆积分均较治疗前明显下降(P均<0.05),且观察组各项中医症状积分均明显低于对照组(P均<0.05)。观察组治疗总有效率为93.3%(28/30),明显高于对照组的73.4%(22/30),差异有统计学意义(P<0.05)。结论益气化瘀通腑法治疗早中期慢性肾脏病可明显改善患者肾功能,缓解临床症状,疗效优于肾衰宁。

Objective It is to observe the clinical effect of the treatment of early and middle stage chronic kidney disease(CKD)with the method of TCM supplementing Qi and removing stasis and unblocking organs.Methods Sixty patients with chronic kidney disease at early and middle stage treated in Qinhuangdao Hospital of Traditional Chinese Medicine were randomly divided into the control group and the observation group,30 patients in each group.The patients in the control group were treated with Shenshuaining,and the patients in the observation group were treated with the decoction for invigorating Qi and removing blood stasis and unblocking organs.Both groups were treated continuously for 12 weeks.The changes in renal function indexes[β_(2) microglobulin(β2-MG),cystatin C(CysC),serum creatinine(SCr),blood urea nitrogen(BUN),glomerular filtration rate(eGFR)],the scores of TCM symptoms(fatigue,shortness of breath,lazy speech,soreness of waist and knees,lack of food and appetite)after treatment and treatment effects were observed in the two groups.Results After treatment,the levels of BUN,SCr,β_(2)-MG,and CysC in the two groups were significantly reduced(all P<0.05),and eGFR was significantly increased(P<0.05),the improvement of each index of the observation group was significantly better than that of the control group(P<0.05).After treatment,the scores of fatigue,shortness of breath,soreness of waist and knees,and lack of appetite in the two groups were significantly lower than those before treatment in the two groups(P<0.05),and the scores of various TCM symptom in the observation group were significantly lower than those in the control group(P<0.05).The total effective rate of treatment in the observation group was 93.3%(28/30),which was significantly higher than that 73.4%(22/30)in the control group(P<0.05).Conclusion The method of TCM supplementing Qi and removing stasis and unblocking organs can obviously improve renal function and relieve clinical symptoms in the treatment of chronic kidney disease at early and middle stage,its curative effect is better than Shenshuaining.