芪黄益肾汤对慢性肾衰竭脾肾亏虚证患者蛋白尿和肾功能的影响

Efficacy of the Qihuang Yishen decoction on proteinuria and renal function in patients with chronic renal failure of spleen and kidney deficiency syndrome

目的:观察芪黄益肾汤对慢性肾衰竭脾肾亏虚证患者蛋白尿和肾功能的影响。方法:选取安徽省天长市中医院肾病科门诊及住院收治的60例慢性肾衰竭患者为研究对象,随机分为两组,对照组30例予以慢性肾脏病内科治疗方案,治疗组30例在前者治疗的基础上加用芪黄益肾汤,治疗8周后,对比两组患者治疗前后临床疗效、中医证候积分、24小时尿蛋白定量(24 hours Urine Protein,24 h Upro)、尿素氮(Blood Urea Nitrogen,BUN)、血肌酐(Serum Creatinine,Scr)、估算肾小球滤过率(estimated Glomerular Filtration Rate,eGFR)水平变化情况。结果:治疗后,治疗组临床疾病总有效率优于对照组,治疗组中医证候疗效总有效率高于对照组,差异有统计学意义(P <0.05)。两组腰膝酸软、倦怠乏力、气短懒言、脘腹胀满积分均较治疗前降低,且治疗组均低于对照组,差异有统计学意义(P <0.05)。两组治疗后24 hUpro、BUN、Scr较治疗前均显著降低,eGFR水平较治疗前升高,且治疗组优于对照组,差异有统计学意义(P <0.05)。结论:芪黄益肾汤在治疗慢性肾衰竭脾肾亏虚证患者疗效显著,可有效减轻临床症状,降低尿蛋白,改善肾功能,延缓慢性肾衰竭进展。

Objective:To observe the effect of Qihuang Yishen decoction(芪黄益肾汤) on proteinuria and renal function in patients with chronic renal failure of spleen and kidney deficiency syndrome.Methods:60 cases were randomly divided into two groups.30 cases in the control group were given the medical treatment plan,and 30 cases in the treatment group were treated with the Qihuang Yishen decoction more.Results:The total efficiency of clinical diseases in the treatment group was better than the control group,and the total efficiency of TCM syndrome was higher in the treatment group(P<0.05).The scores of sore waist and knees,fatigue,shortness of breath,abdominal distension in the two groups were lower than before treatment,and those in the treatment group were lower than the control group(P<0.05).24 h Upro,BUN and Scr were significantly lower than before treatment in the two groups at 24 h after treatment,and eGFR was higher than before treatment,and those in the treatment group were better than the control group(P<0.05).Conclusion:The Qihuang Yishen decoction is effective in treating chronic renal failure with spleen and kidney deficiency syndrome.It can effectively reduce clinical symptoms,reduce urine protein,improve renal function,and delay the progression of chronic renal failure.