基于大数据平台的“益肾清利、和络泄浊方”治疗慢性肾脏病3-5期肾功能进展的疗效分析

Analysis of the Therapeutic Effect of"Yishen Qingli,Heluo Xiezhuo Recipe"in the Treatment of Chronic Kidney Disease(CKD)3-5 Stages Based on Big Data Platform

目的基于“中国肾脏病大数据应用平台”数据,分析孙伟教授运用“益肾清利、和络泄浊方”治疗慢性肾脏病3-5期非透析患者的临床疗效。方法收集2018年5月到2020年6月之间在江苏省中医院肾内科就诊的患者数据,其中慢性肾脏病3期随访超过48周患者107例,慢性肾脏病4-5期随访超过24周患者129例,比较治疗前后患者各项肾功能指标进展情况。结果与治疗前相比,治疗48周后,慢性肾脏病3期患者尿素氮(治疗前9.90±3.90 mmol·L^(-1),治疗后9.87±3.88 mmol·L^(-1))、血肌酐(治疗前137.78±25.76μmol·L^(-1),治疗后135.40±27.23μmol·L^(-1))、eGFR(治疗前44.87±7.97 mL·min^(-1),治疗后46.00±9.46 mL·min^(-1))等指标均保持稳定,变化无统计学差异(P≥0.05)。治疗24周后,慢性肾脏病4-5期患者肾功能指标尿素氮(治疗前17.59±5.82 mmol·L^(-1),治疗后19.30±6.47 mmol·L^(-1))、血肌酐(治疗前341.89±114.36μmol·L^(-1),治疗后384.11±134.81μmol·L^(-1))、eGFR(治疗前17.14±6.65 mL·min^(-1),治疗后15.05±6.47 mL·min^(-1))较治疗前略有进展,治疗前后有统计学差异(P<0.05)。结论“益肾清利、和络泄浊方”在48周内能稳定慢性肾脏病3期患者肾功能,并对慢性肾脏病3-5期患者的血浆白蛋白、血红蛋白、血钾、二氧化碳结合力、尿酸有一定的稳定作用,中药治疗能有效稳定慢性肾脏病3-5期患者的血浆白蛋白水平及电解质酸碱平衡。

Objective To analyze the clinical efficacy of Professor Sun Wei's"Yishen Qingli,Heluo Xiezhuo Recipe"in the treatment of CKD 3-5 stages,based on the data of"China Kidney Disease Big data Application Platform".Methods A total of 107 patients with CKD 3 stage and 129 patients with CKD 4-5 stage were admitted to the Department of Nephrology,Jiangsu Hospital of Traditional Chinese Medicine from May 2018 to June 2020.Patients of CKD 3 stage were observed for 48 weeks and those with CKD 4-5 stage were observed for 24 weeks.The progress of renal function indexes before and after treatment was compared.Results After 48 weeks of treatment,the indexes of Bun,Scr,eGFR,Alb,Hb,K and UA in patients with CKD 3 stage remained stable,and there was no statistical difference(P≥0.05)compared with those before treatment.After 24 weeks of treatment,renal indexes Bun,Scr and eGFR of patients with CKD4-5 stage were deteriorated compared with that before,and there were statistically significant differences(P<0.05).Plasma albumin was significantly higher than that before treatment(P<0.05).Conclusion"Yishen Qingli,Heluo Xiezhuo Recipe"can stabilize renal function in patients with CKD 3 stage within 48 weeks,and has a certain stabilizing effect on plasma albumin,hemoglobin,blood potassium,carbon dioxide binding force and uric acid in patients with CKD 3-5 stage.Traditional Chinese medicine treatment can effectively stabilize the protein level and electrolyte acid-base balance in patients with CKD3-5tages.