祛风胜湿通络法治疗慢性肾病疗效及对肾功能及钙磷代谢的影响

Effect of Dispelling Wind, Eliminating Dampness and Dredging Collaterals Method on Renal Function and Calcium Phosphorus Metabolism in Patients with Chronic Kidney Disease

目的探究祛风胜湿通络方联合西药治疗慢性肾脏病患者对肾功能及钙磷代谢的影响。方法选取2019年1月—2020年1月连云港市第一人民医院肾内科收治的慢性肾脏病3~5期患者80例。采用随机数字表法分为观察组(43例)和对照组(37例),对照组进行降压、纠正贫血、肠道排毒、纠正钙磷代谢紊乱治疗,观察组在对照组基础上加用祛风胜湿通络法治疗。治疗3个月观察两组中医证候积分、临床疗效、肾功能、钙磷代谢指标、不良反应。结果观察组治疗3个月后中医证候积分低于对照组(P<0.05)。观察组治疗总有效率90.70%(39/43)高于对照组67.57%(25/37)(P<0.05)。观察组治疗3个月后血清肌酐(Scr)、血尿素氮(BUN)低于对照组,肾小球滤过率高于对照组(P<0.05)(P<0.05)。观察组治疗3个月后血清钙(Ca)水平高于对照组,血清磷(P)、全段甲状旁腺激素(iPTH)水平低于对照组(P<0.05)。观察组总不良反应发生率16.28%(7/43)高于对照组10.81%(4/37),组间比较差异无统计学意义(P>0.05)。结论祛风胜湿通络法联合西药治疗慢性肾脏病患者效果较好,有利于改善临床症状和肾功能,调节钙磷代谢,且未新增不良反应。

Objective To explore the effects of dispelling wind, eliminating dampness and dredging collaterals method combined with western medicine on renal function and calcium and phosphorus metabolism in patients with chronic kidney disease. Methods Between January 2019 and January 2020, 80 patients with chronic kidney disease in stage 3~5 admitted to the Department of Nephrology of the First People’s Hospital of Lianyungang were selected and randomly divided into observation group(43 cases) and control group(37 cases). The control group was treated with blood pressure reduction, anemia correction, intestinal detoxification, and calcium and phosphorus metabolism disorders correction, and the observation group was treated with dispelling wind, eliminating dampness and dredging collaterals method on the basis of the control group. After 3 months of treatment, the scores of TCM syndromes, clinical efficacy, renal function, calcium and phosphorus metabolism indexes, and adverse reactions were observed in the two groups. Results The scores of TCM syndromes in the observation group were lower than those in the control group after 3 months of treatment(P<0.05). The total effective rate of treatment in the observation group was higher than that of the control group[90.70%(39/43) vs. 67.57%(25/37), P<0.05]. Serum creatinine(Scr) and blood urea nitrogen(BUN) in the observation group were lower than those in the control group, but the glomerular filtration rate was higher than that of the control group(P<0.05). After 3 months of treatment, the calcium(Ca) level in serum in the observation group were higher than that in the control group(P<0.05), and levels of phosphorus(P) and intact parathyroid hormone(iPTH) in serum were lower than those in the control group(P<0.05). The total adverse reaction rate of the observation group was higher than that of the control group[16.28%(7/43) vs. 10.81%(4/37),P>0.05]. Conclusions The dispelling wind, eliminating dampness and dredging collaterals method combined with western medicine is effective in treating patients with chronic kidney disease, which is beneficial to improve clinical symptoms and renal function, regulate the level of calcium and phosphorus metabolism with no new adverse reactions.