益肾泄浊汤治疗肾虚湿浊型慢性肾衰竭的临床研究

Clinical study of Yishen Xiezhuo Decoction in the treatment of chronic renal failure of type of kidney deficiency and dampness turbidity

目的探讨益肾泄浊汤治疗肾虚湿浊型慢性肾衰竭(CRF)的临床疗效。方法选取辽宁中医药大学附属医院2019年1月—2020年12月收治的110例肾虚湿浊型CRF患者,采用随机数字表法分为2组,对照组55例给予常规治疗,观察组55例在常规治疗基础上给予益肾泄浊汤治疗,2组均治疗4周。比较2组治疗前后中医症状积分、肾功能指标和血清钙、磷、Klotho、成纤维生长因子-23(FGF-23)水平及临床疗效,评估治疗安全性。结果治疗后2组中医症状积分、血尿素氮、血肌酐、血磷、FGF-23水平均明显低于治疗前,估算肾小球滤过率(eGFR)、血钙、Klotho水平均明显高于治疗前,且观察组各指标改善情况均明显优于对照组,差异均有统计学意义(P均<0.05)。观察组总有效率为81.82%(45/55),明显高于对照组的60.00%(33/55),差异有统计学意义(P<0.05)。2组患者均无不良反应出现。结论益肾泄浊汤治疗肾虚湿浊型CRF疗效确切,能有效改善患者临床症状和钙磷代谢,延缓疾病进展,且安全性高。

Objective It is to explore the clinical efficacy of Yishen Xiezhuo Decoction in the treatment of chronic renal failure(CRF)with syndrome of kidney deficiency and dampness turbidity.Methods A total of 110 cases of CRF patients with syndrome of kidney deficiency and dampness turbidity who were admitted to the Affiliated Hospital of Liaoning University of Traditional Chinese Medicine from January 2019 to December 2020 were selected and divided into 2 groups by random number table method,55 cases in the control group were treated with routine therapy,and 55 cases in the observation group were treated with Yishen Xiezhuo Decoction on the basis of conventional treatment.Both groups were treated for 4 weeks.The traditional Chinese medicine syndrome scores,indexes of renal function,and the levels of serum calcium,phosphorus,Klotho,and fibroblast growth factor-23(FGF-23)before and after treatment were compared between the two groups,the clinical curative effect and the safety of the treatment were evaluated in the two groups.Results After treatment,the traditional Chinese medicine syndrome scores,blood urea nitrogen,blood creatinine,blood phosphorus,and FGF-23 levels in the two groups were significantly lower than those before treatment,and the estimated glomerular filtration rate(eGFR),blood calcium,and Klotho levels were significantly higher than those before treatment,and the improvement of each index in the observation group was significantly better than that in the control group,the differences were all statistically significant(all P<0.05).The total effective rate in the observation group was 81.82%(45/55),which was significantly higher than 60%(33/55)in the control group,and the difference was statistically significant(P<0.05).There were no adverse reactions in the patients of the two groups.Conclusion Yishen Xiezhuo Decoction has definite curative effect in the treatment of CRF of type of kidney deficiency and dampness turbidity.It can effectively improve the clinical symptoms and calcium and phosphorus metabolism of patients,delay disease progression with high safety.