补肾健脾涤浊汤辅助治疗慢性肾脏病3期脾肾阳虚证临床研究

Clinical Study on Bushen Jianpi Dizhuo Tang for Stage 3 of Chronic Kidney Disease with Spleen-Kidney Yang Deficiency Syndrome

目的:观察在常规疗法基础上加用补肾健脾涤浊汤治疗慢性肾脏病3期脾肾阳虚证患者的临床疗效。方法:选取112例慢性肾脏病3期脾肾阳虚证患者,按随机数字表法分成对照组和治疗组各56例。2组均给予现代医学常规治疗措施,观察组加予补肾健脾涤浊汤内服。2组均连续治疗3个月。观察2组治疗前后肾功能[24 h尿蛋白定量(24 hU-Pro)、肌酐(SCr)、尿素氮(BUN)、胱抑素C (CysC)]、脾肾阳虚证主症以及血浆纤维蛋白原、D-二聚体水平的变化。比较2组的临床疗效。结果:治疗3个月,观察组、对照组的临床疗效总有效率分别为80.36%、 62.50%,2组比较,差异有统计学意义(P<0.05)。2组BUN、SCr、24 hU-Pro、CysC水平均较治疗前降低,肾小球滤过率均较治疗前增加,差异均有统计学意义(P<0.01)。观察组BUN、SCr、24 hU-Pro、CysC水平均低于对照组,肾小球滤过率高于对照组,差异均有统计学意义(P<0.01)。2组脾肾阳虚证主症评分均较治疗前降低(P<0.01),观察组脾肾阳虚证主症评分低于对照组(P<0.01)。2组纤维蛋白原、D-二聚体水平均较治疗前减少(P<0.01)。观察组纤维蛋白原、D-二聚体水平均低于对照组(P<0.01)。结论:在常规疗法基础上加用补肾健脾涤浊汤治疗慢性肾脏病3期脾肾阳虚证能改善患者的肾功能、凝血功能,缓解症状,提高临床疗效。

Objective:To observe the clinical effect of the additional application of Bushen Jianpi Dizhuo tang based on routine therapy for stage 3 of chronic kidney disease with spleen-kidney yang deficiency syndrome.Methods:A total of112 cases of patients with stage 3 of chronic kidney disease with spleen-kidney yang deficiency syndrome were divided into the control group and the treatment group according to the random number table method,with 56 cases in each group.Both groups were given routine treatment in modern medicine,and the observation group was additionally given oral administration of Bushen Jianpi Dizhuo tang.Both groups were treated for three months.Before and after treatment,the changes in 24-hour urinary protein excretion(24 hU-Pro),kidney function including serum creatinine(SCr),blood urea nitrogen(BUN) and cystatin C(CysC),main symptoms of spleen-kidney yang deficiency syndrome and levels of fibrinogen and Ddimer in plasma in the two groups were observed.The clinical effects in the two groups were compared.Results:After three-month treatment,the total effective rate of clinical effect was 80.36% in the observation group and 62.50% in the control group,the difference being significant(P<0.05).The levels of BUN,SCr,24 hU-Pro and CysC in the two groups were decreased when compared with those before treatment,and the glomerular filtration rates were increased,differences being significant(P<0.01).The levels of BUN,SCr,24 hU-Pro and CysC in the observation group were lower than those in the control group,and the glomerular filtration rate was higher,differences being significant(P<0.01).The scores of main symptoms of spleen-kidney yang deficiency syndrome in the two groups were decreased when compared with those before treatment(P<0.01),and the score in the observation group was lower than that in the control group(P<0.01).The levels of fibrinogen and D-dimer in the two groups were decreased when compared with those before treatment(P<0.01),and the levels in the observation group were lower than those in the control group(P<0.01).Conclusion:Based on routine treatment,the additional application of Bushen Jianpi Dizhuo tang for stage 3 of chronic kidney disease with spleen-kidney yang deficiency syndrome can improve kidney function,coagulation function and clinical effect,and relieve symptoms.