中药复方抑囊方治疗常染色体显性遗传多囊肾病的临床研究

Clinical research on the treatment of autosomal dominant polycystic kidney disease with TCM Compound Yinang Formula

目的:观察中药复方抑囊方治疗脾肾亏虚兼血瘀型常染色体显性遗传多囊肾病(ADPKD)患者的临床疗效。方法:收集符合研究条件的ADPKD患者70例,随机分为抑囊方+基础治疗的治疗组和基础治疗的对照组,各35例,治疗6个月。第0、3、6个月分别进行中医证候积分评定;第0、6个月进行肾功能血肌酐(Scr)、血尿素(BUN)、尿酸(UA)、肾小球滤过率(eGFR)检查;6个月治疗结束后观察各组临床症状及Scr、BUN、UA、eGFR的改善情况。结果:治疗6个月后,治疗组中医证候有效率97.14%(34/35)和综合疗效有效率71.43%(25/35)显著高于对照组的45.71%(16/35)和37.14%(13/35)(P<0.01);主要症状中除腹部包块外,有效率显著高于对照组(P<0.05,P<0.01);治疗组Scr、eGFR较治疗前显著改善(P<0.05,P<0.01)。结论:中药复方抑囊方具有改善ADPKD患者临床症状、延缓肾功能恶化的作用,中医补肾健脾活血软坚法契合ADPKD的病机。

Objective: To observe the clinical efficacy of TCM Compound Yinang Formula in treating autosomal dominant polycystic kidney disease(ADPKD) patients with spleen-kidney deficiency and blood stasis. Methods: A total of 70 patients with ADPKD who met the study conditions were collected and randomly divided into the treatment group of Yinang Formula plus basic treatment and the control group of basic treatment, 35 cases in each group, treated for 6 months. The TCM syndrome score was evaluated at 0, 3 and 6 months respectively. Serum creatinine(Scr), blood urea(BUN) and uric acid(UA) of renal function were examined at 0 and 6 months. The improvement of clinical symptoms,Scr, BUN, UA and eGFR were observed after 6 months of treatment. Results: After 6 months of treatment, the effective rate of TCM syndrome in the treatment group was 97.14%(34/35) and the effective rate of comprehensive curative effect was 71.43%(25/35), significantly higher than 45.71%(16/35) and 37.14%(13/35)(P<0.01);The effective rate of major symptoms except abdominal mass was significantly higher than that of control group(P<0.05, P<0.01);Scr and eGFR in treatment group were significantly improved compared with those before treatment(P<0.05, P<0.01). Conclusion: The TCM Compound Yinang Foumula can improve the clinical symptoms and delay the deterioration of renal function in patients with ADPKD. The TCM method of tonifying kidney, invigorating spleen and promoting blood circulation fits the pathogenesis of ADPKD.