扶正祛瘀泄浊方口服联合通腑泄浊方保留灌肠治疗慢性肾脏病3~4期临床观察

Efficacy observation of oral Fuzheng Quyu Xiezhuo formula and Tongfu Xiezhuo formula for retention enema on chronic kidney disease with 3~4 phase

目的:观察扶正祛瘀泄浊方口服联合通腑泄浊方间歇保留灌肠治疗慢性肾脏病(CKD3~4期)的临床疗效。方法:将60例CKD3~4期患者随机分为两组各30例。对照组予降蛋白尿、控制血压及血糖等对症治疗,治疗组在西医常规治疗的基础上予扶正祛瘀泄浊方口服联合通腑泄浊方保留灌肠,两组均治疗8周。观察治疗前后血肌酐(Scr)、血尿素氮(BUN)、肾小球滤过率(eGFR)及中医证候积分变化情况,比较两组临床疗效。结果:治疗组中医证候总有效率为80.0%,明显高于对照组的46.7%(P﹤0.05)。治疗组疾病疗效总有效率为63.3%,明显高于对照组的30.0%(P﹤0.05)。治疗8周后,治疗组患者治疗后Scr、BUN、eGFR水平均较治疗前明显改善(P﹤0.05),且明显优于对照组。治疗组治疗后中医证候积分较治疗前有明显下降(P﹤0.05),且改善优于对照组(P﹤0.05)。结论:扶正祛瘀泄浊方口服联合灌肠治疗可有效改善延缓CKD3~4期患者肾功能,改善中医证候,提高临床疗效,延缓CKD进展。

Objective:To observe the clinical efficacy of oral Fuzheng Quyu Xiezhuo formula and Tongfu Xiezhuo formula for intermittent retention enema on chronic kidney disease(CKD 3~4 stage).Methods:60 cases of patients with CKD 3~4 stage were randomly divided into two groups,30 cases in each group.The control group was symptomatically treated by reducing proteinuria,controlling blood pressure and blood sugar and others,while the treatment group was treated plus with oral Fuzheng Quyu Xiezhuo formula and Tongfu Xiezhuo formula for retention enema on the basis of treatment with conventional western medicine.Both groups were treated for 8 weeks.The changes of serum creatinine(Scr),blood urea nitrogen(BUN),glomerular filtration rate(eGFR)and TCM syndrome score were observed before and after treatment,and the clinical efficacy was compared between two groups.Results:The total effective rate of TCM syndromes in treatment group was 80.0%,which was significantly higher than 46.7%in ontrol group(P﹤0.05).The total effective rate of disease curative effect in treatment group was 63.3%,which was significantly higher than 30.0%in control group(P﹤0.05).After 8 weeks of treatment,the levels of Scr,BUN and eGFR of patients in treatment group were significantly improved after treatment compared with before treatment(P﹤0.05),and the treatment group was significantly better than control group after treatment.TCM syndrome score in treatment group after treatment was significantly reduced compared with before treatment(P﹤0.05),and the improvement of treatment group was better than that of control group(P﹤0.05).Conclusion:Oral Fuzheng Quyu Xiezhuo formula and retention enema can effectively improve the renal function of patients with CKD 3~4 stage,improve TCM syndromes,enhance the total effective rate of clinical efficacy,and delay the progress of CKD.