百令胶囊联合阿托伐他汀治疗终末期肾病合并颈动脉硬化51例

Clinical effect of Bailing capsules combined with atorvastatin in treatment of end-stage renal disease with carotid atherosclerosis:An analysis of 51 cases

目的:探讨百令胶囊联合阿托伐他汀治疗终末期肾病合并颈动脉硬化的临床疗效。方法:选取终末期肾病合并颈动脉硬化患者102例,采取随机数字表法将其分为治疗组和对照组,每组各51例。2组均予西医基础治疗(含持续非卧床腹膜透析治疗),对照组在基础治疗上加阿托伐他汀钙片治疗,治疗组在对照组基础上再加百令胶囊治疗,2组疗程均为2个月。对比2组中医证候疗效、中医证候积分、钙磷代谢水平[全段甲状旁腺激素(iPTH)、血钙、血磷]、血脂水平[总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白(LDL-C)、高密度脂蛋白(HDL-C)]、肾功能水平(血肌酐、血尿素氮、内生肌酐清除率)、血清成纤维细胞生长因子23(FGF23)、klotho蛋白指标及颈动脉超声指标(颈动脉内膜中层厚度、斑块面积)。结果:总有效率治疗组为86.27%(44/51),对照组为76.47%(39/51),组间比较,差异有统计学意义(P<0.05);治疗后2组中医证候积分、iPTH、血钙、血磷、TC、TG、LDL-C、FGF23、血肌酐、血尿素氮水平均较治疗前降低,颈动脉内膜中层厚度、斑块面积均较治疗前减小,HDL-C、klotho蛋白指标、内生肌酐清除率水平均较治疗前升高,且治疗组改善幅度较对照组更大(P<0.05)。结论:百令胶囊联合阿托伐他汀可改善终末期肾病患者临床症状,提高患者肾功能,减小颈动脉内膜厚度以及斑块面积,降低血清FGF23水平,提高klotho蛋白的表达,临床疗效颇佳。

Objective:To investigate the clinical effect of Bailing capsules combined with atorvastatin in the treatment of end-stage renal disease with carotid atherosclerosis.Methods:A total of 102 patients with end-stage renal disease and carotid atherosclerosis were selected and divided into treatment group and control group using a random number table,with 51 patients in each group.The patients in the control group were given basic Western medicine treatment(including continuous ambulatory peritoneal dialysis)and atorvastatin calcium tablets,while those in the treatment group were given Bailing capsules in addition to the treatment in the control group,and the course of treatment was 2 months for both groups.The two groups were compared in terms of treatment outcome of TCM syndrome,TCM syndrome score,calcium-phosphorus metabolism[intact parathyroid hormone(iPTH),serum calcium,and serum phosphate],blood lipid levels[total cholesterol(TC),low-density lipoprotein cholesterol(LDL-C),and high-density lipoprotein cholesterol(HDL-C)],renal function(serum creatinine,blood urea nitrogen,and endogenous creatinine clearance rate),serum fibroblast growth factor 23(FGF23),klotho protein,and carotid artery sonography(carotid intima-media thickness and plaque area).Results:There was a significant difference in overall response rate between the treatment group and the control group[86.27%(44/51)vs 76.47%(39/51),P<0.05].After treatment,both groups had significant reductions in TCM syndrome score,iPTH,serum calcium,serum phosphate,TC,TG,LDL-C,FGF23,serum creatinine,and blood urea nitrogen,significant reductions in carotid intima-media thickness and plaque area,and significant increases in HDL-C,klotho protein,and endogenous creatinine clearance rate,and the treatment group had significantly greater improvements than the control group(P<0.05).Conclusion:In patients with end-stage renal disease,Bailing capsules combined with atorvastatin can improve clinical symptoms and renal function,reduce carotid intima-media thickness,plaque area,and serum FGF23 level,and increase the expression of klotho protein,and therefore,it shows a good clinical effect.