补脾和胃泄浊法联合常规西药治疗早中期慢性肾功能不全脾虚湿盛证临床研究

Clinical Study on Method of Supplementing the Spleen,Harmonizing the Stomach and Directing the Turbid Downward Combined with Routine Western Medicine for Chronic Kidney Disease in Early and Middle Stages with Spleen Deficiency and Excessive Dampness Syndr

目的:观察补脾和胃泄浊法治疗早中期慢性肾功能不全脾虚湿盛证的临床疗效。方法:选择94例早中期慢性肾功能不全患者,按随机数字表法分为对照组和观察组各47例。对照组给予常规西药治疗,观察组在对照组基础上给予补脾和胃泄浊法治疗。评价2组临床疗效,比较2组治疗前后中医证候评分、肾功能、肾血流变化、炎症因子水平及免疫功能。结果:观察组总有效率为89.36%,高于对照组72.34%(P<0.05)。治疗后,2组各项中医证候评分低于治疗前(P<0.05),且观察组各项中医证候评分低于对照组(P<0.05)。治疗后,2组血肌酐(SCr)、尿素氮(BUN)、胱抑素C (Cys-C)、β_(2)-微球蛋白(β_(2)-MG)、白细胞介素-6 (IL-6)、C-反应蛋白(CRP)及免疫球蛋白抗体G (IgG)水平较治疗前降低,且观察组低于对照组(P<0.05);2组肾小球滤过率(e GFR)、补体C3水平较治疗前升高,且观察组高于对照组(P<0.05)。治疗后,观察组平均灌注强度(Imix)、血流速度(Vmix)高于治疗前和对照组(P<0.05)。结论:补脾和胃泄浊法能有效改善早中期慢性肾功能不全脾虚湿盛证患者肾功能及肾皮质血流情况,同时还能改善肾脏炎症程度并提高免疫功能,疗效确切。

Objective:To observe the clinical effect of the method of supplementing the spleen,harmonizing the stomach,and directing the turbid downward for chronic kidney disease in early and middle stages with spleen deficiency and excessive dampness syndrome.Methods:A total of 94 cases of patients with chronic kidney disease in the early and middle stages were divided into the control group and the observation group according to the random number table method,with 47 cases in each group.The control group was treated with routine western medicine,and the observation group was additionally treated with the method of supplementing the spleen,harmonizing the stomach,and directing the turbid downward based on the treatment of the control group.Clinical effects were evaluated in the two groups.The changes in traditional Chinese medicine (TCM) syndrome scores,kidney function,and renal blood flow,as well as the levels of inflammatory factors,and the immune function before and after treatment were compared between the two groups.Results:The total effective rate was 89.36% in the observation group,higher than that of 72.34% in the control group (P<0.05).After treatment,each TCM syndrome score in the two groups was lower than that before treatment (P<0.05),and each TCM syndrome score in the observation group was lower than that in the control group (P<0.05).After treatment,levels of serum creatinine (SCr),blood urea nitrogen (BUN),cystatin-C (Cys-C) β_(2)-microglobulin (β_(2)-MG),interleukin-6 (IL-6),C-reactive protein (CRP) and immunoglobulin antibody G (IgG) in the two groups were decreased when compared with those before treatment (P<0.05),and the above levels in the observation group were lower than those in the control group (P<0.05);estimated glomerular filtration rates (eGFR) and complement C3 levels in the two groups were increased when compared with those before treatment,and e GFR and complement C3 levels in the observation group were higher than those in the control group (P<0.05).After treatment,mean flow intensity (Imix) and mean blood flow velocity (Vmix) in the observation were higher than those before treatment and those in the control group (P<0.05).Conclusion:For patients with chronic kidney disease in early and middle stages with spleen deficiency and excessive dampness syndrome,the method of supplementing the spleen,harmonizing the stomach,and directing the turbid downward can effectively improve the kidney function,renal cortex blood flow,the degree of renal inflammation,and the immune function,with a definite curative effect.