摘要
目的观察川黄方联合中医外治法治疗脾肾亏虚、毒瘀互结证慢性肾脏病(CKD)2~4期患者的临床疗效。方法选取2019年5月—2021年12月在上海中医药大学附属市中医医院治疗且辨证为脾肾亏虚、毒瘀互结证的CKD 2~4期患者120例,随机分为对照组、治疗1组和治疗2组,每组40例。对照组给予对症及西医常规药物(α-酮酸和包醛氧淀粉)治疗,治疗1组在对照组治疗基础上给予川黄方口服及中医外治法(穴位注射+中药灌肠)干预,治疗2组在治疗1组基础上加三伏贴治疗,3组疗程均为2周。比较3组治疗前后血尿素氮(BUN)、血肌酐(SCr)、尿酸(UA)、肾小球滤过率(eGFR)、中医症状积分及治疗2周后临床疗效。结果治疗2周后,3组BUN水平及治疗1组、治疗2组SCr、UA水平均明显降低(P均<0.05),治疗1组、治疗2组eGFR均明显升高(P均<0.05);3组治疗2周后BUN、SCr、UA、eGFR比较差异均无统计学意义(P均>0.05),但治疗1组、治疗2组SCr治疗前后差值均明显高于对照组(P均<0.05),治疗1组与治疗2组SCr治疗前后差值比较差异无统计学意义(P均>0.05)。治疗2周后,3组中医症状积分均明显降低(P均<0.05),且治疗1组、治疗2组均明显低于对照组(P均<0.05),治疗2组明显低于治疗1组(P<0.05),治疗1组、治疗2组总有效率明显高于对照组(P均<0.05),治疗1组与治疗2组总有效率比较差异均无统计学意义(P均>0.05)。结论川黄方联合中医外治法能有效改善脾肾亏虚、毒瘀互结证CKD 2~4期患者的肾功能,疗效优于西医常规治疗,且联合三伏贴治疗对改善中医证候更有优势。
Objective It is to observe the clinical efficacy of Chuanhuang decoction combined with external treatment of traditional Chinese medicine in the treatment of patients with chronic kidney disease(CKD)at 2~4 stages with syndrome of spleen-kidney deficiency and toxin-blood stasis blinding.Methods One hundred and twenty patients with CKD at 2~4 stages who were treated at Shanghai Hospital of Traditional Chinese Medicine Affiliated to Shanghai University of Traditional Chinese Medicine from May 2019 to December 2021 and syndrome of spleen-kidney deficiency and toxin-blood stasis blinding were randomly divided into control group,treatment groupⅠand treatment groupⅡ,with 40 cases in each group.The control group was given symptomatic therapy and conventional western medicine(α-Ketone acid and aldehyde-coated oxystarch),the treatment groupⅠwas given Chuanhuang decoction orally and external treatment of traditional Chinese medicine(acupoint injection+traditional Chinese medicine enema)on the basis of the treatment of the control group,and the treatment groupⅡwas treated with three-fu plaster on the basis of the treatment of the treatment groupⅠ,and the course of treatment of the three groups was 2 weeks.The blood urea nitrogen(BUN),serum creatinine(SCr),uric acid(UA),glomerular filtration rate(eGFR),TCM symptom scores before and after treatment and clinical efficacy of the three groups were compared.Results After 2 weeks of treatment,the levels of BUN in the three groups and the levels of SCr and UA in the treatment groupⅠand treatment groupⅡwere significantly decreased(all P<0.05),while the eGFR in the treatment groupⅠand treatment groupⅡwas significantly increased(both P<0.05).There was no statistically significant difference in BUN,SCr,UA and eGFR among the three groups after 2 weeks of treatment(all P>0.05),but the difference in SCr before and after treatment in in the treatment groupⅠand treatment groupⅡwas significantly higher than that in the control group(both P<0.05),there was no significant difference in the the difference in SCr before and after treatment between the treatment groupⅠand treatment groupⅡ(P>0.05).After 2 weeks of treatment,the TCM symptom scores of the three groups were significantly decreased(all P<0.05),and the scores of the treatment groupⅠand treatment groupⅡwere significantly lower than that of the control group(both P<0.05),and the treatment groupⅡwas significantly lower than the treatment group I(P<0.05).The total effective rate of the treatment group I and treatment group II was significantly higher than that of the control group(both P<0.05),there was no significant difference between the treatment groupⅠand treatment groupⅡ(P>0.05).Conclusion Chuanhuang decoction combined with external treatment of traditional Chinese medicine can effectively improve the renal function of patients with CKD at 2~4 stage with syndrome of spleen-kidney deficiency and toxin-blood stasis blinding,its efficacy is better than that of the conventional treatment of western medicine,and the combination of three-fu therapy has more advantages in improving the syndrome of traditional Chinese medicine.
作者
袁喆平
魏丽
汤志奇
王骞
陶灵佳
龚学忠
YUAN Zheping;WEI Li;TANG Zhiqi;WANG Qian;TAO Lingjia;GONG Xuezhong(Shanghai Hospital of Traditional Chinese Medicine,Shanghai 200071,China)
出处
《现代中西医结合杂志》
CAS
2023年第1期45-49,共5页
Modern Journal of Integrated Traditional Chinese and Western Medicine
基金
上海市卫生和计划生育委员会科研课题(20184Y0252)
国家自然科学基金面上项目(82074387,81873280)
上海市科委医学创新研究专项项目(20Y21902200)。
关键词
慢性肾脏病
川黄方
中医外治法
脾肾亏虚
毒瘀互结
chronic kidney disease
Chuanhuang decoction
external treatment of traditional Chinese medicine
syndrome of spleen-kidney deficiency
syndrome of toxin-blood stasis blinding