清瘀降浊汤联合西药治疗脾肾气虚型慢性肾衰竭肾功能不全失代偿期临床研究

Clinical Study on Qingyu Jiangzhuo Decoction Combined with Western Medicine for Decompensated Period of Renal Insufficiency in Chronic Renal Failure of Spleen-Kidney Qi-Deficiency Type

目的:观察清瘀降浊汤联合西药治疗脾肾气虚型慢性肾衰竭(CRF)肾功能不全失代偿期的临床疗效。方法:选取100例脾肾气虚型CRF肾功能不全失代偿期患者,采用随机数字表法分为研究组和参照组各50例。参照组给予常规西药治疗,研究组在参照组基础上予以清瘀降浊汤治疗,2组均治疗2个月。比较2组临床疗效、不良反应发生率,以及治疗前后症状积分、肾功能指标[血肌酐(SCr)、血尿素氮(BUN)、内生肌酐清除率(CCr)]与血清C-反应蛋白(CRP)水平。结果:治疗2个月后,研究组临床疗效总有效率90.00%,高于参照组74.00%(P<0.05)。治疗后,2组倦怠乏力、食少纳呆、腰膝酸软、气短懒言积分均较治疗前降低(P<0.05),研究组上述4项症状积分均低于参照组(P<0.05)。治疗后,2组SCr、BUN水平均较治疗前降低(P<0.05),研究组SCr、BUN水平均低于参照组(P<0.05);2组CCr值均较治疗前升高(P<0.05),研究组CCr值高于参照组(P<0.05)。治疗后,2组血清CRP水平均较治疗前降低(P<0.05),研究组血清CRP水平低于参照组(P<0.05)。治疗期间,研究组不良反应发生率8.00%,与参照组6.00%比较,差异无统计学意义(P>0.05)。结论:清瘀降浊汤联合西药治疗脾肾气虚型CRF肾功能不全失代偿期可提升临床疗效,缓解临床症状,抑制机体炎症反应,提升肾功能,安全性高。

Objective:To observe the clinical effect of Qingyu Jiangzhuo Decoction combined with western medicine on decompensated period of renal insufficiency in chronic renal failure(CRF)of spleenkidney qi-deficiency type.Methods:A total of 100 patients with decompensated period of renal insufficiency in CRF of spleen-kidney qi-deficiency type were selected and divided into the study group and the control group according to the random number table method,with 50 cases in each group.The control group was given routine western medicine and the study group was additionally treated with Qingyu Jiangzhuo Decoction based on the treatment of the control group.Both groups were treated for 2 months.The clinical effects,incidence of adverse reactions,and the symptom scores and levels of indexes of kidney function,including serum creatinine(SCr),blood urea nitrogen(BUN)and creatinine clearance rate (CCr), as well as the levels of serum C- reactive protein (CRP) were compared between the two groupsbefore and after treatment. Results: After 2 months of treatment, the total clinical effective rate was90.00% in the study group,higher than that of 74.00% in the control group (P<0.05). After treatment,thescores of fatigue and lack of strength,intake less and poor appetite,sore and weak waists and short ofbreath and reluctant to speak in both groups were decreased when compared with those before treatment(P<0.05),and the above 4 scores in the study group were lower than those in the control group (P<0.05).After treatment, the levels of SCr and BUN in both groups were decreased when compared with thosebefore treatment (P<0.05),and the above 2 levels in the study group were lower than those in the controlgroup (P<0.05);the CCr values in both groups were increased when compared with those beforetreatment (P<0.05),and the CCr value in the study group was higher than that in the control group (P<0.05). After treatment,the serum CRP levels in both groups were decreased when compared with thosebefore treatment (P<0.05),and the serum CRP level in the study group was lower than that in the controlgroup (P<0.05). During treatment,the incidence of adverse reactions was 8.00% in the study group,and6.00% in the control group, there being no significance in the difference (P>0.05). Conclusion: QingyuJiangzhuo Decoction combined with western medicine for decompensated period of renal insufficiency inCRF of spleen- kidney qi- deficiency type can enhance the clinical effect,mitigate the clinical symptoms,inhibit the inflammatory responses of the body,and improve the kidney function,with good safety.