温肾泄浊汤治疗慢性肾衰竭73例疗效研究

Effect of Wenshen Xiezhuo decoction on chronic renal failure

目的:研究温肾泄浊汤治疗慢性肾衰竭的疗效及对患者肾功能、氧化应激指标与营养状况的影响。方法:146例慢性血液透析肾衰竭患者随机分为对照组(73例)和观察组(73例)。对照组采用血液透析进行治疗,观察组采用血液透析、温肾泄浊汤进行治疗,两组均治疗4周。统计分析两组临床疗效、中医症状积分、氧化应激指标、营养状态指标及肾功能。结果:治疗4周后,观察组总有效率更高(P<0.05)。治疗4周后与治疗前比较,两组恶心、呕吐、肢体困重、食少纳呆、脘腹胀满、口中黏腻评分、血清丙二醛(MDA)、晚期氧化蛋白产物(AOPP)、透明质酸(HA)、转化生长因子-β1(TGF-β1)、血肌酐(Scr)、尿素氮(BUN)水平及24 h尿蛋白(24 h-UTP)水平均降低,观察组相对更低(P<0.05)。治疗4周后与治疗前比较,两组血清超氧化物歧化酶(SOD)、总抗氧化能力(TAC)、白蛋白(ALB)、血红蛋白(HGB)、转铁蛋白(TRF)、骨形成蛋白-7(BMP-7)水平及主观综合性营养评分、肾小球滤过率(eGFR)均升高,观察组相对更高(P<0.05)。结论:温肾泄浊汤可改善慢性肾衰竭患者中医症状,抑制机体氧化应激,缓解患者肾纤维化,提高机体营养状态及肾功能,具有较好的治疗效果。

Objective:To study the therapeutic effect of Wenshen Xiezhuo decoction on chronic renal failure and its influence on renal function,oxidative stress index and nutritional status of patients.Methods:146 patients with chronic renal failure were divided into the control group(73 cases)and the observation group(73 cases).The control group was treated with hemodialysis,and the observation group was treated with hemodialysis and warm Wenshen Xiezhuo decoction.Both groups were treated for 4 weeks.Clinical efficacy,TCM symptom score,oxidative stress index,nutritional status index and renal function of the two groups were analyzed.Results:After 4 weeks of treatment,the total effective rate of the observation group was higher(P<0.05).After 4 weeks of treatment,compared with before treatment,scores of nausea,vomiting,body weight,eating less and eating less,abdominal distension,mouth viscosity,levels of serum malondialdehyde(MDA),advanced oxidized protein product(AOPP),hyaluronic acid(HA),transforming Growth factor-β1(TGF-β1),blood creatinine(Scr),urea nitrogen(BUN)levels and 24 h urinary protein(24 h-UTP)decreased in both groups,the observation group was lower(P<0.05).After 4 weeks of treatment,compared with before treatment,levels of serum SOD,TAC,albumin(ALB),hemoglobin(HGB),transferrin(TRF),bone morphogenetic protein-7(BMP-7),subjective comprehensive nutrition score and glomerular filtration rate(eGFR)in two groups increased,and the observation group was higher(P<0.05).Conclusion:Wenshen Xiezhuo decoction could improve the symptoms of traditional Chinese medicine of patients with chronic renal failure,inhibit the oxidative stress of the body,relieve the renal fibrosis of patients,improve the nutritional state of the body and kidney function,and had a good therapeutic effect.