肾衰Ⅱ号方颗粒联合恩格列净对慢性肾脏病2~3期患者蛋白尿和肾功能的影响

Effect of Renal FailureⅡPrescription granule combined with empagliflozin on proteinuria and renal function in patients with CKD at stages 2-3

目的:观察肾衰Ⅱ号方颗粒联合恩格列净对慢性肾脏病(CKD)2~3期患者蛋白尿和肾功能的影响。方法:纳入脾肾两虚、湿浊瘀阻证CKD 2~3期患者60例,随机分为对照组30例和治疗组30例。两组患者均予西医一体化治疗,在此基础上,对照组患者予安慰剂颗粒联合恩格列净治疗,治疗组患者予肾衰Ⅱ号方颗粒联合恩格列净治疗,疗程为3个月。治疗后,评价并比较两组患者的临床疗效及中医证候疗效;治疗前后,检测并比较两组患者的血肌酐(Scr)、血尿酸(UA)、血尿素氮(BUN)、肾小球滤过率估计值(eGFR)及24 h尿蛋白定量(24 h UPro)水平。结果:(1)治疗后,对照组的临床疗效总有效率为56.67%,治疗组为86.67%,治疗组的疗效显著优于对照组(P<0.05)。(2)治疗后,对照组的中医证候疗效总有效率为56.67%,治疗组为83.33%,治疗组的中医证候疗效显著优于对照组(P<0.05)。(3)治疗后,两组患者的Scr、UA、24 h UPro水平较治疗前均明显降低(P<0.05),eGFR水平明显升高(P<0.05),治疗组患者的BUN水平亦明显降低(P<0.05),且治疗组患者的Scr水平显著低于对照组(P<0.05)、eGFR水平显著高于对照组(P<0.05)。结论:肾衰Ⅱ号方颗粒联合恩格列净可更好地改善脾肾两虚、湿浊瘀阻证CKD 2~3期患者的中医证候和肾功能,提高临床疗效,具有较好的肾脏保护作用。

Objective:To observe the effects of Renal FailureⅡPrescription combined with empagliflozin on proteinuria and renal function in patients with chronic kidney disease(CKD)at stages 2-3.Methods:Sixty patients of CKD at stages 2-3 with spleen-kidney deficiency and dampness-turbidity-stasis syndrome were included,and randomly divided into the control group(30 cases)and treatment group(30 cases).The patients in both groups were treated with conventional western medicine.Based on above,the patients in the control group were treated with placebo granule combined with empagliflozin,and the patients in the treatment group were treated with Renal FailureⅡPrescription granule combined with empagliflozin.The treatment course was 3 months.After treatment,the clinical efficacy and the efficacy of traditional Chinese medical syndrome were evaluated and compared between the two groups.Before and after treatment,the levels of serum creatinine(Scr),uric acid(UA),blood urine nitrogen(BUN),estimated glomerular filtration rate(eGFR)and 24 h urinary protein quantification(24 h UPro)in the two groups were detected and compared.Results:(1)After treatment,the total clinical effective rate was 56.67%in the control group and 86.67%in the treatment group,and the curative effect of the treatment group was significantly better than that of the control group(P<0.05).(2)After treatment,the total effective rate of traditional Chinese medical syndrome was 56.67%in the control group and 83.33%in the treatment group,and the curative effect of traditional Chinese medical syndrome in the treatment group was significantly better than that in the control group(P<0.05).(3)After treatment,the levels of Scr,UA and 24 h UPro in the two groups were significantly decreased compared with those before treatment(P<0.05),the level of eGFR was significantly increased(P<0.05),the level of BUN in the treatment group was also significantly decreased(P<0.05),and the level of Scr in the treatment group was significantly lower than that in the control group(P<0.05),the level of eGFR was significantly higher than that in the control group(P<0.05).Conclusion:Renal FailureⅡPrescription granule combined with empagliflozin can better improve the traditional Chinese medical syndrome and renal function in patients of CKD at stages 2-3 with spleen-kidney deficiency and dampnessturbidity-stasis syndrome,and enhance the clinical efficacy,which has better renal protection effect.