肾衰方Ⅱ号联合西药治疗对慢性肾脏病3~5期非透析患者肾功能及钙磷代谢影响研究

Effect of No.2 Renal Failure Recipe combined with Western medicine on renal function and calcium and phosphorus metabolism in patients with non-dialysis chronic kidney disease stages 3~5

目的观察肾衰方Ⅱ号联合西药治疗脾肾气虚兼浊瘀型慢性肾脏病3~5期非透析患者对肾功能及钙磷代谢的影响。方法将64例脾肾气虚兼浊瘀型慢性肾脏病3~5期非透析患者按照随机数字表法分为2组,对照组32例采取降血压、纠正肾性贫血、肠道吸附毒素、纠正水电解质及钙磷代谢紊乱等治疗,治疗组32例在对照组治疗基础上联合肾衰方Ⅱ号治疗。治疗3个月后评估2组临床疗效,比较2组治疗前后中医证候评分、肾功能指标[血肌酐(SCr)、尿素氮(BUN)、肾小球滤过率(GFR)]、血清钙(Ca)、血清磷(P)、全段甲状旁腺激素(iPTH)水平,并统计不良反应发生率。结果治疗组总有效率90.63%(29/32),对照组总有效率65.63%(21/32),治疗组临床疗效优于对照组(P<0.05)。2组治疗后中医证候各项评分及总分均较本组治疗前降低(P<0.05),且治疗组治疗后均低于对照组(P<0.05)。治疗组治疗后SCr、BUN水平及对照组治疗后SCr水平均较本组治疗前降低(P<0.05),2组治疗后GFR均升高(P<0.05),且治疗组治疗后SCr、BUN均低于对照组(P<0.05),GFR高于对照组(P<0.05)。2组治疗后血清Ca水平均较本组治疗前升高(P<0.05),P、iPTH水平均降低(P<0.05),且治疗组治疗后Ca水平高于对照组(P<0.05),P、iPTH水平均低于对照组(P<0.05)。2组不良反应发生率比较差异无统计学意义(P>0.05)。结论肾衰方Ⅱ号联合西药治疗慢性肾脏病3~5期非透析患者临床疗效显著,能够改善临床症状及肾功能,有利于纠正钙磷代谢紊乱,且未增加不良反应发生率,值得临床借鉴。

Objective To observe the effect of No.2 Renal Failure Recipe(No.2RFR)combined with Western medicine on renal function and calcium and phosphorus metabolism in patients with non-dialysis chronic kidney disease(CKD)stages 3~5 of spleen-kidney qi deficiency and blood stasis type.Methods A total of 64 patients with non-dialysis CKD stages 3~5(spleen-kidney qi deficiency and blood stasis type)were randomly assigned into the treatment group(n=32)and the control group(n=32).All patients were managed by conventional Western medicine treatment,and those in the treatment group were additionally treated with No.2 RFR.Treated for 3 months,the aim was to compare traditional Chinese medicine(TCM)syndrome scores,renal function indicators(serum creatinine[SCr],blood urea nitrogen[BUN]),serum calcium(Ca),serum phosphorus(P),intact parathyroid hormone(iPTH)levels and glomerular filtration rate(GFR).The curative effect and incidence of adverse reactions were assessed.Results The overall effective rate in the treatment group was better than that in the control group(90.63%[29/32]vs 65.63%[21/32],[P<0.05],respectively).After treatment,TCM symptom scores in groups were decreased(P<0.05),the decrease in the treatment group was more common compared with the control group(P<0.05).Decreased SCr,BUN and increased GFR were detected in the both groups,there was significant difference in SCr,BUN and GFR between groups(P<0.05).Significantly increased Ca,and significantly decreased P and iPTH were detected in the two groups(all P<0.05),and the treatment group was superior to the control group for Ca,P,iPTH(all P<0.05).None of the incidence of adverse reactions differed significantly between groups(P>0.05).Conclusion For patients with non-dialysis CKD stages 3~5(spleen-kidney qi deficiency and blood stasis type),No.2 RFR combined with Western medicine has significant clinical efficacy,which can improve clinical symptoms and renal function.It is conducive to correcting calcium and phosphorus metabolism disorders,and decreasing incidence of adverse reactions,which is worth clinical reference.