固肾解毒汤联合西医常规治疗终末期肾病临床研究

Clinical Study on Gushen Jiedu Decoction Combined with Conventional Western Medicine Therapy for Hemodialysis Patients with End-Stage Renal Disease

目的:观察固肾解毒汤联合西医常规治疗终末期肾病血液透析患者的临床疗效。方法:选择110例终末期肾病血液透析患者为研究对象,按随机数字表法分为研究组和对照组各55例。对照组给予常规西医治疗,研究组在对照组基础上给予固肾解毒汤治疗。2组疗程均为3个月。评价2组临床疗效,比较2组中医证候评分、肾功能、微炎症反应及预后情况。结果:研究组总有效率为89.09%,对照组为74.55%,2组比较,差异有统计学意义(P<0.05)。治疗后,2组各项中医证候评分均较治疗前降低(P<0.05),且研究组各项中医证候评分均低于对照组(P<0.05)。治疗后,2组血肌酐(SCr)、尿素氮(BUN)指标均较治疗前降低(P<0.05),且研究组SCr、BUN指标均低于对照组(P<0.05)。治疗后,2组血清白细胞介素-6 (IL-6)、肿瘤坏死因子-α (TNF-α)水平均较治疗前降低(P<0.05),且研究组血清IL-6、TNF-α水平均低于对照组(P<0.05)。研究组1年生存率为87.76%,病死率为12.24%;对照组1年生存率为70.73%,病死率为29.27%。2组1年生存率和病死率比较,差异有统计学意义(P<0.05)。结论:固肾解毒汤联合西医常规治疗终末期肾病血液透析患者的临床疗效较好,可以减轻临床症状,改善肾功能及微炎症反应,还可有效改善预后,延长患者生存时间。

Objective:To observe the clinical effect of Gushen Jiedu Decoction combined with conventional western medicine therapy for hemodialysis patients with end-stage renal disease.Methods:A total of 110 cases of hemodialysis patients with end-stage renal disease were selected as the study objects and divided into the study group and the control group according to the random number table method,with55 cases in each group.The control group was treated with conventional western medicine treatment,and the study group was additionally treated with Gushen Jiedu Decoction based on the treatment of the control group.Both groups were treated for 3 months.Clinical effects in the two groups were evaluated.Traditional Chinese medicine(TCM) syndrome scores,kidney function,microinflammatory reactions,and prognosis were compared between the two groups.Results:The total effective rate was 89.09% in the study group and 74.55% in the control group,the difference being significant(P<0.05).After treatment,TCM syndrome scores in the two groups were decreased when compared with those before treatment(P<0.05),and each TCM syndrome score in the study group was lower than that in the control group(P<0.05).After treatment,blood creatinine(SCr) and urea nitrogen(BUN) in the two groups were decreased when compared with those before treatment(P<0.05),and SCr and BUN in the study group were lower than those in the control group(P<0.05).After treatment,the levels of interleukin-6(IL-6) and tumor necrosis factor-α(TNF-α) in serum in the two groups were decreased when compared with those before treatment(P<0.05),and the levels of IL-6 and TNF-α in serum in the study group were lower than those in the control group(P<0.05).The one-year survival rate in the study group was 87.76%,and the mortality rate was 12.24%;the oneyear survival rate and mortality rate in the control group were 70.73% and 29.27% respectively.There was significant difference in one-year survival and mortality rates between the two groups(P<0.05).Conclusion:Gushen Jiedu Decoction combined with conventional western medicine therapy has good clinical effects in the treatment of hemodialysis patients with end-stage renal disease,which can relieve clinical symptoms,improve kidney function,microinflammatory reactions,and prognosis,and extend their survival time.