芪黄益肾汤联合治疗对慢性肾脏病脾肾亏虚证患者的效果及血清Lp-PLA 2、VEGF的作用

Effect of Qihuang Yishen Decoction on Serum Lp-PLA 2 and VEGF in Chronic Kidney Disease Patients with Spleen-kidney Deficiency Syndrome

目的探讨芪黄益肾汤联合治疗在慢性肾脏病(CKD)脾肾亏虚证中的治疗效果及对患者血清脂蛋白相关磷脂酶A 2(Lp-PLA 2)、血管内皮生长因子(VEGF)的作用。方法选取2021年7月—2023年6月80例CKD脾肾亏虚证患者,采用随机数字表法分为2组各40例。对照组采用常规西医治疗,研究组在西医治疗基础上联合芪黄益肾汤治疗,连续治疗3个月。统计对比2组中西医疗效、不良反应,治疗前后肾功能指标[尿素(BUN)、血肌酐(Scr)、肾小球滤过率(eGFR)]、中医证候积分、Lp-PLA 2、VEGF。结果治疗1个月后、治疗3个月后研究组中医证候主症积分、次症积分、总积分均小于对照组,差异有统计学意义(P<0.01)。治疗3个月后研究组BUN、Scr、Lp-PLA 2、VEGF均低于对照组,eGFR高于对照组,差异有统计学意义(P<0.05,P<0.01)。研究组中西医总有效率分别为95.0%(38/40)、92.5%(37/40)均高于对照组的77.5%(31/40)、75.0%(30/40),差异有统计学意义(P<0.05)。2组肝肾功能均无异常,不良反应发生率比较差异无统计学意义(P>0.05)。结论芪黄益肾汤联合治疗能进一步改善CKD脾肾亏虚证患者肾功能,减轻症状,提高临床疗效,对Lp-PLA 2、VEGF等因子也有一定的调节作用,且安全性较高。

Objective To investigate the therapeutic effect of Qihuang Yishen decoction on chronic kidney disease(CKD)patients with spleen and kidney deficiency syndrome and the intervention effect on serum lipoprotein-associated phospholipase A 2(Lp-PLA 2)and vascular endothelial growth factor(VEGF).Methods From July 2022 to June 2023,80 CKD patients with spleen and kidney deficiency syndrome were selected and divided into two groups by random number table method,with 40 cases in each group.The control group was treated with conventional Western medicine,and the research group was treated with Qihuang Yishen decoction for 3 consecutive months.The therapeutic effects of traditional Chinese and Western medicine,adverse reactions,renal function indexes[blood urea nitrogen(BUN),blood creatinine(Scr),glomerular filtration rate(eGFR)],TCM syndrome score,Lp-PLA 2,and VEGF before and after treatment were statistically compared between the two groups.Results At 1 month and 3 months after treatment,the main TCM syndrome score,secondary TCM syndrome score and total score of the research group were lower than those of the control group,and the difference was statistically significant(P<0.01).BUN,Scr,eGFR,Lp-PLA 2 and VEGF in the research group were lower than those in the control group at 1 month and 3 months after treatment,and the differences were statistically significant(P<0.05,P<0.01).The total effective rates of the research group were 95.0%(38/40)and 92.5%(37/40),respectively,which were higher than those of the control group[77.5%(31/40)and 75.0%(30/40)],and the difference was statistically significant(P<0.05).There was no abnormal liver and renal function between the two groups,nor significant difference in the incidence of adverse reactions(P>0.05).Conclusion Qihuang Yishen decoction can further improve renal function,relieve symptoms,improve clinical efficacy,and regulate Lp-PLA 2,VEGF and other factors in CKD patients with spleen and kidney deficiency syndrome,with high safety.