川黄1号方治疗2~4期慢性肾脏病基础上急性肾损伤的临床分析

Clinical analysis of Chuanhuang No.1 formula in the treatment of acute kidney injury on the basis of stage 2~4 chronic kidney disease

目的:探讨川黄1号在2~4期慢性肾脏病合并急性肾损伤患者中的临床应用效果。方法:选取2020年2月~2022年1月期间进行,共纳入94例患者。研究目的旨在评估川黄1号方对慢性肾脏病基础上急性肾损伤患者的治疗效果。研究方法采用随机对照试验设计,研究方法采用随机选取的方式对照试验设计,将患者分为治疗组和对照组,各47人。两组均接受基础治疗,对照组在此基础上加用前列腺素E1,实验组则在对照组基础上联合川黄1号方汤剂口服及浓煎灌肠。治疗两周后,比较两组的临床效果、中医证候积分、肾功能指标(eGFR、Scr、BUN、UA)、24hU-pro水平,以及HO-1、MDA与SOD水平、结果发现,治疗组在改善肾功能指标、减轻症状以及提高生活质量方面均表现出显著优势。与对照组相比,治疗组患者的总有效率也显著提高。治疗后,两组的Scr、BUN、UA低于治疗前,eGFR高于治疗前,24hU-pro水平低于治疗前;实验组Scr、BUN降低程度优于对照组,eGFR也比对照组高,此外,与对照组相比,治疗组患者的总有效率也显著提高。本研究为中医药治疗慢性肾脏病急性肾损伤提供了有力证据,有助于进一步推广和应用川黄1号方。结论:川黄1号方可改善慢性肾脏病并急性肾损伤患者的肾功能和伴随症状,可作为治疗慢性肾脏病并急性肾损伤的有效方案,值得临床推广应用。

Objective:To investigate the clinical effect of Chuanhuang No.1in patients with stage 2~4chronic kidney disease complicated with acute kidney injury.Methods:A total of 94patients were enrolled from February 2020to January 2022.The objective of this study was to evaluate the therapeutic effect of Chuanhuang No.1prescription on patients with acute kidney injury based on chronic kidney disease.Randomized controlled trial design was adopted in this study.Patients were divided into treatment group and control group,with 47patients in each group.Both groups received basic treatment,the control group was added with prostaglandin E1on this basis,the experimental group was combined with Chuanhuang No.1decoction and decocted enema on the basis of the control group.After two weeks of treatment,the clinical effect,TCM syndrome score,renal function index(eGFR,Scr,BUN,UA),24hU-pro level,as well as HO-1,MDA and SOD levels of the two groups were compared.The results showed that the treatment group showed significant advantages in improving renal function index,alleviating symptoms and improving quality of life.The total response rate of patients in the treatment group was also significantly improved compared with the control group.After treatment,Scr,BUN and UA of the two groups were lower than before treatment,eGFR was higher than before treatment,24hU-pro level was lower than before treatment.The experimental group Scr,BUN reduction degree is better than the control group,eGFR is also higher than the control group,in addition,compared with the control group,the total effective rate of patients in the treatment group is also significantly improved.This study provides strong evidence for the treatment of chronic kidney disease and acute kidney injury by Chinese medicine,which is helpful to further promote and apply Chuanhuang No.1formula.Conclusion:Chuanhuang No.1can improve the renal function and accompanying symptoms of patients with chronic kidney disease and acute kidney injury,and can be used as an effective regimen for the treatment of chronic kidney disease and acute kidney injury,which is worthy of clinical application.