益肾培元方辅助治疗慢性肾功能衰竭脾肾两虚证39例临床观察

Clinical observation of 39 cases of chronic renal failure with spleen-kidney deficiency syndrome treated by Yishen Peiyuan Fang(益肾培元方)

目的 观察益肾培元方辅助治疗慢性肾功能衰竭(CRF)脾肾两虚证的临床疗效,以及对肾功能、肾纤维化的影响。方法 将78例CRF脾肾两虚证患者采用随机数字表法分为对照组和治疗组,各39例。对照组予西医对症治疗,治疗组在对照组治疗方法的基础上予益肾培元方辅助治疗。连续治疗3个月后,比较2组的临床疗效以及治疗前后的中医症候积分、肾功能指标[尿素氮(BUN)、血肌酐(Scr)、内生肌酐清除率(Ccr)]水平、肾纤维化指标[胱抑素C(CysC)、转化生长因子β1(TGF-β1)]水平。结果 治疗组总有效率为89.74%(35/39),对照组为74.36%(29/39),2组比较差异有统计学意义(P<0.05);治疗后2组中医症候积分明显降低,与同组治疗前比较差异均有统计学意义(P<0.01),且治疗组降低更明显,与对照组治疗后比较差异均有统计学意义(P<0.01);治疗后2组血清BUN、Scr、CysC、TGF-β1水平明显降低,Ccr明显升高,与同组治疗前比较差异均有统计学意义(P<0.01),且治疗组改善更明显,与对照组治疗后比较差异均有统计学意义(P<0.01)。结论 在西医对症治疗的基础上联合益肾培元方辅助治疗CRF脾肾两虚证可提高临床疗效,明显改善患者的临床症状和肾功能,抑制肾纤维化。

Objective To observe the clinical efficacy of Yishen Peiyuan Fang(益肾培元方)in the adjuvant treatment of chronic renal failure(CRF)with spleen-kidney deficiency syndrome,and its influence on renal function and renal fibrosis.Methods 78 patients with spleen-kidney deficiency syndrome of CRF were divided into control group and treatment group by random number table method,39 cases in each group.The control group received symptomatic treatment of western medicine,and the treatment group received adjuvant treatment of Yishen Peiyuan Fang on the basis of the treatment method of the control group.After 3 months of continuous treatment,the clinical efficacy of the two groups were compared,as well as the TCM syndrome score,renal function index[blood urea nitrogen(BUN),serum creatinine(Scr),endogenous creatinine clearance rate(Ccr)]levels,and renal fibrosis index[cystatin C(CysC),transforming growth factorβ1(TGF-β1)]levels before and after treatment.Results The total effective rate was 89.74%(35/39)in the treatment group and 74.36%(29/39)in the control group,with a statistically significant difference(P<0.05).After treatment,there was a significant decrease in TCM symptom scores in both groups compared to before treatment(P<0.01),with a more pronounced decrease observed in the treatment group,this difference was also statistically significant compared to the control group after treatment(P<0.01).BUN,Scr,CysC,TGF-β1 levels significantly decreased while Ccr significantly increased in both groups after treatment;these changes were statistically significant compared to pre-treatment values(P<0.01).The improvements were more pronounced in the treatement group,and the differences were statistically significant compared to the control group after treatment(P<0.01).Conclusion In addition to symptomatic western medicine treatments,Yishen Peiyuan Fang can improve clinical effect for CRF patients with spleen-kidney deficiency syndrome,symptoms,and renal function.It can also inhibit renal fibrosis.