扶正泄浊保肾汤治疗慢性肾功能衰竭(脾肾阳虚)临床观察

Randomized Parallel Controlled Study on Fuzheng Xiezhuo Baoshen Decoction for Chronic Renal Failure(Spleen and Kidney Yang Deficiency)

[目的]观察扶正泄浊保肾汤治疗慢性肾功能衰竭(脾肾阳虚)疗效。[方法]将106例门诊患者按就诊顺序号方法随机分为两组。对照组53例甲钴胺,0. 5mg/次,3次/d;阿司匹林,75mg/次,1次/d。治疗组53例扶正泄浊保肾汤(虫草菌粉9g,熟地黄12g,生晒参、枳实、竹茹、苍术、水蛭、制大黄各10g,黄芪30g,当归10g,陈皮、法半夏各12g,云茯苓、车前子、猪苓各20g,山药、杜仲、牛膝、枸杞各15g,肉桂、附子各8g),水煎300mL,2次/d,早晚温服。连续治疗8周为1疗程。观测临床表现、肌酐清除率、血肌酐、血尿素氮、中医证候积分、不良反应。治疗1疗程(8周),判定疗效。[结果]治疗组临床痊愈31例,显效12例,有效7例,无效3例,总有效率94. 34%;对照组临床痊愈28例,显效7例,有效8例,无效10例,总有效率79. 24%;治疗组疗效优于对照组(P <0. 05)。Ccr、Scr、BUN、中医证候积分两组均有改善(P <0. 05,P <0. 01),治疗组改善优于对照组(P <0. 05,P <0. 01)。[结论]扶正泄浊保肾汤治疗慢性肾功能衰竭(脾肾阳虚),疗效满意,无严重不良反应,值得推广。

[Objective]To observe the curative effect of Fuzheng Xiezhuo Baoshen Decoction on chronic renal failure(spleen and kidney yang deficiency).[Method]A total of 106 outpatients were randomly divided into two groups according to the order number of visits by randomized parallel control method.In the control group,53 cases were treated with mecobalamin,0.5 mg/time,3 times/day,aspirin,75 mg/time,1 time/day.In the treatment group,53 cases were treated with Fuzheng Xiezhuo Baoshen Decoction[Cordyceps militaris powder 9 g,Shudihuang(cooked Rehmannia glutinosa 12 g),Shengshaishen(sun-dried ginseng10 g),Zhishi(Citrus aurantium L 10 g),zhuru(Bamboo Shavings10 g),Cangzhu(Atractylodes rhizome10 g),Shuizhi(leech10 g),Dahuang(rhubarb 10 g),Huangqi(Astragalus 30 g),Danggui(Angelica10 g),Chenpi(tangerine peel12 g),Banxia(Pinellia ternata 12 g),Fuling(Poria cocos20 g),Cheqianzi(plantain seed20 g),Zhuling(porus Cocos 20 g),Shaoyao(yam15 g),Duzhong(Eucommia ulmoides15 g),Niuxi(achyrrhiza bidentata 15 g),Rougui(cinnamon 8 g)and Fuzi(aconite 8 g)],decocted 300 m L,twice a day in the morning and evening.Continuous treatment for 8 weeks was a course of treatment.Clinical manifestations,creatinine clearance rate,serum creatinine,blood urea nitrogen,TCM syndrome score and adverse reactions were observed.One course of treatment(8 weeks)was used to determine the curative effect.[Result]Thirty-one cases were cured in the treatment group,12 cases were markedly effective,7 cases were effective and 3 cases were ineffective and the total effective rate was 94.34%.Twenty-eight cases were cured in the control group,7 cases were markedly effective,8 cases were effective and 10 cases were ineffective and the total effective rate was 79.24%.The curative effect of the treatment group was better than that of the control group(P<0.05).The scores of Ccr,Scr,BUN and TCM syndromes were improved in both groups(P<0.05,P<0.01).The improvement of treatment group was better than that of the control group(P<0.05,P<0.01).[Conclusion]Fuzheng Xiezhuo Baoshen Decoction has satisfactory curative effect on chronic renal failure(spleen and kidney Yang deficiency)and has no serious adverse reactions.It is worthy of popularizing.