Shenkang Ⅶ Recipe Attenuates Unilateral Ureteral Obstruction-induced Renal Fibrosis via TGF-β/Smad, NF-κB and SHH Signaling Pathway

This study aimed to explore the protective effects of the traditional Chinese Medicine formula Shenkang Ⅶ recipe(SK-7)on renal fibrosis and the mechanisms.Renal fibrosis was induced by unilateral ureteral obstruction(UUO)in rats.The rats were then divided into 5 groups:control group(Sham operation),UUO model group,UUO model plus low to high doses of SK-7(0.5,1.0,or 2.0 g/kg/day,for 14 days)groups.The animals were sacrificed on the 7th or 14th day.K idney tissues were collected for histopathological exarminations(hematoxylin and cosin and Masson's trichrome staining).Immunohistochemistry was used to detect the expression of collagen type II(Col II),fibronectin(FN),α-smooth muscle actin(a-SMA),TIMP metallopeptidase inhibitor 2(TIMP2),matrix metallopeptidase 2(MMP2),tumor necrosis factor-α(TNF-α),interleukin-1β(IL-1β)and monocyte chemotactic protein-1(MCP-1).The TGF-β1/Smad,NF-κB and Sonic hedgehog signaling proteins were detected by Western blotting.Our results showed that SK-7 prevented UUO-induced renal injury and accumulation of collagen fibrils.Renal fbrosis biomarkers Col Ⅲ,FN,α-SMA and TMP2 were increased in the rats after UUO and decreased by SK-7,while MMP2 was upregulated after treatment.SK-7 also suppressed the levels of TNF-α,IL-1βand MCP-1 in UUO rats.In addition,SK-7 inhibited activation of the TGF-B/Smad,NF-κB and sonic hedgehog signaling(SHH)pathways.Taken together,these findings suggest that SK-7 may regulate the synthesis and degradation of extracellular matrix,reduce inflammation and suppress the proliferation of fibroblasts,by blocking the TGF-β1/Smad,NF-κB and SHH signaling pathways to exert its anti-renal fbrosis effect in UUO rats.

Effect of Shenkang granule combined with Atorvastatin on renal function, urinary protein and coagulation function in patients with chronic nephritis

Objective: To investigate the effect of Shenkang granule combined with Atorvastatin on renal function, urinary protein and coagulation function in patients with chronic nephritis. Methods:A total of 100 patients with chronic nephritis who were treated in our hospital between May 2016 to May 2017 were randomly divided into control group and observation group, 50 cases in each group. Patients in the control group were treated with Atorvastatin, while patients in the observation group were treated with Shenkang granule on the basis of the treatment in the control group. The changes of renal function, coagulation function and inflammatory factors were detected and compared between the patients in the two groups before and after treatment. Result: After treatment, the levels of Cr, BUN and 24hUpro in serum of patients in the two groups were significantly decreased, and the levels of ALB were significantly increased, and the changes of the above factors of patients in the observation group were more obvious. After treatment, the levels of PT, APTT and TT of patients in the two groups were significantly increased, and the levels of FIB were significantly decreased, and the changes of the above indexes of patients in the observation group were more obvious. After treatment, the levels of hs-CRP and TNF-α in serum of patients in the two groups were significantly decreased, and the decrease trend of inflammatory factors of patients in the observation group was more obvious. Conclusion: Shenkang granule combined with Atorvastatin has a good effect on treatment of chronic nephritis. It can significantly improve renal function and coagulation function, alleviate inflammation, and has a certain protective effect on kidney of patients.

Effects of Shenkang Injection Combined with Hemodialysis on Dialysis Rate and Nutriture in Patients with Chronic Renal Failure

OBJECTIVE: To explore the effects of Shenkang Injection combined with hemodialysis on dialysis rate and nutriture in patients with chronic renal failure (CRF).METHODS: A total of 110 CRF patients admitted in the hospital from January 2016 to January 2018 were randomly divided into 2 groups.The control group was treated with hemodialysis while the observation group was additionally treated with Shenkang Injection on the treatment basis of the control group.They were treated for 4 weeks and reexamined 1 d after the treatment.Renal function,nutriture,dialysis adequacy,oxidative stress level and inflammatory factor level in the 2 groups were determined before and after the treatment,and traditional Chinese medicine (TCM) syndrome score,dialysis rate within 1 week and incidence of adverse reactions during the treatment were counted before and after the treatment.RESULTS: After the treatment,the levels of serum creatinine (Scr) and urea nitrogen (BUN) in the observation group were lower than those in the control group,and the endogenous creatinine clearance rate (Ccr) was higher than that in the control group (P < 0.05).After the treatment,the nutriture in the observation group was better than that in the control group (P < 0.05).After the treatment,the dialysis rate and time average concentration of urea (TACurea) in the observation group were lower than those in the control group,while the overall urea clearance rate (Kt/V) and protein catabolic rate (PCR) were higher than those in the control group (P < 0.05).After the treatment,the TCM syndrome scores in the observation group was lower than that in the control group (P < 0.05) and the level of serum malondialdehyde (MDA) in the observation group was lower than that in the control,while the level of superoxide dismutase (SOD) and total antioxidant capacity (T-AOC) in the observation group were higher than those in the control group (P < 0.05).After the treatment,the levels of inflammatory factors in the observation group were lower than those in the control group (P < 0.05).No serious adverse reactions occurred in the 2 groups.CONCLUSION: Shenkang Injection combined with hemodialysis for the treatment of CRF can effectively improve clinical symptoms and nutriture,and reduce the dialysis rate.

Meta-analysis of the efficacy and safety of Shenkang injection combined with Western medicine in the treatment of chronic glomerulonephritis

Objective:The purpose of the research was to systematically evaluate the clinical efficacy and safety of Shenkang injection combined with Western medicine in treating chronic glomerulonephritis.Methods:Randomized controlled trials of Shenkang Injection combined with Western medicine in treating CGN were obtained from 8 Science databases including China National Knowledge Infrastructure(CNKI),China Biomedical Database(SinMed),Weipu Database(VIP),Wanfang Database(Wanfang),PubMed,The Cochrane Library,Embase,Web of Science from establishment to June 2022.Two researchers screened literature and extracted useful data according to inclusion and exclusion criteria,and used RevMan 5.3 and STATA SE 14.0 software to perform meta-analysis.Results:1,214 patients were included in 15 studies,with 607 in treatment group and 607 in control group.The results of meta-analysis showed that the treatment group could improve the clinical effective rate[RR=1.33,95%CI(1.25,1.40),P<0.00001],reduce serum creatinine[MD=-31.28,95%CI(-42.90,-19.66),P<0.00001],blood urea nitrogen[MD=-2.26,95%CI(-3.08,-1.44),P<0.00001],24-hour urine protein quantification[MD=-0.37,95%CI(-0.49,-0.25),P<0.00001],tumor necrosis factor-α[MD=-7.93,95%CI(-10.56,-5.30),P<0.00001],systolic blood pressure[MD=-10.81,95%CI(-13.66,-7.96),P<0.00001]and diastolic blood pressure[MD=-7.36,95%CI(-9.34,-5.38),P<0.00001].Conclusion:Shenkang injection combined with Western medicine can enhance the clinical effective rate of CGN and reduce the levels of serum creatinine,blood urea nitrogen,24-hour urine protein quantification,tumor necrosis factor-α,systolic blood and diastolic blood pressure.However,due to the low quality of literature,the conclusion still needs to be supported by more multi-center,large-sample studies with rigorous design and standardized implementation.

基于申康医联平台的急性胰腺炎专病数据库设计与应用

为了更好地满足急性胰腺炎临床科研需求,迫切需建立标准统一、多中心专病数据库,指导临床持续改进诊疗质量。在市政府的支持下,联合9家市级医院合作制定多中心急性胰腺炎标准数据模型。基于申康医联平台,将多中心多源异构数据融合自然语言处理技术标准化,深度处理整合。实现结构化专病数据库,已支持科研人员开展相关临床研究。市级急性胰腺炎专病数据库可促进数据汇聚标准化,提高临床科研水平,同时促进信息化的应用。

Preventive effect of Shenkang injection against high glucose-induced senescence of renal tubular cells

Shenkang injection (SKI) is a classic prescription composed of Radix Astragali, rhubarb, Astragalus, Safflower, and Salvia. This treatment was approved by the State Food and Drug Administration of China in 1999 for treatment of chronic kidney diseases based on good efficacy and safety. This study aimed to investigate the protective effect of SKI against high glucose (HG)-induced renal tubular cell senescence and its underlying mechanism. Primary renal proximal tubule epithelial cells were cultured in (1) control medium (control group), medium containing 5 mmol/L glucose;(2) mannitol medium (mannitol group), medium containing 5 mmol/L glucose, and 25 mmol/L mannitol;(3) HG medium (HG group) containing 30 mmol/L glucose;(4) SKI treatment at high (200 mg/L), medium (100 mg/L), or low (50 mg/L) concentration in HG medium (HG+ SKI group);or (5) 200 mg/L SKI treatment in control medium (control+ SKI group) for 72 h. HG-induced senescent cells showed the emergence of senescence associated heterochromatin foci, up-regulation of P16INK4 and cyclin D1, increased senescence-associated β-galactosidase activity, and elevated expression of membrane decoy receptor 2. SKI treatment potently prevented these changes in a dose-independent manner. SKI treatment prevented HG-induced up-regulation of pro-senescence molecule mammalian target of rapamycin and p66Shc and down-regulation of anti-senescence molecules klotho, sirt1, and peroxisome proliferator-activated receptor-g in renal tubular epithelial cells. SKI may be a novel strategy for protecting against HG-induced renal tubular cell senescence in treatment of diabetic nephropathy.

Shenkang injection improves coagulation in patients with chronic kidney disease: a systematic review and Meta-analysis

OBJECTIVE: To investigate the effect of Shenkang injection(SKI) on chronic kidney disease(CKD).METHODS: Seven databases including Cochrane Central Register of Controlled Trials, PubMed, EMBASE, MEDLINE, China National Knowledge Infrastructure, Wanfang Database, and CQVIP from their inception to March 2018 were searched. Only randomized controlled trials that evaluated conventional treatment and conventional treatment with SKI in CKD patients were investigated. Outcomes such as fibrinogen(FIB), D-dimer, prothrombin time(PT), activated partial thromboplastin time(APTT), and the side effects of SKI were analyzed using Revman 5.3 software. The quality of the studies was assessed using the Cochrane Collaboration’s Risk of Bias tool and the quality of evidence was assessed using GRADEpro.RESULTS: Four randomized controlled trials were investigated in our analysis, and these studies were of moderate quality. For FIB and D-dimer, SKI had a superior effect compared with the control group(mean difference(MD)=-1.23, 95% confidence interval(CI):-1.46,-0.99, P < 0.01;MD =-0.36, 95%CI:-0.51,-0.21, P < 0.01, respectively)SKI increased APTT and PT compared with the control(MD = 7.34, 95% CI: 3.05, 11.62, P < 0.01;MD = 3.40,95% CI: 2.2, 4.61, P < 0.01, respectively). In the four studies, there were no side effects that were related to SKI.CONCLUSION: SKI may be effective in improving coagulation in patients with CKD without obvious adverse reactions. However, more well-designed studies are required to confirm the findings.

Shenkang Injection protects against diabetic nephropathy in streptozotocin(STZ)-induced mice through enhancement of anti-oxidant and anti-inflammatory activities

Objective:To investigate the protective effects and possible mechanisms of Shenkang Injection(SKI)on the diabetic nephropathy in streptozotocin-induced mice.Methods:STZ with the feeding of high fat diet(HFD)was used to induce diabetic mice.The balb/c mice and diabetic mice were then randomly divided into five groups:(1)control group,(2)model group,(3)alprostadil(Alp,1.5μg/kg)group,(4)SKI(30 ml/kg)group,(5)Alp(1.5μg/kg)+SKI(15 ml/kg)group.After six weeks'treatment,blood,urine and kidney tissues were collected for biochemical assay,EUSA assay,and pathological analysis.Results:Diabetic mice exhibited evident manifestations of diabetic nephropathy(DN),as indicated by increased 24-h urine volume,urinary albumin and kidney weight index(P<0.01),which could be attenuated by SKI treatment(P<0.01).SKI was further found to improve abnormal morphology in glomerulus with increased glomerular volume and to decrease urinary N-acetyl-b-D-glucpsaminidase(NAG),β2-microglobulin(β2-MG),and kidney injury molecules-1(KIM-1)levels(P<0.05,P<0.01).Plasma levels of anti-oxidant enzymes significantly reduced in the diabetic mice,and those decreases could be reversed by SKI and Alp treatments.Additionally,SKI obviously suppressed the diabetes-induced increases of proinflammatory cytokines(IL-6,IL-1βand TNF-α)(P<0.01).Meanwhile,SKI was found to effectively attenuate the diabetes-induced coagulation dysfunction,as evidenced by lengthening prothrombin and thrombin time,and decreasing plasma levels of fibrinogen(FIB),6-K-PGF1αand thromboxane B2(TXB2)(P<0.05,P<0.01).With SKI and Alp combined treatment,the anti-oxidant activities and improvements of coagulation dysfunction were enhanced.Conclusion:SKI possesses a remarkable property to prevent diabetic nephropathy.The improvements of kidney function and hypercoagulability by SKI were enhanced with Alp combined treatment.The molecular mechanisms underlying the protection of SKI against DN may be related to enhancing the antioxidant and anti-inflammatory activities,and improving the coagulation dysfunction.

肾康注射液用于糖尿病肾病治疗的快速卫生技术评估

目的 快速卫生技术评估肾康注射液用于糖尿病肾病治疗的有效性、安全性及经济性,为临床实践和决策者提供循证依据。方法 检索PubMed、Cochrane Library、Embase和CNKI、VIP、WanFang、SinoMed等数据库以及卫生技术评估(Health Technology Assessment, HTA)网站,设置检索文献发表时间为2000年1月1日—2023年5月31日,对肾康注射液用于糖尿病肾病治疗的相关循证证据进行汇总分析。结果 共纳入8篇文献,结果显示,与常规治疗相比,肾康注射液在尿素氮(Blood Urea Nitrogen, BUN)、血肌酐(Serum Creatinine,SCr)、尿白蛋白排泄率(Urinary Albumin Excretion Rates, UAER)和总有效率等方面均有明显改善,差异有统计学意义(P均<0.05)。肾康注射液总体安全性较好,其不良反应以注射部位疼痛、潮红为主,但经济性方面不占优势。结论 肾康注射液用于糖尿病肾病的治疗有较好的有效性、安全性,但其经济性不占优势。

肾康注射液联合百令片治疗老年糖尿病肾病患者的效果

目的:观察肾康注射液联合百令片治疗老年糖尿病肾病(DN)患者的效果。方法:回顾性分析2021年8月至2023年5月该院收治的68例老年DN患者的临床资料,按照治疗方法不同将其分为对照组和观察组各34例。两组均予以对症治疗,在此基础上,对照组予以百令片治疗,观察组在对照组基础上联合肾康注射液治疗,两组均治疗4周。比较两组临床疗效,治疗前后肾功能指标[24 h尿蛋白定量(24hUP)、血肌酐(Scr)、血尿素氮(BUN)]水平、凝血功能指标[纤维蛋白原(FIB)、凝血酶原时间(PT)]水平、氧化应激指标[超氧化物歧化酶(SOD)、丙二醛(MDA)]水平、转化生长因子-β1(TGF-β1)水平,以及不良反应发生率。结果:观察组治疗总有效率为94.12%(32/34),高于对照组的76.47%(26/34),差异有统计学意义(P<0.05);治疗后,观察组24hUP、Scr、BUN水平均低于对照组,差异有统计学意义(P<0.05);治疗后,观察组PT长于对照组,FIB水平低于对照组,差异均有统计学意义(P<0.05);治疗后,观察组SOD水平高于对照组,MDA、TGF-β1水平低于对照组,差异均有统计学意义(P<0.05);两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:肾康注射液联合百令片治疗老年DN患者可提高治疗总有效率,降低肾功能指标水平,改善凝血功能指标和氧化应激指标水平,降低TGF-β1水平,效果优于单纯百令片治疗。

肾康注射液联合连续性肾脏替代治疗脓毒症合并急性肾损伤患者的效果

目的:观察肾康注射液联合连续性肾脏替代治疗(CRRT)脓毒症合并急性肾损伤(AKI)患者的效果。方法:回顾性分析2021年2月至2023年2月该院收治的106例脓毒症合并AKI患者的临床资料,根据治疗方案不同将其分为对照组与研究组各53例。对照组行CRRT治疗,研究组在对照组基础上联合肾康注射液治疗,比较两组临床疗效、治疗前后中医证候积分、器官功能损伤程度[序贯性器官功能衰竭(SOFA)]评分、肾功能指标[胱抑素C(CysC)、血肌酐(Scr)、β_(2)-微球蛋白(β_(2)-MG)、血尿素氮(BUN)]水平、炎性指标[肾损伤分子-1(KIM-1)、可溶性细胞间黏附分子-1(sICAM-1)、C反应蛋白(CRP)、中性粒细胞明胶酶相关载脂蛋白(NGAL)]水平,以及不良反应发生率。结果:研究组治疗总有效率为94.34%(50/53),高于对照组的81.13%(43/53),差异有统计学意义(P<0.05);治疗后,两组中医证候积分、SOFA评分均低于治疗前,且研究组低于对照组,差异有统计学意义(P<0.05);两组CysC、Scr、β_(2)-MG、BUN水平均低于治疗前,且研究组低于对照组,差异有统计学意义(P<0.05);两组KIM-1、sICAM-1、CRP、NGAL水平均低于治疗前,且研究组低于对照组,差异有统计学意义(P<0.05);研究组不良反应发生率为3.76%,低于对照组的15.04%,差异有统计学意义(P<0.05)。结论:肾康注射液联合CRRT治疗脓毒症合并AKI患者可提高治疗总有效率,降低中医证候积分、SOFA评分、肾功能指标水平、炎性指标水平和不良反应发生率,其效果优于单纯CRRT治疗。

肾康注射液联合非布司他治疗痛风性肾病合并慢性肾衰竭患者的效果

目的:观察肾康注射液联合非布司他治疗痛风性肾病(GN)合并慢性肾衰竭(CRF)患者的效果。方法:回顾性分析2021年5月至2023年5月该院收治的134例GN合并CRF患者的临床资料,按照治疗方法不同将其分为对照组和观察组各67例。对照组采用非布司他治疗,观察组在对照组基础上联合肾康注射液治疗,比较两组临床疗效,治疗前后肾功能指标[估算肾小球滤过率(eGFR)、血肌酐(Scr)、血尿素氮(BUN)]水平、氧化应激指标[超氧化物歧化酶(SOD)、髓过氧化物酶(MPO)、丙二醛(MDA)]水平、肾纤维化指标[成纤维细胞生长因子2(FGF2)、骨形态发生蛋白-7(BMP-7)、结缔组织生长因子(CTGF)]水平,以及不良反应发生率。结果:观察组治疗总有效率为91.04%(61/67),高于对照组的77.61%(52/67),差异有统计学意义(P<0.05);治疗后,观察组eGFR、SOD、BMP-7水平均高于对照组,Scr、BUN、MPO、MDA、FGF2、CTGF水平均低于对照组,差异有统计学意义(P<0.05);两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:肾康注射液联合非布司他治疗GN合并CRF患者可提高治疗总有效率,改善肾功能指标、氧化应激指标和肾纤维化指标水平,效果优于单纯非布司他治疗。

肾康注射液联合西药治疗肾病综合征疗效的Meta分析

目的系统评价肾康注射液联合西药治疗肾病综合征的临床疗效及安全性。方法检索中国知网、万方数据库、维普中文数据库、中国生物医学文献服务系统、Web of Science、Embase、PubMed及Cochrane Library数据库自建库至2022年6月30日期间所有肾康注射液联合西药治疗肾病综合征(Nephrotic syndrome,NS)的随机对照试验(Randomized controlled trial,RCT),并由两名研究人员提取资料并进行质量评价,采用Review Manager 5.4.1软件和R语言进行Meta分析。结果共纳入19篇文献,涉及1509例患者,治疗组763例,对照组746例。Meta分析结果显示:肾康注射液联合西药较单纯西药治疗肾病综合征可以显著提高临床总有效率[RR=1.27,95%CI(1.20;1.34),P<0.00001]、内生肌酐清除率(Creatinine clearance rate,Ccr)[MD=6.36,95%CI(3.04;9.68),P=0.0002]、血浆白蛋白(Plasma Albumin,ALB)[MD=4.94,95%CI(3.23;6.64),P<0.00001]水平,能有效降低甘油三酯(Triglycerides,TG)[MD=-0.86,95%CI(-1.05;-0.67),P<0.00001]、总胆固醇(Total cholesterol,TC)[MD=-1.44,95%CI(-2.14;-0.74),P<0.00001]、血清肌酐(Serum creatinine,Scr)[MD=-33.60,95%CI(-67.03;-0.17),P<0.00001]、尿素氮(Urea nitrogen,BUN)[MD=-2.47,95%CI(-2.89;-2.05),P<0.00001]、24 h尿蛋白定量(24 h urine total protein,24 h UTP)[MD=-0.57,95%CI(-0.78;-0.35),P<0.00001]水平,且差异有统计学意义。结论肾康注射液联合西药可以提高肾病综合征患者的临床总有效率,提高Ccr和ALB,能有效降低TG、低胆固醇、Scr、BUN和24 h UTP,在一定程度上可以减少肾病综合征患者的肾功能的损伤。

中药结肠透析联合肾康注射液治疗慢性肾脏病3~4期临床观察

目的观察中药结肠透析联合肾康注射液对慢性肾脏病(CKD)3~4期患者的临床疗效。方法60例确诊患者随机分为对照组(肾康注射液治疗)30例和观察组(肾康注射液联合中药结肠透析治疗)30例,观察用药前后2组患者血尿素氮(BUN)、肌酐(Scr)、尿酸(UA)、血清胱抑素C(Cys-C)、超敏C反应蛋白(hs-CRP)的变化。结果治疗后,2组患者的BUN、Scr、UA、Cys-C、hs-CRP水平均有改善,差异有统计学意义(P<0.05),并且观察组优于对照组(P<0.05)。结论中药结肠透析联合肾康注射液可明显改善慢性肾脏病3~4期患者肾功能、降低炎症因子水平,延缓肾功能进展,并且安全性好。

肾康注射液联合穴位敷贴治疗慢性肾功能衰竭疗效及作用机制

目的:探讨肾康注射液联合穴位敷贴治疗慢性肾功能衰竭(CRF)的临床疗效及作用机制。方法:选取150例CRF患者,依据随机数字表法分为两组,各75例。对照组予肾康注射液治疗,治疗组予肾康注射液联合穴位敷贴治疗。比较两组总有效率、治疗前后症状体征积分、肾功能、氧化应激和肾纤维化指标。结果:治疗组总有效率92.00%高于对照组的74.67%(P<0.05)。治疗后两组症状体征有所缓解,且治疗组恶心呕吐、腰膝酸软、倦怠乏力、脘腹胀满、口渴不饮、食欲欠佳积分均低于对照组(P<0.05)。治疗后两组血肌酐(Scr)、血尿素氮(BUN)、血尿酸(UA)、活性氧(ROS)、丙二醛(MDA)、透明质酸(HA)、Ⅲ型前胶原(PCⅢ)、半胱氨酸蛋白酶抑制蛋白C(Cys-C)均较治疗前降低,内生肌酐清除率(Ccr)、超氧化物歧化酶(SOD)、谷胱甘肽过氧化物酶(GSH-Px)较治疗前升高,且治疗组上述指标优于对照组(P<0.05)。治疗组总不良反应发生率为6.67%,与对照组的14.67%比较差异无统计学意义(P>0.05)。结论:肾康注射液联合穴位敷贴治疗CRF疗效显著,可明显缓解患者临床症状,改善肾功能,其机制可能与该方能有效调节氧化应激、抑制肾纤维化进展有关。

不同剂量肾康注射液辅助治疗慢性肾脏病3~5期的效果及对肾功能的影响

目的:探究不同剂量肾康注射液辅助治疗慢性肾脏病(chronic kidney disease,CKD)3~5期的效果及对肾功能的影响。方法:选择2020年1月1日—2022年12月31日贵溪市人民医院收治的80例3~5期CKD患者,参照随机数字表法分为观察组及对照组,每组40例,对照组采用60 mL/次肾康注射液治疗,观察组采用80 mL/次肾康注射液治疗。比较治疗2周后两组临床效果;比较分析两组治疗前、治疗2周后中医症候积分(水肿、腹胀腹痛、腰脊酸痛、疲倦无力、尿频、大便稀溏)、肾功能[血肌酐(Scr)、尿素氮(BUN)、β2微球蛋白(β2-MG)]、炎症指标[C反应蛋白(CRP)及肿瘤坏死因子-α(TNF-α)]差异;探究两组治疗期间的用药不良反应发生差异。结果:治疗2周后,观察组总有效率高于对照组,差异有统计学意义(P<0.05);治疗2周后,两组中医症候积分均较治疗前有所下降,且观察组的中医症候积分均低于对照组,差异均有统计学意义(P<0.05);治疗2周后,两组Scr、BUN、β2-MG水平均低于治疗前,且观察组均低于对照组,差异均有统计学意义(P<0.05);治疗2周后,两组CRP、TNF-α均低于治疗前,且观察组均低于对照组,差异均有统计学意义(P<0.05);两组治疗期间用药不良反应发生率差异无统计学意义(P>0.05)。结论:80 mL/次剂量的肾康注射液辅助治疗3~5期CKD患者有助于效果的提升,且对其临床症状、肾功能及炎症的改善更为显著。

肾康注射液联合前列地尔对比单用前列地尔治疗慢性肾衰竭的Meta分析

目的:系统评价肾康注射液联合前列地尔(试验组)对比单用前列地尔(对照组)治疗慢性肾衰竭(CRF)的临床疗效及安全性,为临床治疗提供参考。方法:采用Cochrane协作组提供的Revman5.4软件对纳入的RCT文献进行风险评估与Meta分析。结果:共纳入9项RCT研究,共计691例患者。Meta分析结果显示,试验组在提高优化总有效率(RR=1.24,95%CI[1.16,1.33],P<0.00001),BUN(MD=-4.28,95%CI[-6.10,-2.46],P<0.00001),Scr(MD=-51.91,95%CI[-68.11,-35.70],P<0.00001),Ccr(MD=5.78,95%CI[2.15,9.41],P=0.002),24 h Upro(MD=-0.56,95%CI[-0.66,-0.46],P<0.00001)方面明显优于对照组,不良反应发生率差异无统计学意义,无严重不良反应。结论:肾康注射液联合前列地尔对比单用前列地尔疗效更佳,值得临床推广使用。但由于证据质量不高,还需要更多严格的、多中心的、随机双盲、大样本的RCT试验进一步探讨。

达格列净联合肾康注射液治疗糖尿病肾病Ⅳ期临床疗效

目的观察达格列净联合肾康注射液治疗糖尿病肾病Ⅳ期的临床疗效。方法选择2020年1月—2022年3月临沂市中心医院收治的糖尿病肾病Ⅳ期患者92例,采用随机数字表法分为观察组和对照组,每组46例。2组患者均给予降压、控制血糖、调脂等常规治疗,对照组在常规治疗的基础上给予肾康注射液治疗,观察组在对照组治疗的基础上加用达格列净治疗,2组疗程均为4周。比较2组临床疗效、治疗前后空腹血糖(FBG)、糖化血红蛋白(HbA_(1c))、胱抑素C(CysC)、24 h尿蛋白定量(24 hUTP)、尿白蛋白/尿肌酐(UACR)、肾小球滤过率(GFR)水平。结果观察组总有效率为91.30%,高于对照组的71.74%(χ^(2)=5.845,P=0.016)。治疗4周后,2组FBG、HbA_(1c)、CysC、24 hUTP、UACR水平均低于治疗前,GFR高于治疗前,且观察组变化幅度大于对照组(P<0.01)。结论达格列净联合肾康注射液治疗糖尿病肾病Ⅳ期疗效较好,能够改善血糖水平,降低尿蛋白,改善肾功能,值得临床推广应用。

肾康贴穴位敷贴联合新肾炎康颗粒治疗脾肾气虚型慢性肾炎的临床效果

目的探讨肾康贴穴位敷贴^(+)新肾炎康颗粒应用在脾肾气虚型慢性肾炎患者中的临床效果。方法选取2021年2月至2022年2月九江市中医医院收治的74例脾肾气虚型慢性肾炎患者作为研究对象,采用随机数字表法将其分为对照组与观察组,每组各37例。对照组患者采用西医常规治疗,观察组患者采用肾康贴穴位敷贴^(+)新肾炎康颗粒治疗。比较两组患者的中医证候积分、肾功能指标、血清炎症因子、免疫指标、治疗有效率。结果治疗前,两组患者的中医证候积分、肾功能指标[血肌酐(SCr)、血尿素氮(BUN)、尿蛋白]、血清炎症因子[白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、白细胞介素-1β(IL-1β)]、免疫指标(CD8^(+)、CD4^(+)、CD3^(+))比较,差异无统计学意义(P>0.05);治疗2个月后,观察组患者的中医证候积分、SCr、BUN、尿蛋白、IL-6、TNF-α、IL-1β、CD8^(+)低于对照组,CD4^(+)、CD3^(+)高于对照组,差异有统计学意义(P<0.05)。观察组患者的治疗总有效率(91.89%)高于对照组(72.97%),差异有统计学意义(P<0.05)。结论对脾肾气虚型慢性肾炎患者行肾康贴穴位敷贴^(+)新肾炎康颗粒治疗,能够增强疗效及免疫功能,降低炎症因子水平,尽快改善肾功能、临床症状,值得推广。

肾康注射液联合六君子汤治疗慢性肾衰竭临床观察

目的探讨肾康注射液联合六君子汤加减治疗慢性肾衰竭的临床效果。方法选取进贤县人民医院116例慢性肾衰竭患者作为本次研究对象,收治时间为2019年1月—2021年12月,使用随机数字表法进行分组,即试验组和参照组,每组58例。给予参照组患者肾康注射液;给予试验组患者肾康注射液联合六君子汤加减治疗。比较2组患者疗效;比较2组患者肾功能指标以及中医证候评分。结果试验组治疗有效率高于参照组(P<0.05);治疗后,2组Scr、BUN水平均有下降,且试验组显著低于参照组(P<0.05);Hb水平则差异无统计学意义;治疗后,试验组中医证候评分均小于参照组(P<0.05)。结论肾康注射液联合六君子汤加减治疗对慢性肾衰竭患者具有良好的临床效果,可以提升治疗有效率,改善中医证候。