Advances in Research of Treatment of Angina Pectoris in Coronary Heart Disease from the Method of Dredging Collaterals with Pungent

The angina pectoris in coronary heart disease belongs to the category of"chest impediment"in traditional Chinese medicine,and belongs to the syndrome of root deficiency with tip excess.Its main pathogenesis is obstruction of the heart collaterals,and treatment mainly adopts dredging collaterals and relieving pain.Based on the treatment principles of dredging collaterals with pungent,aiming at the etiology,pathogenesis and disease characteristics of angina pectoris in coronary heart disease,this article systematically analyzes the Method of Dredging Collaterals with Pungent including the methods of dredging collaterals with pungent moisture,dredging collaterals with pungent warm,dredging collaterals with pungent aroma,and dredging collaterals with insect type drugs,to provide ideas for the treatment of angina pectoris in coronary heart disease.

Clinical observation on efficacy of compound of warming yang, descending turbidity and dredging collaterals in the treatment of diabetic kidney disease with Yin-Yang deficiency and blood stasis syndrome

Objective:To observe the clinical efficacy of compound of owarming yang,descending turbidity and dredging collaterals in the treatment of diabetic kidney disease with yin-yang deficiency and blood stasis syndrome.Methods:Seventy-six patients of diabetic kidney disease with yin-yang deficiency and blood stasis syndrome were randomly divided into observation group and control group,thirty-eight cases in each group.The control group was given conventional western medicine treatment,while the observation group took compound of owarming yang,descending turbidity and dredging collaterals orally on the basis of conventional western medicine treatment.The course of treatment covered for one month.Before and after treatment,we observed the scores of traditional Chinese medicine symptoms,indicators of renal function[serum creatinine(Scr),blood urea nitrogen(BUN),microalbuminuria(MALB)],indicators of glucose metabolism[fasting plasma glucose(FPG),2-hour postprandial blood glucose(2hPG),glycosylated hemoglobin(HbAlc)],indicators of hemorheology[plasma viscosity(PV),platelet aggregation rate(PAR),fibrinogen(FIB)],Cystatin-C(Cys-C),C-reactive protein(CRP)in the two groups.Results:After treatment,the clinical effect of the observation group was significantly better than the control group(P<0.05).The scores of traditional Chinese medicine symptoms,indicators of renal function(Scr、BUN、UAER),indicators of glucose metabolism(FPG、2hPG、HbAlc),indicators of hemorheology(PV、PAR、FIB),Cys-C and CRP in the two groups were decreased significantly compared with those before treatment(P<0.05),and the decrease in the observation group was superior to that in the control group(P<0.05).Conclusion:Compound of warming yang,descending turbidity and dredging collaterals has remarkable efficacy in treating of diabetic kidney disease patients with yin-yang deficiency and blood stasis syndrome by alleviating clinical symptoms,glucose metabolism,renal function and microcirculatory disturbance,and the mechanism related to alleviation of microinflammation.

Differentiating and Treating Gynecological Diseases based on the Theory of Collateral Diseases

The collateral disease theory is a unique component of the theoretical system of traditional Chinese medicine(TCM),which is currently applied to all kinds of diseases related to the collaterals.With the in-depth study of collaterals theory by many practitioners,its advantages in differentiating and treating gynecological diseases are gradually embodied.Based on the theory of collaterals disease,we discussed the pathogenesis,syndrome differentiation and treatment of gynecological diseases,concluded that the deficient collaterals under nourishment and the stagnant and blocked uterine collateral are the important pathogenesis of gynecological illness.Then we pointed out that invigorating the spleen and tonifying the kidney,and unblocking collateral and dissipating stasis are important treatment methods.We discussed the application of collateral disease theory in Tianjin HA's gynecology,and provided certain theoretical basis and clinical reference for the treatment of gynecologic diseases.

The Relationships between Serum Concentration of IGF-I and Left Ventricular Function as well as Coronary Collateral Circulation in Patients with Coronary Artery Disease

Objective To investigate therelationships between serum concentration of insulin -like growth factor - I (IGF-I) and left ventricular function as well as coronary collateral circulation in patients with coronary artery disease (CAD) . Methods In 41 patients with CAD and 15 control subjects without CAD, the concentrations of serum IGF - I were measured using radioimmunoassay. The relationships between the concentration of serum IGF - I and Leaman coronary artery score, Rentrop grade of coronary collateral circulation, left ventricular ejection fraction (LVEF) as well as left ventricular wall motion Cortina score were assessed. Results 1. There was no significant difference in the mean level of serum IGF -I between the CAD group and the control group (107. 92±44.74 ng/ml vs 113.05 ±33. 65 ng/ml, P> 0. 05), but the IGF - I concentrations in the subgroup with collateral circulation were significantly greater than that in the control group (147. 33 ±29. 92 ng/ml vs 113. 05±33. 65 ng/ml, P < 0. 01) or in the subgroup without collateral circulation (147. 33 ±29. 92 ng/ml vs 80. 01±29. 75 ng/ml , P < 0. 01). 2. The serum concentration of IGF -I had no significant correlation to the Leaman coronary artery score. 3. The serum level of IGF -I had significantly positive correlation to both LVEF ( r = 0. 45, P < 0. 001) and the Rentrop grade of coronary collateral circulation ( r = 0. 74, P < 0. 001), and was negatively related to the left ventricular wall motion Cortina score (r = -0. 53, P < 0. 001). 4. The Leaman coronary artery score had no significant correlation to the Rentrop grade of coronary collateral circulation. 5. The Leaman coronary artery score was related to neither the LVEF nor the Cortina score in the whole CAD group. In the subgroup without coronary collateral circulation, however, the Leaman score had significantly negative correlation to LVEF ( r = - 0. 46, P < 0. 05) and positive correlation to the Cortina score (r = 0. 47, P < 0. 05) . Conclusions The serum concentration of IGF -I was associated with both left ventricular function and coronary collateral circulation in patients with CAD. IGF -I may play a role in promoting coronary collateral circulation and in protecting left ventricular function in patients with coronary artery disease.

Angiographic Evaluation of Coronary Collateral Circulation Patterns in Patients with Coronary Artery Disease Requiring Surgical Revascularization

Background: Coronary artery disease is highly prevalent in India with onset at a younger age. Coronary collateral circulation plays an important role in protecting myocardium from infarction, preserving myocardial contractility and reducing cardiovascular events. The objective of the present study is to assess the pattern of coronary collateral circulation in known cases of coronary artery disease with correlation to age, gender and degree of occlusion. Method: This is a retrospective study done on 200 preoperative angiograms in patients with coronary artery disease. Patients were classified according to age, gender and degree of obstruction in major vessels. Collateral vessels were graded according to the Rentrop classification. Patients with collaterals were further classified on the basis of intensity of collaterals into 3 groups: those with no collateralization (Grade 0), poor collateralization (Grade 1) and those with adequate collateralization (Grade 2 - 3). Results: Collateral development was seen in 175 (87.5%) angiograms. Collaterals were seen in 66% for left anterior descending (LAD), 44.5% for circumflex (LCx) and 70.5% for right coronary artery (RCA) block. Coronary collaterals between LAD and posterior descending artery (PDA) via ventricular septal branches were most common pathways. Adequate collaterals were seen in 53% males and 29.3% females (p 50 years and in 32% in cases with age p = 0.014) and 54.8% cases with arterial obstruction > 90%. Conclusion: Collateral circulation between LAD and PDA via ventricular septal branches is the commonest pathway to develop. Although prevalence of LAD occlusion is higher but collaterals develop more for RCA occlusion. Adequate collaterals develop more frequently in males, cases above 50 years and in vessels with >90% obstruction.

Combing and exploring the origin and development of diabetic nephropathy based on the theory of collateral disorders

By searching TCM disease names"Xiao Shen","Shen Xiao"and"Xin Xiao",which are considered higher degree of coincidence with diabetic nephropathy according to study.And combined with the theory of collateral disorders,sort out the classic literature of traditional Chinese medicine and modern experts'works in chronological order.To make a preliminary exploration of the origin of diabetic nephropathy based on the theory of collateral disorders.Hope to provide reference for TCM theory and clinical research on treating diabetic nephropathy from the theory of collateral disorders in the future.

Idiopathic steno-occlusive disease with bilateral internal carotid artery occlusion:A Case Report

BACKGROUND Moyamoya disease(MMD)is a rare cause of acute stroke and transient ischemic attacks in children.We described clinical,diagnostic features and follow-ups of a young child with acute stroke.CASE SUMMARY We report a 4-year-old girl with left hemiparesis after an acute ischemic stroke.Her history was also significant for repeated left or right focal motor seizures,generalized tonic-clonic convulsions and transient ischemic attacks.Her magnetic resonance imaging and computed tomography(CT)of the brain and magnetic resonance angiography,CT angiography and venography on the cerebral vessels revealed evidence of bilateral fronto-parietal ischemic infarctions,occlusion of the right and left internal carotid arteries started at its bifurcation and non-visualization of right and left anterior and middle cerebral arteries.There was evidence of progression in angiography manifested as development of collaterals from the basal perforating vessels,increase in the extent of large intracranial arterial stenosis/occlusion and extensive collateral circulation with predominance from the posterior circulation.Physical and neurological evaluation and comprehensive laboratory investigations excluded an obvious comorbid disease or risk factor for the child’s condition.The diagnosis of MMD was highly suggested as a cause of the child’s steno-occlusive condition.She was treated symptomatically with levetiracetam,an antiepileptic medication.Aspirin was prescribed for secondary prevention.Her clinical manifestations were improved during the three years of follow-up.Revascularization surgery was postponed.CONCLUSION Up to our knowledge,this is the first report for MMD in a child in our country.The clinical improvement and the stabilization of the child’s condition over the 3 years of follow-up could be attributed to the rapid and extensive recruitment of collaterals and absence of risk factors or comorbidities.Revascularization surgery is highly recommended.

Gut Lymphangiopathy: Adding Fuel to the Fire in Chronic Liver Disease

The splanchnic inflammation inchronic liver disease increases intestinal angiogenesis. In the current study our aim was demonstrating that the small bowel lymphangiogenesis is associated with angiogenesis in chronic cholestasis in the rat. A stereological study of the lymphatic microcirculation in the small intestine was performed in cholestatic rats. Portal enteropathy in cholestasis increases lymphatic microvessels in the mucosa and submucosa layers. Thus, the lymphatic microvessel volume fraction was superior (p < 0.001) in the mucosa (0.16 ± 0.01) and submucosa (0.16 ± 0.01), in regard to the muscle layer 0.015 ± 0.01. The lymphatic microvessel length density was higher in the mucosa (76.89 ± 2.86 mm-2;p -2;p < 0.01), in relationship to the muscle layer (5.04 ± 2.92 mm-2). These alterations predominate in the duodenum (volume fraction: 0.10 ± 0.01 and length density: 33.55 ± 5.98 mm-2) and ileum (volume fraction: 0.16 ± 0.01 and length density: 38.62 ± 6.07 mm-2). This study demonstrates the predominance of an increased lymphangiogenic response in both end sides of the small bowel associated with chronic liver disease. Since the porto-systemic venous collateral circulation in the chronic liver insufficiency is developed in the ends of the gastrointestinal tract, the excessive duodeno-ileal lymphangiogenesis could suggest the development of amesenteric-systemic lymphatic bypass in the chronic portal hypertension.

A Case of Muscle Contraction-Induced Ischemic Limb Hyperemia in a Patient with Peripheral Arterial Disease during Incremental Repeat Isometric Knee Extensor Workloads

Background: To determine whether muscle contraction-induced leg blood flow (LBF) during exercise may be altered in a patient with an ischemic limb due to peripheral arterial disease (PAD) compared with the non-PAD limb. Case Presentation: A 66-year-old male patient with intermittent claudication due to PAD in the right leg (ankle brachial pressure index, 0.69) showed complete obstruction in both common iliac arteries including internal/external segments with collaterals above the femoral artery and popliteal artery with collaterals, and in the healthy left non-PAD-leg (1.06). He attempted unilateral repeat isometric knee extensions at a target contraction rhythm with each leg at incremental contraction intensities (5%, 10%, and 30% of maximum voluntary contraction [MVC] for 3 min at each intensity). Blood velocity/flow (Doppler ultrasound) in the femoral artery, blood pressure, and leg vascular conductance (LVC) were measured. Isometric thigh MVC strength pre-exercise was similar between the PAD-leg (48.0 kg) and non-PAD-leg (48.7 kg). Pre-exercise LBF (ml/min) was also similar between the PAD-leg (316) and non-PAD-leg (327). Blood pressure increases were similar during exercise. Average exercising LBF in ml/min in the last 1 min at each intensity was higher in the PAD-leg than the non-PAD-leg: 1087 vs. 471 at 5%, 2097 vs. 712 at 10%, and 2656 vs. 1517 at 30% MVC with a close positive linear relationship between LBF and %MVC in the non-PAD-leg (r = 0.999, P < 0.01), in agreement with previous findings, but less significant in the PAD-leg (r = 0.879, P = NS), indicating intense vasodilation (increasing LVC) in the PAD-leg compared with the non-PAD-leg. Conclusion: Knee extensor exercising LBF in the femoral artery was dissimilar between the PAD-leg and non-PAD-leg at the same exercise intensity, even though pre-exercising LBF was the same. Further research on the time-course in hemodynamics during leg exercise in PAD might potentially provide insight for the cardiovascular adjustment in severity of arteriosclerosis, stenosis and/or collaterals reserve.

“肺虚络瘀”病机观与氧化应激在慢性阻塞性肺疾病发病过程中相关性探讨

将“肺虚络瘀”病机观为作为慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)发病的核心理论指导以探讨其与氧化应激的相关性,结合对COPD机制的现代临床调查与实验研究,对COPD病理改变过程中出现的氧化应激进行分析与探讨,认为氧化应激是COPD的重要病机之一;从肺虚对机体氧化-抗氧化平衡调节失调,提出COPD氧化-抗氧化失衡是肺虚的微观病理表现基础;氧化应激及其产生的病理改变与“肺虚络瘀”具有相同的病机改变表现;通补肺络法通过调节机体的氧化-抗氧化水平,减轻氧化应激,延缓COPD进程,从这3个方面深入探究COPD的“肺虚络瘀”病机制论与氧化应激的相关性,全面阐释COPD“肺虚络瘀”病机观的科学内涵,并从分子机制水平上诠释从肺络论治COPD的作用机制与靶点,为COPD的中医药治疗与其治疗机制研究提供新的思路及科学依据。

基于毒邪与络病学说探讨免疫炎症在慢性心力衰竭中作用

慢性心力衰竭(以下简称心衰),是各种心脏疾病的终末期阶段,其发病机制与免疫炎症密切相关。免疫细胞激活后,产生大量炎症因子,损伤心肌细胞,导致心肌纤维化、心室重构等病理改变。“毒损心络”是心衰发生、发展的主要病机,贯穿心衰发展的始终,以不同的形式影响心衰的发展及预后。该文通过查阅相关文献,基于毒邪与络病学说,从免疫炎症与心衰的关系及中药防治进行系统梳理,提出心衰早期,以心气虚为主,兼心气阴虚,尚未化毒、入络;心衰中期,心气亏虚为本,痰浊、瘀血、水饮留滞络脉,有化毒、入络趋势;心衰晚期,痰、瘀、水蕴结成毒,损伤心络。中药以复方治疗为主,多具有益气温阳、化瘀利水、解毒通络之功效,通过恢复M1/M2、Th1/Th2及Th17/Treg细胞之间的动态平衡,调节促炎/抗炎因子,从根本上祛除或缓解因毒邪产生的病理状态,减轻炎症,调整心之气血阴阳,达到扶正祛邪、保护心功能的作用,为临床防治心衰提供指导。

急诊介入治疗在肺血减少型复杂先天性心脏病外科术后的应用

目的:探讨急诊介入治疗在复杂先天性心脏病术后的应用经验。方法:收集我中心2013年1月至2023年5月,复杂先天性心脏病外科术后行急诊介入治疗的病例,分析基线资料、侧枝封堵前后的临床特点,外科术后侧枝分布、处理及临床转归。结果:共有12例肺血减少型复杂先天性心脏病术后因体肺侧枝行急诊介入治疗,其中男8例(66.7%)、女4例(33.3%);外科矫治手术中位年龄48(7.5, 93.0)个月,体质量13(6.9, 31.1)kg。其中10例术前行造影检查,有6例于外科术前行体肺侧枝封堵术,4例未见明显体肺侧枝或因体肺侧枝细小未封堵。所有患儿均行外科矫治术。7例患儿在外科术中有回血增多现象,2例在术中行体肺侧枝结扎。所有患儿因术后至少出现下述表现之一:不同程度的肺出血、血痰;需较高条件的呼吸机支持,呼吸末气道压高;影像学改变(胸X线片提示肺血多、肺部渗出或斑片影);无法拔除气管插管或拔管后不耐受;可伴有心功能不全及血氧饱和度维持不佳。所有患儿于外科矫治术后平均4.5(3.0,13.0)d行急诊体肺侧枝介入封堵术,共封堵体肺侧枝29支,平均每例患儿封堵侧枝2.4支。体肺侧枝主要源于胸主动脉(8例,66.7%)、头臂干动脉(8例,66.7%)及腹主动脉(2例,16.7%)。10患儿侧枝封堵术后病情改善:侧枝封堵后(55.8±30.4)h脱离呼吸机;且循环趋于平稳,心功能好转,顺利出院。另外2例因同时合并其他复杂情况,预后不良。结论:复杂多变的体肺侧枝循环是肺血减少型复杂先天性心脏病患儿的诊治难点之一,除了术前、术中早发现早干预,术后积极有效的急诊体肺侧枝封堵可作为补救措施,降低围术期并发症并改善围术期预后。

张守琳运用“温阳解毒通络”法治疗糖尿病肾脏病(Ⅳ-Ⅴ期)经验探析

糖尿病肾脏病属中医学的“肾消(消肾)”“下消”“水肿”等范畴,目前已成为终末期肾病的主要原因。张守琳教授认为“阳虚毒瘀肾络”是糖尿病肾脏病(Ⅳ-Ⅴ期)的基本病机,阳气受损为发病之本,毒瘀肾络是发病的关键环节,并确立了“温阳解毒通络”的治疗原则,有效延缓了肾功能损伤的进展和进入透析的进程。

基于络病学说浅析广泛性焦虑障碍发病与治疗

广泛性焦虑障碍(GAD)在临床中越来越常见,患者除心理上持久而过度的紧张担心外,还伴随一系列躯体化症状。本文将络病学说引入广泛性焦虑障碍,从络脉网状结构与广泛性焦虑障碍症状分布、络病病机与广泛性焦虑障碍病变特点、络病证治与广泛性焦虑障碍治疗三个方面说明两者之间的相似性和关联性。基于络病学说总结出“瘀”“滞”“虚”“损”为该病病机演变的关键,气滞血瘀为初始状态,日久则向络虚不荣、络脉损伤阶段转化,呈现虚实夹杂的病理状态。因此,根据以上核心病机,治疗上应注重行滞通络法和补虚通络法的应用。

不同辨证体系中类风湿关节炎中医病机研究进展

类风湿关节炎属于一种以周围关节骨质损害为主要特征的自身免疫性疾病。中医学对其曾多以病因角度辨证,且多从风、寒、湿、热论治,其他辨证体系涉及较少。近年来,类风湿关节炎病机的相关研究得到广泛重视,其辨证体系和角度的探索也得到进一步拓展。该文对近年发表的有关中医治疗类风湿关节炎的文献进行梳理总结,从脏腑理论、气血津液理论及络病理论共三种辨证体系论述其论治研究进展。期望通过该文的归纳、分类与总结,为今后类风湿关节炎的病机研究和证型分类提供参考和思路。

基于气络学说运用芪归通络口服液联合艾灸治疗气虚血瘀型慢性疲劳综合征的临床观察

【目的】观察基于气络学说,运用芪归通络口服液(广东省第二中医院院内制剂,由黄芪、当归、三七、赤芍、牛膝、鸡血藤、丹参、地龙等中药组成)联合艾灸治疗气虚血瘀型慢性疲劳综合征(chronic fatigue syndrome,CFS)的临床疗效。【方法】采用回顾性研究方法,根据治疗方法的不同将60例气虚血瘀型CFS患者分为观察组和对照组,每组各30例。对照组给予艾条温和灸神阙穴治疗,观察组在对照组的基础上联合芪归通络口服液治疗,疗程为4周。观察2组患者治疗前后中医证候积分、疲劳量表-14(FS-14)评分、血清免疫球蛋白IgA、IgM、IgG含量及皮质醇(COR)水平的变化情况,并评价2组患者的临床疗效和安全性。【结果】(1)疗效方面,治疗4周后,观察组的总有效率为96.67%(29/30),对照组为80.00%(24/30),组间比较,观察组的临床疗效明显优于对照组(P<0.05)。(2)量表评分方面,治疗后,2组患者的中医证候积分、FS-14评分均较治疗前明显降低(P<0.01),且观察组对中医证候积分、FS-14评分的降低作用均明显优于对照组(P<0.01)。(3)实验室指标方面,治疗后,2组患者血清IgA、IgG水平以及观察组血清IgM、COR水平均较治疗前明显升高(P<0.01),且观察组对血清IgA、IgM、IgG及COR水平的升高作用均明显优于对照组(P<0.05或P<0.01)。(4)安全性方面,治疗过程中,2组患者均未发生明显不良反应。【结论】基于中医气络学说,以正虚络阻为CFS核心病机,运用补虚通络法,采用芪归通络口服液联合艾灸治疗气虚血瘀型CFS患者疗效确切,能明显缓解患者的临床症状,提高患者的免疫力水平,调节患者的神经-内分泌-免疫(NEI)网络。

从“毒损脑络-从化”理论探讨脑卒中后认知障碍病机及针刺治疗思路

毒损脑络理论以毒邪和络脉为切入点,探讨脑络、气血、脑神与机体功能活动的生理病理联系;从化理论从邪气自身性质从化、体质从化等角度阐释疾病的病机。脑卒中后认知障碍(PSCI)强调脑卒中与认知功能之间潜在的因果关系,从毒损脑络理论探讨较为贴合,同时其发展转归、临床表现与从化理论相契合,故可从“毒损脑络-从化”理论出发,探讨PSCI的病机特点及针刺治疗思路。由此认为,浊毒是PSCI发病的物质基础,脑络损伤、脑神失养是PSCI发病的关键所在,基于此,治疗以解毒通络为首,毒邪去则络脉不再受损而易复,络脉通则气血畅,神机自复。此外,PSCI波动期邪多从火而化,蕴化热毒,故治以清热泻火;PSCI稳定期邪多从体质而化,因人而异,治宜调平体质。

参松养心胶囊治疗老年冠心病室性早搏气阴两虚、心络瘀阻型患者临床观察

目的:观察参松养心胶囊对老年冠心病室性早搏气阴两虚、心络瘀阻型患者临床疗效、动态心电图室性早搏次数及中医证候积分的影响。方法:选择老年冠心病室性早搏气阴两虚、心络瘀阻型患者60例,按照随机数字表法分为对照组和观察组,每组30例。对照组给予口服酒石酸美托洛尔,观察组在对照组基础上口服参松养心胶囊。两组均连续治疗4周。观察两组治疗前后临床疗效,24 h动态心电图室性早搏次数及中医证候积分。结果:对照组有效率[73.33%(22/30)]高于观察组[96.67%(29/30)](P<0.05)。两组治疗后室性早搏次数均减少,观察组减少较对照组更明显(P<0.05)。与治疗前比较,两组心悸、悸动不安、神疲乏力、气短、五心烦热等中医证候积分均下降(P<0.05),且治疗后观察组上述指标改善优于对照组(P<0.05)。结论:参松养心胶囊能有效减少老年冠心病室性早搏患者的室性早搏次数,改善患者临床症状。

培本清利通络方治疗慢性肾脏病3~5期伴CKD-MBD脾肾两虚兼湿瘀证的临床研究

目的:观察基于吴门医派“络病理论”创立的培本清利通络方联合骨化三醇胶丸治疗慢性肾脏病(CKD)3~5期伴CKD-矿物质及骨代谢紊乱(CKD-MBD)脾肾两虚兼湿瘀证患者的效果。方法:选择2022年7月—2023年6月于南京中医药大学附属苏州市中医医院就诊的脾肾两虚兼湿瘀证CKD 3~5期合并有CKD-MBD的患者60例,随机分为治疗组和对照组,每组30例。对照组予控制血压、控制血糖、改善贫血等基础治疗,同时口服骨化三醇胶丸;治疗组在对照组治疗基础上加服培本清利通络方,两组疗程均为12周。比较两组患者治疗前后肾功能[血肌酐(Scr)、血尿素氮(BUN)、尿酸(UA)]、矿物质及骨代谢[钙(Ca)、磷(P)、全段甲状旁腺激素(iPTH)、碱性磷酸酶(ALP)]、中医症候积分、生活质量评分,并评估临床疗效;治疗前后检测两组血常规、肝功能、血钾,以评估用药安全性。结果:两组治疗后中医症候积分均较治疗前降低,且治疗组低于对照组(P<0.05);治疗组总有效率为93.33%,明显高于对照组的73.33%(P<0.05);治疗后,治疗组BUN、UA均明显低于治疗前,且Scr、BUN均明显低于对照组,差异均有统计学意义(P<0.05);治疗后,治疗组P、iPTH均明显低于治疗前,Ca明显高于治疗前,且治疗组Ca高于对照组,iPTH低于对照组,差异均有统计学意义(P<0.05);治疗后,治疗组生活质量评分较治疗前明显下降,且治疗组低于对照组(P<0.05);两组治疗后安全性指标比较,差异均无统计学意义(P>0.05)。结论:培本清利通络方可改善CKD 3~5期合并CKD-MBD脾肾两虚兼湿瘀证患者Ca、P、iPTH指标,延缓肾功能减退,减轻患者腰脊酸痛、皮肤瘙痒、倦怠乏力等症状,并可提高患者生活质量。