芪黄益肾汤治疗3～4期脾肾亏虚型慢性肾脏病的临床疗效OACSTPCD
Clinical efficacy of Qihuang Yishen Decoction for the treatment of chronic kidney disease with deficiency in spleen and kidney in stage 3-4
目的 探讨芪黄益肾汤治疗3～4期脾肾亏虚型慢性肾脏病(CKD)的临床疗效.方法 选取3～4期脾肾亏虚型CKD患者82例,随机分为观察组和对照组,每组41例.两组患者均接受常规治疗,观察组加用芪黄益肾汤治疗.治疗前后比较两组患者中医证候(面色晦暗、倦怠乏力、气短懒言、食少纳呆、腰膝酸软)积分、肾功能指标[血尿素氮水平、血肌酐水平、估算肾小球滤过率(eGFR)]、血清炎症因子[血管内皮生长因子(VEGF)、转化生长因子(TGF)-β1、白细胞介素(IL)-6]水平,治疗后比较两组的临床疗效.观察治疗期间两组患者不良反应发生情况.结果 治疗后,两组患者的中医证候积分降低,观察组的中医证候积分低于对照组(P<0.05);两组患者的血尿素氮、血肌酐水平降低,eGFR升高,观察组的血尿素氮水平、血肌酐水平、eGFR优于对照组(P<0.05);两组患者血清VEGF、TGF-β1、IL-6水平降低,观察组上述指标低于对照组(P<0.05);观察组总有效率高于对照组(P<0.05).治疗期间,两组的不良反应发生率差异无统计学意义(P>0.05).结论 芪黄益肾汤可以改善3～4期脾肾亏虚型CKD患者的中医证候积分,提高临床疗效,其机制可能与下调VEGF、TGF-β1、IL-6水平有关.
Objective To explore the clinical efficacy of Qihuang Yishen Decoction for the treatment of chronic kidney disease(CKD)with deficiency in spleen and kidney in stage 3-4.Methods A total of 82 CKD patients with deficiency in spleen and kidney in stage 3-4 were selected,and they were randomly divided into observation group or control group,with 41 cases in each group.Both groups received routine treatment,based on which the observation group received additionally Qihuang Yishen Decoction for treatment.Pre-and post-treatment syndrome scores of Traditional Chinese Medicine(gloomy complexion,fatigue and lack of strength,short of breath and lazy to speak,less eating and anorexia,and soreness and weakness of waist and knees),renal function indices in terms of blood urea nitrogen level,blood creatinine level,estimated glomerular filtration rate(eGFR),and serum inflammatory factors levels with respect to vascular endothelial growth factor(VEGF),transforming growth factor(TGF)-β1,and interleukin(IL)-6,as well as post-treatment clinical efficacy were compared between patients of the two groups.The occurrence of adverse reactions in patients of both groups during treatment was observed.Results After treatment,the syndrome scores of Traditional Chinese Medicine in both groups were decreased,and the observation group yielded lower syndrome scores of Traditional Chinese Medicine as compared with the control group(P<0.05).Patients of both groups obtained decreased blood urea nitrogen level,blood creatinine level,whereas an elevated eGFR,and the observation group exhibited superior blood urea nitrogen level and blood creatinine level,as well as a superior eGFR as compared with the control group(P<0.05).Both groups interpreted decreased levels of VEGF,TGF-β1,and IL-6,and the aforementioned levels of the observation group were lower than those of the control group(P<0.05).The total effective rate of the observation group was higher than that of the control group(P<0.05).During treatment,there was no statistically significant difference in the incidence rate of adverse reactions between the two groups(P>0.05).Conclusion Qihuang Yishen Decoction can ameliorate syndrome scores of Traditional Chinese Medicine in CKD patients with deficiency in spleen and kidney in stage 3-4,and elevate clinical efficacy,as well as its mechanism may be related to down-regulate levels of VEGF,TGF-β1,and IL-6.
宣建宗;丁仁华;王义元;吴亮亮;刘源;潘军
天长市中医院肾病科,安徽省天长市 239300
中医学
慢性肾脏病芪黄益肾汤脾肾亏虚型临床疗效肾功能中医证候炎症因子
Chronic kidney diseaseQihuang Yishen DecoctionDeficiency in spleen and kidneyClinical efficacyRenal functionSyndrome of Traditional Chinese MedicineInflammatory factors
《广西医学》 2024 (005)
704-708 / 5
安徽省中医药传承创新科研项目(2022CCYB12);市级临床重点专科建设项目[滁卫健函(2024)47号]
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