益气护肾方佐治慢性肾衰竭3～5期肾气虚夹瘀临床研究OACSTPCD
Clinical efficacy of Yiqi Hushen decoction adjuvant therapy on patients with stage 3～5 chronic renal failure with syndrome of kidney deficiency and blood stasis
目的:观察益气护肾方佐治慢性肾衰竭(CRF)3～5 期肾气虚夹瘀患者的临床疗效.方法:选取 106 例肾气虚夹瘀CRF 3～5 期患者作为研究对象,按照随机数字表法分为常规组(予以常规治疗及穴位贴敷和中药直肠滴入治疗)和益气护肾组(在常规组基础上联合使用益气护肾方治疗),每组 53 例.比较两组临床疗效、中医症状积分、治疗前后肾功能[肾小球滤过率(eGFR)、血肌酐(Scr)、尿素氮(BUN)、24 h尿蛋白定量(24 h-UPRO)]、炎性因子[粒细胞-巨噬细胞集落刺激因子(GM-CSF)、白细胞诱素-1(LKN-1)、肿瘤坏死因子-α(TNF-α)]、氧化应激指标[晚期糖基化终产物(AGEs)、丙二醛(MDA)、活性氧(ROS)].结果:益气护肾组总有效率高于常规组(P<0.05).治疗后,两组中医症状评分下降,且益气护肾组低于常规组(均P<0.05).治疗后,两组 Scr、BUN、24 h-UPRO 下降,eGFR升高(均P<0.05),且组间比较差异具有统计学意义(均 P<0.05).治疗后,两组 GM-CSF、LKN-1、TNF-α水平下降,且益气护肾组低于常规组(均P<0.05).治疗后,两组 AGEs、MDA、ROS水平下降,且益气护肾组低于常规组(均P<0.05).结论:益气护肾方佐治CRF 3～5 期肾气虚夹瘀患者可调节其炎症因子水平,减轻氧化应激反应和肾损伤,从而改善患者症状和提高疗效.
Objective:To observe the clinical efficacy of Yiqi Hushen decoction in the adjuvant treatment of pa-tients with stage 3～5 chronic renal failure(CRF)with syndrome of kidney deficiency and blood stasis.Methods:106 patients with stage 3～5 CRF with syndrome of kidney deficiency and blood stasis were selected as the research sub-jects.According to the random number table method,they were divided into conventional group(conventional treat-ment,acupoint application and rectal drip of traditional Chinese medicine)and Yiqi Hushen group(Yiqi Hushen de-coction on the basis of conventional group),with 53 cases in each group.The two groups were compared in terms of clinical efficacy,TCM symptoms scores,renal function[estimated glomerular filtration rate(eGFR),serum creati-nine(Scr),blood urea nitrogen(BUN),24-hour urinary protein quantification(24 h-UPRO)],inflammatory factors[granulocyte-macrophage colony-stimulating factor(GM-CSF),leukotactin-1(LKN-1),tumor necrosis factor-α(TNF-α)]and oxidative stress indicators[advanced glycation end products(AGEs),malondialdehyde(MDA),reac-tive oxygen species(ROS)]before and after treatment.Results:The total effective rate in Yiqi Hushen group was higher compared to conventional group(P<0.05).The scores of TCM syndromes were declined in groups after treatment,and the scores in Yiqi Hushen group were lower than those in conventional group(all P<0.05).The lev-els of Scr,BUN and 24 h-UPRO were reduced in both groups after treatment,while the level of eGFR was enhanced(all P<0.05),and there were statistical differences between groups after treatment(all P<0.05).The levels of GM-CSF,LKN-1 and TNF-αwere declined in both groups after treatment,and the levels after treatment were lower in Yiqi Hushen group than those in conventional group(all P<0.05).After treatment,the levels of AGEs,MDA and ROS in the two groups were lowered,and the Yiqi Hushen group had lower AGEs,MDA and ROS(all P<0.05).Conclusion:Yiqi Hushen decoction can regulate the levels of inflammatory factors,relieve the oxidative stress re-sponse and renal injury,improve the symptoms and enhance the efficacy in the adjuvant treatment of patients with stage 3～5 CRF with syndrome of kidney deficiency and blood stasis.
刘文君;王亿平;吕伟;刘诗富
芜湖市中医医院肾病科,安徽 芜湖 241001安徽中医药大学第一附属医院 安徽省中医院肾内科,安徽 合肥 230031
临床医学
慢性肾衰竭肾气虚夹瘀中医症状积分肾功能氧化应激炎性因子
Chronic renal failureKidney deficiency and blood stasisTCM symptoms scoresRenal functionOxidative stressInflammatory factors
《陕西中医》 2024 (008)
1056-1060 / 5
安徽省重点研究与开发计划项目(202104J07020014)
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