湖南中医药大学学报2026，Vol.46Issue(6)：1246-1253,8.DOI:10.3969/j.issn.1674-070X.2026.06.022
益肾清浊汤联用艾灸与前列地尔对慢性肾衰竭的疗效及预后因素研究
Efficacy and prognostic factors of Yishen Qingzhuo Decoction combined with moxibustion and alprostadil in chronic renal failure
摘要
Abstract
Objective To explore the clinical efficacy of Yishen Qingzhuo Decoction(YSQZD)combined with moxibustion and alprostadil injection in the treatment of chronic renal failure(CRF)and analyze the risk factors affecting survival prognosis.Methods A total of 150 CRF patients admitted to the Department of Nephrology,Sichuan Integrative Medicine Hospital from January 2022 to September 2024 were enrolled as study subjects and randomly divided into control group and observation group,with 75 cases in each group.The control group received conventional treatment with alprostadil,while the observation group received additional YSQZD and moxibustion on the basis of the control group.Clinical efficacy,TCM pattern scores,renal function,and microinflammatory factors were compared between the two groups.All patients were followed up for 1 year,and were classified into survival group(n=112)and death group(n=38)based on their survival status.LASSO regression was used to screen variables,and variables with non-zero coefficients were retained for multivariate logistic regression analysis to identify independent prognostic factors.A nomogram prediction model was then constructed.Results The total effective rate in the observation group(90.67％)was higher than that in the control group(77.33％)(P<0.05).After treatment,all dimensions of TCM pattern scores and levels of micro-inflammatory factors in the observation group were lower than those in the control group(P<0.05).The levels of blood urea nitrogen(BUN)and serum creatinine(Scr)in the observation group were lower than those in the control group,while endogenous creatinine clearance rate(Ccr)and estimated glomerular filtration rate(eGFR)were higher(P<0.05).After LASSO regression screening,multivariate Logistic regression analysis showed that heart failure,duration of maintenance hemodialysis,low albumin level,high lipoprotein(a)level,and monotherapy were independent risk factors for death in CRF patients(P<0.05).The nomogram model constructed based on these factors had an AUC of 0.846(95％CI:0.785-0.908)for predicting death risk.Bootstrap resampling with 1,000 iterations verified the model's reliability.The Hosmer-Lemeshow(H-L)test indicated good calibration(χ2=12.635,P=0.125),and the decision curve showed that the model provided a stable net clinical benefit when the risk threshold exceeded 0.08.Conclusion YSQZD combined with moxibustion and alprostadil shows definite efficacy in treating CRF,improving TCM patterns,renal function indicators,and micro inflammatory status.Heart failure,prolonged continusus hemodialfsis,hypoalbuminemia,elevated lipoprotein(a)level,and single-modality treatment are independent risk factors for death in CRF patients.The nomogram model constructed based on these factors can provide a reliable basis for clinical prognostic assessment and individualized treatment.关键词
慢性肾衰竭/益肾清浊汤/艾灸/前列地尔/预后因素Key words
chronic renal failure/Yishen Qingzhuo Decoction/moxibustion/alprostadil/prognostic factor分类
医药卫生引用本文复制引用
杨兰,王贺勇,周靖颖,蒋廷,何倩..益肾清浊汤联用艾灸与前列地尔对慢性肾衰竭的疗效及预后因素研究[J].湖南中医药大学学报,2026,46(6):1246-1253,8.基金项目
四川省中医药管理局科学技术研究专项项目(2024MS567). （2024MS567）
