上海中医药大学附属曙光医院
纸质出版:2018
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[1]徐亚赟,何峥,周圆,杨婧,王琛.肾衰Ⅱ号方联合西药对原发性慢性肾脏病3、4期患者肾功能及肾血流灌注的影响[J].中医杂志,2018,59(17):1480-1484.
XU Yayun, HE Zheng, ZHOU Yuan, et al. Effects of the Meliorated Renal Failure Decoction(肾衰Ⅱ号方) Combined with Western Medicine on Renal Function and Renal Perfusion in Primary Chronic Kidney Disease 3 or 4 Stage Patients[J]. Journal of Traditional Chinese Medicine2018, 59(17): 1480-1484.
[1]徐亚赟,何峥,周圆,杨婧,王琛.肾衰Ⅱ号方联合西药对原发性慢性肾脏病3、4期患者肾功能及肾血流灌注的影响[J].中医杂志,2018,59(17):1480-1484. DOI: 10.13288/j.11-2166/r.2018.17.010.
XU Yayun, HE Zheng, ZHOU Yuan, et al. Effects of the Meliorated Renal Failure Decoction(肾衰Ⅱ号方) Combined with Western Medicine on Renal Function and Renal Perfusion in Primary Chronic Kidney Disease 3 or 4 Stage Patients[J]. Journal of Traditional Chinese Medicine2018, 59(17): 1480-1484. DOI: 10.13288/j.11-2166/r.2018.17.010.
目的观察肾衰Ⅱ号方联合西药对原发性慢性肾脏病(CKD)3、4期脾肾气虚、湿浊瘀阻型患者的疗效。方法原发性CKD 3、4期脾肾气虚、湿浊瘀阻型患者88例随机分为治疗组和对照组各44例。两组患者均给予西医基础治疗
治疗组加用肾衰Ⅱ号方
对照组加用尿毒清颗粒
治疗6个月。治疗前后检测血肌酐(SCr)、血尿素氮(BUN)、血尿酸(UA)、24小时尿蛋白定量(24h Upro)、血红蛋白(Hb)
肾脏超声造影检测右肾髓质、皮质到达时间(AT)、达峰时间(PT)、峰值强度(PI)
上升支斜率(A)、曲线下面积(AUC)
观察中医临床症状
治疗后评价中医症状疗效和临床疗效。结果治疗组临床疗效总有效率为82.92%
高于对照组的60.00%(P<0.05)。治疗组气短懒言、食少纳呆、脘腹胀满、肢体麻木、口中黏腻、倦怠乏力、腰膝酸软、恶心呕吐、腰痛、面色晦暗总有效率高于对照组(P<0.05或P<0.01)。与本组治疗前比较
治疗组治疗2、4、6个月SCr、BUN、UA、24h UPro均明显下降
2、4、6个月GFR及治疗4、6个月Hb均明显升高(P<0.05或P<0.01);对照组治疗6个月SCr、24h UPro均明显下降
治疗4、6个月GFR均明显升高(P<0.05或P<0.01)
且治疗组治疗6个月BUN明显低于对照组
Hb明显高于对照组(P<0.05)。与治疗前比较
治疗组治疗后皮质和髓质肾血流灌注定量参数AT、PT、A、AUC降低
PI升高(P<0.01)
对照组髓质PT、AUC降低(P<0.05);且治疗组治疗后皮质AT、PT、A
髓质AT、PT小于对照组(P<0.05或P<0.01)。结论肾衰Ⅱ号方联合西药治疗原发性CKD 3、4期脾肾气虚、湿浊瘀阻型患者临床疗效确切
能改善中医症状
减轻24小时蛋白尿定量
改善贫血
增加肾血流量。
Objective To observe the effect of Meliorated Renal Failure Decoction(肾衰Ⅱ号方
MRFD) combine with western medicine on primary chronic kidney disease(CKD) 3 or 4 stage patients with spleen and kidney qi deficiency
dampness retention and stasis obstruction syndrome. Methods A total of 88 cases of primary CKD 3 or4 stage of spleen and kidney qi deficiency and dampness retention and stasis obstruction syndrome were randomly divided into treatment group of 44 cases and control group of 44 cases. Patients in both groups were given long term western medicine treatment
respectively add MRFD to treatment group
and uremic clearance granules to control group for continuous 6 months. Serum creatinine(SCr)
blood urea nitrogen(BUN)
uric acid(UA)
24-hour urinary protein quantity(24 h Upro)
and hemoglobin(Hb) were detected before and after the treatment. Ultrasonic detection and measurement was used to detect radiography of right renal medulla(AT
PT
PI
A
AUC
TIC).Clinical symptoms of traditional Chinese medicine were observed to evaluate the symptoms of traditional Chinese medicine and clinical efficacy after treatment. Results The total effective rate of the treatment group was 82. 92%
which was higher than 60. 00% of the control group(P < 0. 05). In the treatment group
the total effective rate of shortness of breath
laziness to speak
little intake of food
poor appetite
abdominal distension
limb numbness
greasy and sticky mouth
fatigue
weakness waist and knees
nausea and vomiting
low back pain
dull complexion were higher than the control group(P < 0. 05 or P < 0. 01). Compared with before treatment
SCr
BUN
UA and24 h UPro were significantly decreased in the treatment group at 2
4
and 6 months
and GFR and Hb after 4 and 6 months’ treatment were significantly increased(P < 0. 05 or P < 0. 01). The control group had a significant decrease in SCr and 24 h UPro at 6 months of treatment
and the GFR was significantly increased at 4 and 6 months of treatment(P < 0. 05 or P < 0. 01)
and the BUN in the treatment group was significantly lower than that in the control group at6 months
and Hb was significantly higher than the control group(P < 0. 05). Compared with before treatment
the cortex and medullary renal blood perfusion quantitative parameters AT
PT
A
AUC of treatment group were decreased after treatment
and PI increased(P < 0. 01). The medullary PT
AUC of control group decreased(P <0. 05). And the cortex AT
PT
A
medullary AT
PT of treatment group was smaller than the control group after treatment(P < 0. 05 or P < 0. 01). Conclusion Meliorated Renal Failure Decoction combined with western medicine in the treatment of primary CKD 3 or 4 stage patients with spleen and kidney qi deficiency and dampness and phlegm obstruction syndrome is effective
which can improve the symptoms of traditional Chinese medicine
reduce the 24-hour proteinuria quantification
improve anemia and increase renal blood flow.
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