摘要
目的观察畲医益肾泻浊方对脾肾两虚、浊毒内蕴型早中期慢性肾衰竭患者的中医证候、肾功能、转化生长因子(transforming growth factor,TGF)-β1水平的影响,探讨该方肾脏保护机制。方法选取2019年6月至2020年12月丽水市中医院收治的早中期慢性肾衰竭的患者80例,采用随机数字表法分为对照组(n=40)和观察组(n=40),对照组给予西医常规治疗,包括生活习惯调整,饮食营养治疗,血压、血糖、血脂管理等,观察组在对照组的基础上加用畲医益肾泻浊方。观察两组患者治疗前后中医证候、肾功能、TGF-β1水平的变化。结果治疗前,两组中医证候积分比较,差异无统计学意义(P>0.05);治疗后,观察组中医证候积分明显下降且低于对照组,差异有统计学意义(P<0.05)。治疗后,对照组、观察组的总有效率分别为60%、82.50%,差异有统计学意义(P<0.05)。观察组在改善中医证候的疗效方面优于对照组,差异有统计学意义(P<0.05)。治疗前,两组的肌酐清除率(creatinine clearance rate,CCr)、血肌酐(serum creatinine,SCr)、血尿素氮(blood urea nitrogen,BUN)比较,差异无统计学意义(P>0.05);治疗后,观察组CCr高于对照组,SCr、BUN低于对照组,治疗12周后两组CCr、SCr、BUN比较,差异有统计学意义(P<0.05)。治疗前两组TGF-β1水平比较,差异无统计学意义(P>0.05),治疗后,观察组TGF-β1水平低于治疗组,差异有统计学意义(P<0.05)。观察组治疗末期未发生终末期肾病(end stage renal disease,ESRD),对照组ESRD发生3例,两组均未发生不良反应。结论畲医益肾泻浊方能缓解患者临床症状,可一定程度降低患者SCr、BUN水平及提高患者CCr而改善患者的肾功能,同时能一定程度减低TGF-β1水平,可能延缓患者的肾纤维化进程,临床疗效较好且安全,值得临床推广。
Objective To observe the effects of She Medicine Yishen Xiezhuo prescription on traditional Chinese medicine(TCM)syndrome,renal function and transforming growth factor(TGF)-β1 level in patients with early and middle chronic renal failure with deficiency of spleen and kidney and turbidity toxin,and to explore the renal protection mechanism of this prescription.Methods A total of 80 patients with early to mid-stage chronic renal failure admitted to Lishui Hospital of Tradional Chinese Medicine from June 2019 to December 2020 were selected and divided into the control group(n=40)and the observation group(n=40)according to the random number table method.The control group was given conventional western medical treatment,including lifestyle adjustment,diet and nutrition treatment,blood pressure,blood glucose and lipid management.On the basis of the control group,the observation group was treated with She Medicine Yishen Xiezhuo prescription.The changes of TCM syndrome,renal function and TGF-β1 before and after treatment were observed in the two groups.Results Before treatment,there was no statistically significant difference between the two groups(P>0.05);after treatment,the TCM score of the observation group decreased significantly and was lower than that of the control group,and the difference was statistically significant(P<0.05).After treatment,the total effective rate of the control group and the observation group were 60%and 82.50% respectively, the difference was statistically significant (P<0.05).The observation group was better than the control group in improving the efficacy of TCM syndrome, and the difference was significant (P<0.05). Before treatment, the differences in creatinine clearance rate (CCr), blood creatinine (SCr) and blood urea nitrogen (BUN) between the two groups were not statistically significant (P>0.05);after treatment, CCr was higher in the observation group than that in the control group, while SCr and BUN were lower than those in the control group. After treatment, CCr, SCr and BUN in the observation group were higher than those in the control group, while Scr and BUN were lower than those in the control group,and after 12 weeks of treatment, the differences were statistically significant (P<0.05). There was no statistically significant difference between the TGF-β1 levels of the two groups before treatment (P>0.05), and after treatment, the TGF-β1 level of the observation group weas lower than that of the treatment group, the difference was statistically significant (P<0.05). No end stage renal disease (ESRD) occurred at the end of treatment in the observation group, while 3 cases of ESRD occurred in the control group. Conclusion She Medicine Yishen Xiezhuo prescription treatment can effectively alleviate clinical symptoms, improve the renal function of patients by reducing the SCr and BUN levels and increasing the CCr level of patients to a certain extent, and it can also reduce the TGF-β1 level to a certain extent, which may slow down the process of renal fibrosis in patients, with good clinical efficacy and safety.
作者
刘小菊
王慧
余军
雷强
LIU Xiaoju;WANG Hui;YU Jun;LEI qiang(Department of Nephrology,Lishui Hospital of Traditional Chinese Medicine,Lishui 323000,Zhejiang,China;Party and Government Office,Lishui Maternal and Child Health Hospital,Lishui 323000,Zhejiang,China)
出处
《中国现代医生》
2023年第8期96-99,113,共5页
China Modern Doctor
基金
浙江省中医药科技项目(2019ZA131)。
关键词
畲医益肾泻浊方
慢性肾衰竭
肾纤维化
转化生长因子‐β1
肾功能
She Medicine Yishen Xiezhuo prescription
Chronic renal failure
Renal fibrosis
Transforming growth factor-β1
Renal function
