摘要
目的观察健脾清化汤联合西医常规疗法对脾虚湿热型慢性肾衰竭(CKD3期)微炎症状态的影响。方法将70例脾虚湿热型慢性肾衰竭CKD3期患者随机分为治疗组(36例)与对照组(34例),对照组予西医常规疗法,治疗组在对照组治疗措施基础上加用健脾清化汤。两组疗程均为12周,观察中医证候积分及血清C反应蛋白(CRP)、肌酐(Scr)、核因子kB(NF-kB)、肾小球滤过率(GFR)、血浆白蛋白(ALB)、前白蛋白(PAB)、血红蛋白(Hb)、转铁蛋白(TF)的变化情况。结果 1治疗前后组内比较,治疗组倦怠乏力、气短懒言、食少纳呆、腰膝酸软、恶心呕吐、身重困倦、脘腹胀满、口干口苦积分及总积分差异均有统计学意义(P<0.05),对照组除食少纳呆、口干口苦积分外,其余分项积分及总积分差异均有统计学意义(P<0.05);组间治疗后比较,气短懒言、食少纳呆积分及总积分的差异有统计学意义,治疗组优于对照组(P<0.05)。2治疗前后组内比较,治疗组Scr、CRP、NF-kB水平差异均有统计学意义(P<0.05);组间治疗后比较,Scr、CRP、NF-kB水平差异有统计学意义,治疗组优于对照组(P<0.05)。3治疗前后组内比较,治疗组GFR、ALB、PAB、TF水平差异均有统计学意义(P<0.05);组间治疗后比较,GFR、ALB、PAB、TF水平差异有统计学意义,治疗组优于对照组(P<0.05)。结论健脾清化汤联合西医常规疗法治疗脾虚湿热型慢性肾衰竭(CKD3期),可显著缓解临床症状,改善患者的微炎症及营养状态。
Objective To study the effects of ＂Jianpi Qinghua Decoction＂ combined with conventional treatment in treating the microinflammation in chronic renal failure of spleen- deficiency and dampness-heat state in CKD3. Methods Seventy patients with chronic renal failure of spleen-deficiency and dampness-heat state in CKD3 were randomly divided into two groups. Control group in which 34 cases were treated by western medicine, and treatment group in which 36 cases were added with ＂Jianpi Qinghua Decoction＂, with the course of 12 weeks. The TCM symptom score, CRP, Scr, NF-κB, GFR, ALB, PAB, Hb and TF were observed. Results （1）Compared before and after treatment in the treatment group, there were significant differences in the TCM symptom score and scores of fatigue, short of breath, anorexia, dry and bitter taste etc. in the treatment group （ P 〈 0.05 ） ; except for anorexia, dry and bitter taste, there were significant differences in the other symptom scores in the control group （ P 〈 0.05 ）. Comparison between groups after treatment, there were significant differences in the total syndrome sores and scores of anorexia and short of breath between the two groups （ P 〈 0. 05 ）. （2）After treatment, there were significant differences in the levels of Scr, CRP and NF-κB in the treatment group （P 〈 0. 05 ）, with significant differences in the levels of Scr, CRP and NF-κB between the two groups （P 〈 0.05 ）. （3）There were significant differences in the levels of GFR, ALB, PAB, TF in the treatment group between before and after treatment （ P 〈 0.05 ） ; There were significant differences in the levels of GFR, ALB, PAB, TF between the two groups （ P 〈 0.05 ）. Conclusion Combioned ＂Jianpi Qinghua Decoction＂ and conventional treatment can relieve clinical symptoms, microinflammation state and nutritional status in chronic renal failure patients of spleen-deficiency and dampness-heat state in CKD3.
出处
《上海中医药杂志》
2014年第9期57-59,92,共4页
Shanghai Journal of Traditional Chinese Medicine
基金
上海市卫生局中医药科研基金课题项目(2010L023A)
上海市卫生局"中医药事业发展三年行动计划"项目(ZYSNXD-CC-YJXYY)
关键词
慢性肾衰竭
CKD3期
微炎症状态
脾虚湿热
健脾清化汤
chronic renal failure （CRF）
CKD3
microinflammation
spleen-deficiency and dampness-heat state
＂Jianpi Qinghaa Decoction＂
