摘要
目的:观察温肾培元降毒汤联合复方α-酮酸片治疗慢性肾衰竭的临床效果,初步探讨其肾保护效果及机制。方法:将112例慢性肾衰竭患者按照随机数字表法分为对照组(n=56)和观察组(n=56)。对照组患者给予复方α-酮酸片治疗,观察组在对照组基础上给予温肾培元降毒汤口服,连续治疗4周。比较两组总有效率、中医证候总积分、肾功能指标[血肌酐(Scr)、肾小球滤过率(eGFR)、尿素氮(BUN)]、肾纤维化指标[结缔组织生长因子(CTGF)、金属蛋白酶组织抑制因子-1(TIMP-1)、Ⅳ型胶原(CⅣ)]、血清钙磷、氧化应激指标[过氧化脂质(LPO)、丙二醛(MDA)、超氧化物歧化酶(SOD)]水平。结果:观察组、对照组的有效率分别为91.07%、76.79%,以观察组疗效更好(P<0.05);随着治疗疗程的增多,两组患者的中医证候总积分均明显降低,低于治疗前(P<0.05);同一时间点与对照组进行组间比较,观察组的中医证候总积分均明显降低(P<0.05);治疗2个疗程后,观察组患者的Scr、BUN含量明显低于对照组,eGFR明显高于对照组,肾纤维化指标CTGF、TIMP-1、CⅣ水平明显低于对照组,血钙含量明显高于对照组,血磷含量明显低于对照组,血清中LPO、MAD含量均明显低于对照组,SOD含量明显高于对照组(P<0.05)。结论:温肾培元降毒汤联合复方α-酮酸片治疗慢性肾衰竭疗效确切,可能通过减轻肾纤维化、抗氧化应激等发挥肾保护作用,从而利于减轻症状,调节钙磷代谢,促进肾功能的恢复。
Objective:To observe the clinical effect of Wenshen Peiyuan Jiangdu Decoction combined with compoundα-ketoacid tablets in the treatment of chronic renal failure,and preliminarily explore the protective effect and mechanism of kidney.Methods:112 patients with chronic renal failure were divided into control group(n=56)and observation group(n=56)according to random number table method.Control group was treated with compound alpha-ketoic acid tablets,and observation group was additionally treated with Wenshen Peiyuan Jiangdu Decoction orally for 4 weeks.The total effective rate,total scores of TCM syndromes,renal function indexes[blood creatinine(Scr),glomerular filtration rate(eGFR),urea nitrogen(BUN)],renal fibrosis indexes[connective tissue growth factor(CTGF),tissue inhibitor of metalloproteinase-1(TIMP-1),collagen type IV(CⅣ)]and the serum calcium and phosphorus,oxidative stress index[lipid peroxide(LPO),malondialdehyde(MDA),superoxide dismutase(SOD)]were compared between the two groups.Results:The effective rate of the observation group and the control group were 91.07%and 76.79%respectively,and the observation group had better curative effect(P<0.05).With the increase of treatment course,the total scores of TCM syndrome in 2 groups were significantly decreased,lower than before treatment(P<0.05);Compared with the control group at the same time point,the total scores of TCM syndromes in the observation group were significantly decreased(P<0.05).After 2 courses of treatment,the observation group of patients with Scr,BUN content is significantly lower than the control group,eGFR is significantly higher than the control group,renal fibrosis index CTGF,TIMP-1,CⅣlevel is significantly lower than the control group,blood calcium content is significantly higher than the control group,blood phosphorus content is significantly lower than the control group,serum LPO,MAD content are significantly lower than the control group.The SOD content was significantly higher than that in control group(P<0.05).Conclusion:Wenshen Peiyuan Jiangdu Decoction combined with compoundα-ketoacid tablets has definite curative effect in the treatment of chronic renal failure,which may play a renal protective role by alleviating renal fibrosis and anti-oxidative stress,so as to help alleviate symptoms,regulate calcium and phosphorus metabolism,and promote the recovery of renal function.
作者
张雨帆
姜敏敏
ZHANG Yufang;JIANG Minmin(Shanghai Yangpu District Kongjiang Hospital,Shanghai,200093)
出处
《中国中西医结合肾病杂志》
2024年第7期586-590,共5页
Chinese Journal of Integrated Traditional and Western Nephrology
基金
上海市卫健委课题(No.202040026)。
关键词
温肾培元降毒汤
复方Α-酮酸片
慢性肾衰竭
肾保护
Warming kidney Peiyuan Jiangdu decoction
Compoundα-ketoacid tablets
Chronic renal failure
Renal protection
