补肾健脾降浊汤内服和灌肠治疗慢性肾脏病4期的临床观察

Clinical Observation of Bushen Jianpi Jiangzhuo Decoction for Oral Administration/Enema in Treating Patients with Chronic Kidney Disease Stage 4

摘要:

目的: 观察补肾健脾降浊汤内服和灌肠对慢性肾脏病4期(CKD 4期)肾功能的保护作用. 方法: 100例CKD 4期患者随机按数字表法分为观察组52例和对照组48例.对照组口服氯沙坦钾片,100 mg/次,1次/d.观察组在对照组治疗的基础上加用补肾健脾降浊汤内服和灌肠.两组疗程均为6个月.检测治疗前后24 h尿蛋白定量(24 h Upr),尿素氮(BUN),血肌酐(SCr),并计算表皮生长因子受体(eGFR),记录主要症状、体征评分;记录终点事件发生率;进行治疗前后健康相关生命质量量表(SF-36)评价. 结果: 观察组临床疗效总有效率82.69%,对照组为64.58%,观察组优于对照组(P <0.05),治疗后观察组24 h Upr低于对照组(P <0.01);治疗后对照组BUN,SCr继续上升(P <0.05, P <0.01),eGFR较治疗前下降(P <0.01);治疗后观察组BUN和eGFR较治疗前下降(P <0.01),SCr较治疗前上升;治疗后观察组BUN和SCr水平低于对照组,eGFR水平高于对照组(P <0.01);观察组在治疗后3,6个月主要症状、体征评分均低于对照组(P <0.01);观察组终点事件的发生率为23.08%低于对照组的43.75%(P <0.05);治疗后观察组SF-36量表总体健康(GH),社会功能(SF),生命活力(VT)和精神健康(MH)评分高于对照组(P <0.05). 结论: 在西医常规治疗的基础上,补肾健脾降浊汤内服和灌肠能保护CKD 4期患者肾功能,起到延缓病情发展的作用,并能改善症状,提高患者生活质量,其综合疗效优于单纯西医治疗.

Abstract:

Objective: To observe the protective effect of Bushen Jianpi Jiangzhuo decoction for oral administration/enema in treating patients with chronic kidney disease stage 4 (CKD 4). Method: One hundred patients with CKD 4 were randomly divided into the control group (48 cases) and the observation group (52 cases) by a random number table. Patients in the control group received 100 mg losartan potassium tablets once daily. Based on the treatment of the control group, patients in the observation group added Bushen Jianpi Jiangzhuo decoction for oral administration/enema. All patients in both two groups received 6 months of treatment. Before and after treatment, 24-hour urine protein quantitation (24-h Upr), urea nitrogen (BUN) and serum creatinine (SCr) were detected. Epidermal growth factor receptor (eGFR) was calculated. The main symptoms, signs and the end points of response rate were recorded. Health related quality of life (SF-36) was evaluated. Result: The total clinical efficiency in the observation group was 82.69%, which was superior to that of 64.58% in the control group (P <0.05). After treatment, 24-h Upr in the observation group was lower than that in the control group (P <0.01). BUN and SCr increased persistently (P <0.05, P <0.01), eGFR decreased (P <0.01) in the control group. BUN and eGFR decreased (P <0.01), and SCr increased in the observation group. Levels of UN and SCr were lower than those in the control group, and level of eGFR was higher than that in the control group (P <0.01). At the third and sixth month after treatment, scores of the main symptoms and signs in the observation group were lower than those in the control group (P <0.01). The end point of response rate in the observation group was 23.08%, which was lower than that of 43.75% in the control group (P <0.05). After treatment, scores of general health, social function, vigour of life and mental health in the observation group were higher than those in the control group (P <0.05). Conclusion: Based on the conventional Western treatment, Bushen Jianpi Jiangzhuo decoction for oral administration/enema could protect the renal function and delay condition progress of patients with CKD 4.Moreover, it could ameliorate symptoms, and improve patients' quality of life. Its efficacy is superior to using Western treatment alone.