摘要
目的:观察中药制剂肾通丸(由黄芪、土茯苓、丹参、当归等组成)对慢性肾脏病(chronic kidney disease,CKD)患者的临床疗效及其阻抑肾纤维化进展的作用。方法:用随机化、前瞻性的研究方法,将60例CKD患者按1∶1分为治疗组和对照组。两组均给予低蛋白饮食、血压控制、纠正水电和酸碱平衡等基本治疗,治疗组在基本治疗的基础上加服肾通丸,对照组在基本治疗基础上加服肾衰宁片,两组均以4周为1个疗程,连续治疗6个疗程后统计结果。分别观察两组病人治疗前后相关指标(:1)临床表现:水肿、血压(BP)、24 h尿蛋白总量、血红蛋白(Hb)、红细胞压积(HCT)、血清白蛋白(ALB)。(2)肾功能:血肌酐(Scr)、尿素氮(BUN)、光抑素(Cys C)、肾小球滤过率(GFR)。(3)双肾皮质厚度:以B超测定不同阶段肾脏皮质厚度、肾大小及回声等。(4)纤维化指标:三型前胶原(PC-III)、四型胶原(Col-IV)、层黏蛋白(LN)和透明质酸(HA)。结果:和对照组相比,治疗组主要临床表现均有减轻(P<0.05或P<0.01),总体疗效均高于对照组(P<0.05或P<0.01);肾通丸能提高CKD患者血清ALB、GFR水平,降低Scr、PC-Ⅲ、Col-IV、LN及HA水平(P<0.05或P<0.01),但对Hb、HCT的升高作用与对照组比较无显著性差异(P>0.05)。结论:肾通丸不仅能改善患者临床症状,而且能改善患者的肾功能;对肾纤维化指标也有明显改善作用,提示该药具有较好的抗肾脏纤维化作用。同时发现,肾脏变薄程度有不同程度的延缓倾向,但改善不明显,可能与治疗时间短有关。另外,本研究未发现该药有明显毒副作用。
Objective ： To observe the therapeutic effect of Shentong Pill （ STP ） which has the actions of lifting clear Qi and purging turbidity for chronic kidney disease （ CKD ） and to investigate its influence on renal function, fibrosis parameters and thickness of the renal cortex. Methods ： A prospective study was carried out in 60 CKD patients. The patients were equally randomized into two groups. Besides the basic treatment of feeding with lower-dose protein, controlling blood pressure, maintaining water-electrolyte and acid-base balance, comparative group received Shenshuaining Tablet （ SST ） and treatment group received STP. Four weeks constituted one treatment course and the treatment lasted 6 courses. Before and after treatment, the main clinical manifestations, laboratory parameters such as 24-hr urine protein, hematoglobin （ Hb ）, hematoerit （ HCT ）, serum creatinine （ Scr ）, blood urea nitrogen （ BUN ）, glomerular fihrateion rate （ GFR ）, albumin （ ALB ）, serum precollagen- III （ PC- III ）, collagen IV （ Col-IV ）, laminin （ LN ）, hyaluronie acid （ HA ） and the thickness of the renal cortex were assayed. Results ： The effect on the clinical manifestations and total therapeutic effect were better in treatment group than those in comparative group （ P〈0.05 or P〈0.01 ）. STP increased serum ALB and GFR levels, and reduced 24-hr urine protein, Ser, BUN, PC- III, Col-IV, LN and HA （ P〈0.05 or P〈0.01 ）. However, the effect of STP on the increase of Hb and HCT was insignificant （ P〉0.05 ）. Conclusion ： STP has an effect on relieving symptoms of CKD, and improving renal function and kidney fibrosis parameters, indicating that STP exerts a better eounteraction on kidney fibrosis.
出处
《辽宁中医药大学学报》
CAS
2014年第1期11-14,共4页
Journal of Liaoning University of Traditional Chinese Medicine
关键词
慢性肾脏病
肾脏纤维化
中药疗法
肾通丸
影响
chronic kidney disease
renal fibrosis
traditional Chinese drug therapy
Shentong Pill
effect
