摘要
目的基于真实世界原理评价益肾清利泄浊方对慢性肾脏病3期患者肾功能的影响。方法收集2010年至2019年在江苏省中医院就诊的CKD3期患者,共98例,所有患者均给予西医基础治疗,同时使用益肾清利泄浊方,每月随访1次,3个月为1周期,随访1年,观察患者肾功能的情况;以6个月为一个周期,观察每个周期内患者肾功能的转归情况;以6个月为一周期,进行患者的生存分析;评价尿酸对肾功能的影响。结果①治疗3、6、9、12个月后,患者的血肌酐与治疗前相比,差异均无统计学意义(P>0.05),肾小球滤过率从治疗3个月直至结束,均显著增加,与治疗前相比,有统计学意义(P<0.05);②治疗期间,血尿酸异常的患者肾小球滤过率显著低于血尿酸正常的患者,尿酸水平的高低与肾小球滤过率显著相关;③以6个月为1周期,在每个周期内,肾功能稳定和好转的患者所占比例数远远大于肾功能恶化的患者;④以CKD4期为终点事件,进行患者的生存分析,发现通过长期中药治疗,患者肾功能进展的时间会明显延缓。结论长期服用中药可以稳定肾功能,延缓肾功能进展;高尿酸血症是肾功能进展的危险因素之一。
Objective To observe the effects of Yishen Qingli Xiezhuo Decoction on the effect of renal function of patients with chronic kidney disease stage 3.Methods A total of 98 patients with CKD stage 3 who met the inclusion criteria and sought Chinese medicine treatment from March 2015 to 2019 in Jiangsu Province Hospital of Traditional Chinese Medicine were enrolled.All patients were treated with western medicine combined with Yishen Qingli Xiezhuo Decoction.The patients were followed up once a month,3 months as 1 cycle,and followed up for 1 year.Renal function was observed before and after treatment.The effect of Yishen Qingli Xiezhuo Recipe on the prognosis of patients with CKD3 in a period of 6 months was observed,and the survival of patients in a period of 1 year was analyzed.The effect of uric acid on renal function was evaluated.Result①There was no significant difference in serum creatinine after treatment at 3,6,9 and 12 months(P>0.05).There was significant difference in the glomerular filtration rate from 3 months to the end of treatment(P<0.05);②The glomerular filtration rate of patients with abnormal serum uric acid was significantly lower than that of patients with normal serum uric acid.The level of uric acid is related to the glomerular filtration rate(P<0.05);③98 patients with CKD3 underwent a prognostic outcome with a 6-month cycle,and the outcome of renal function in each cycle was evaluated.In each cycle,the proportion of patients with stable and improved renal function is much larger than that of patients with deteriorated renal function;④With CKD4 as the end point,the survival analysis of patients showed that the time of progression of patients would be significantly delayed by long-term follow-up observation and treatment.Conclusion Long-term use of traditional Chinese medicine can stabilize renal function and delay the progress of renal function.Hyperuricemia is a risk factor for the progress of renal function.
作者
陈继红
盛梅笑
许陵冬
高坤
张露
赵静
刘利华
孙伟
Chen Jihong;Sheng Meixiao;Xu Lingdong;Gao Kun;Zhang Lu;Zhao Jing;Liu Lihua;Sun Wei(Jiangsu Hospital of Traditional Chinese Medicine/Affiliated Hospital of Nanjing University of Chinese medicine,Nanjing 210029,China)
出处
《世界科学技术-中医药现代化》
CSCD
北大核心
2019年第6期1055-1061,共7页
Modernization of Traditional Chinese Medicine and Materia Medica-World Science and Technology
基金
国家中医药管理局项目-2015年度国家中医临床研究基地业务建设第二批科研专项立项计划(JDZX2015093):益肾清利、和络泄浊法延缓慢性肾脏病3期进展疗效观察,负责人:陈继红
关键词
慢性肾脏病
真实世界
中药
临床疗效
Chronic kidney disease
Real world
Traditional Chinese medicine
Clinical effect
