益气通络解毒降浊方结合西医基础疗法治疗早、中期慢性肾功能衰竭疗效观察

目的 观察益气通络解毒降浊方结合西医基础疗法治疗慢性肾功能衰竭（CRF）的临床疗效。方法 选择160例2007年1月—2011年12月河北医科大学中医院门诊及住院中早期CRF患者,按随机数字表法分为治疗组及对照组,每组80例。在西医基础治疗基础上,治疗组予益气通络解毒降浊方,对照组予尿毒清颗粒,治疗12个月后,观察两组疗效,治疗前后中医症状积分、血清肌酐(SCr)、尿素氮（BUN）、24 h尿蛋白定量、Hb及终点事件发生率。结果 治疗组总有效率为77.6% （28/76),对照组为58.1% (43/74),两组比较差异有统计学意义(P<0.05);治疗组治疗后中医症状积分［（18.3±5.3）分］较本组治疗前［（26.0±4.4）分］及对照组治疗后［（22.4±4.9）分］明显降低(P<0.05,P<0.01)。治疗组治疗后SCr［(169.1±22.6) μmol/L］、BUN［(10.4±2.0) mmol/L］、24 h尿蛋白定量［(861.4±232.7) mg/24 h］均低于治疗前［分别为：(204.1±27.7) μmol/L,(13.2±3.2) mmol/L,(1287.5±442.3) mg/24 h,P<0.01］;对照组治疗后上述指标亦有改善(P<0.05,P<0.01);治疗组治疗后较对照组SCr［(185.8±23.9) μmol/L］、BUN［(11.2±2.5) mmol/L］、24 h尿蛋白定量［(1 014.5±301.7) mg/24 h］降低更明显(P<0.05,P<0.01)。治疗组终点事件发生率(10.53%, 8/76) 低于对照组(13.51%, 10/74),但差异无统计学意义。结论 益气通络解毒降浊方结合西医基础治疗早、中期CRF在改善肾功能、降低尿蛋白方面有较好的疗效。

Efficacy Observation of Treating Early and Midterm Chronic Renal Failure Patients by Qi Supplementing,Collateral Dredging,Detoxifying,and Turbidity Descending Recipe Combined with Basic Methods of Western Medicine

Objective To observe therapeutic efficacy of treating early and midterm chronic renal failure(CRF) patients by Qi Supplementing,Collateral Dredging,Detoxifying,and Turbidity Descending Recipe(QSCDDTDR) combined with basic methods of Western medicine(WM).Methods Totally 160 early and midterm CRF patients were recruited from Hebei Hospital of Traditional Chinese Medicine,Hebei Medical University from January 2007 to December 2011.They were randomly assigned to the treatment group and the control group,80 in each group.On the basis of basic treatment of WM,QSCDDTDR was given to patients in the treatment group,while Niaoduqing Granule(NDQG) was given to those in the control group.After 12 months of treatment,the therapeutic efficacy,Chinese medicine(CM) symptom scores,serum creatinine(SCr),blood urine nitrogen(BUN),24 h urine protein quantitation,hemoglobin(Hb),and the occurrence of end-point events were observed.Results The total effective rate in the treatment group was 77.6%(28/76),obviously higher than that in the control group [(58.1%,43/74),P<0.05].After treatment the CM syndrome scores obviously decreased in the treatment group(18.3±5.3),obviously lower than before treatment(26.0±4.4) and the control group(22.4±4.9)(P<0.05,P<0.01).The levels of SCr,BUN,and 24 h urine protein quantitation were(169.1±22.6) μmol/L,(10.4±2.0) mmol/L,(861.4±232.7) mg/24 h,respectively,in the treatment group after treatment,which were lower than before treatment [(204.1±27.7) μmol/L,(13.2±3.2) mmol/L,(1 287.5±442.3) mg/24 h,P<0.01).The aforesaid indices were also improved in the control group after treatment(P<0.05,P<0.01).The decrease in SCr,BUN,and 24 h urine protein quantitation after treatment was more obviously in the treatment group than in the control group [(185.8±23.9) μmol/L,(11.2±2.5) mmol/L,(1 014.5±301.7) mg/24 h;P<0.05,P<0.01).The incidence rate of the end-point events was 10.53%(8/76) in the treatment group and 13.51%(10/74) in the control group,but with no statistical difference.Conclusion QSCDDTDR combined with basic methods of WM showed better therapeutic efficacy in improving the renal function and reducing the level of urinary protein of the early and midterm CRF patients.