益肾降浊冲剂治疗慢性肾衰竭的临床观察及对血清瘦素的影响

目的：观察益肾降浊冲剂治疗慢性肾衰竭（CRF）的临床疗效及治疗前后血清瘦素（leptin）水平的变化情况。方法：选择CRF患者40例，随机分为治疗组20例，对照组20例。治疗组用益肾降浊冲剂治疗，对照组用单味大黄治疗，观察尿素氮、肌酐、肌酐清除率、白蛋白、血红蛋白、瘦素等指标及临床症状的变化。结果：治疗组临床疗效优于对照组（P〈0．05），治疗组降低血清瘦素水平明显优于对照组（P〈0．01），患者血清瘦素与肌酐清除率显著负相关、与血肌酐有显著正相关（P〈0．01）。治疗组改善CRF患者临床证候疗效优于对照组（P〈0．01）。结论：益肾降浊冲剂对CRF辨证属脾肾气虚证为主者，起到改善症状，改善肾功能并能延缓CRF进展；临床疗效优于单味大黄。益肾降浊冲剂能降低CRF血清瘦素水平，可能是其获得疗效的机制之一。

Clinical Effect of Soluble Granules Yishenjiangzhuo for Chronic Renal Failure and Effect to Serum Leptin

Objective：To observe the clinical result of Soluble Granules Yishenjiangzhuo in patients with chronic renal failure （CRF） and the change of serum leptin level. Methods： According to the standard in Chinese journal of internal medicine and national symposium of TCM, 40 patients with CRF were divided into treatment group and contrast group at random, treatment group is 20 case and contrast group is also 20 case, Patients of treatment group took the Yishenjingzhou decoction, Patients of contrast group took the Chinese Rhubarb. Observe the change of Blood urea nitrogen（BUN） .serum creatinine （ser） .clearance of endogenous crea- tinine（Ccr） .Albumin.Hemoglobin. serum Leptin levels and symptom in before and after therapy. Serum Leptin level were detected by radioimmunoassay （RIA） method. Results： The therapeutic efficacy of treatment group on Yisbenjingzhou decoction is much better than that of contrast group （P〈0.05）. The Serum Leptin level was obviously reduced after Soluble Granules Yishenjiangzhuo therapy （P〈 0.01 ）. The analysis of correlation showed that ＇the serum Leptin level of patient is negatively correlated to clearance of endogenous creatinine and positively correlated to the level of serum creatinine. Conclusion：Through the function of supplement and boost the spleen and kidney, and discharge turbidity and dispel stasis, Soluble Granules Yishenjiangzhuo can improve renal function and lighten clinical symptom and delay the development of CRF with spleen- kidney qi vacuity. Soluble Granules Yishenjiangzhuo can decrease the Leptin level in patients with CRF, which may be one of mechanism of its effect.