肾衰Ⅱ号方对慢性肾脏病患者肾功能及炎症因子的影响

目的：观察肾衰Ⅱ号方对慢性肾脏病（CKD）3～4期患者肾功能及炎症因子的影响。方法采用随机数字表法将62例CKD3～4期患者随机分为治疗组（32例）和对照组（30例）。2组均予西医常规一体化治疗,治疗组同时予肾衰Ⅱ号方,治疗6个月。于治疗前后检测血红蛋白（Hb）、血肌酐（Scr）、尿素氮（BUN）、24 h尿蛋白定量（24 h UP）、白细胞介素（IL）-6、IL-8、肿瘤坏死因子（TNF）、估算肾小球滤过率（eGFR）,并对临床疗效进行评价。结果治疗组临床疗效总有效率为65.63%（21/32）,对照组为30.00%（9/30）,治疗组优于对照组（P＜0.01）；治疗组中医证候疗效总有效率为96.88%（31/32）,对照组为53.33%（16/30）,治疗组优于对照组（P＜0.01）。除口干咽燥、大便不实外,治疗组证候改善较对照组明显（P＜0.01）。治疗组可升高eGFR水平,降低Scr、BUN、24 h UP水平（P＜0.05,P＜0.01）,2组比较差异有统计学意义（P＜0.01）。对照组可升高eGFR水平,降低Scr水平（P＜0.01）。2组均可升高Hb水平,降低IL-6、IL-8、TNF水平（P＜0.05,P＜0.01）,2组比较差异无统计学意义（P＞0.05）。结论肾衰Ⅱ号方可能通过降低炎症因子水平抑制 CKD3～4期微炎症状态,从而改善临床证候及肾功能。

Effects of Meliorated Renal Failure Decoction on Renal Function and Inflammatory Cytokines in Patients with Chronic Kidney Disease at 3-4 Stage

Objective To investigate the effects of meliorated renal failure decoction （MRFD） on renal function and inflammatory cytokines in patients with CKD 3-4 stages. Methods Sixty-two patients with CKD 3-4 stages were divided into treatment group and control group through random number table method. Both groups were given conventional treatment of western medicine, and the treatment group was given MRFD additionally. After 6 months of treatment, the changes of TCM symptom scores, Hb, Scr, BUN, 24 h UP, IL-6, IL-8, TNF and eGFR were observed. Meanwhile, the clinical efficacy was evaluated. Results The total clinical effective rate in treatment group was 65.63%（21/32）, and 30.00%（9/30） in the control group （P＆lt;0.01）;the effective rate of TCM syndromes in treatment group was 96.88%（31/32）, and 53.33%（16/30） in the control group （P＆lt;0.01）. The symptoms were improved better in the treatment group than the control group except for the symptoms of dry mouth and throat, and diarrhea. The level of eGFR in treatment group increased obviously （P＆lt;0.05）, while the levels of Scr, 24 h UP and BUN decreased （P＆lt;0.05, P＆lt;0.01）, with statistical significance between the two groups （ P＆lt;0.01）. The level of eGFR increased, and the levels of Scr decreased in the control group （P＆lt;0.01）. The levels of IL-6, IL-8, and TNF in both groups were reduced, while the level of Hb increased in the two groups, without statistical significance （P＆gt;0.05）. Conclusion MRFD can improve TCM syndrome and renal function, delay the progress of patients with CKD at 3-4 stage by means of reducing the inflammatory cytokines and inhibiting micro-inflammatory state.