健脾补肾法联合左卡尼汀治疗 慢性肾衰竭的临床研究

目的 探讨健脾补肾法联合左卡尼汀治疗慢性肾衰竭的疗效及对患者肾功能、炎症因子和免疫功 能的影响。方法 选取2016 年1 月—2018 年12 月杭州市第三人民医院收治的慢性肾衰竭4、5 期患者62 例， 采用随机数字表法分为观察组与对照组，每组31 例。观察组患者采用健脾补肾法联合左卡尼汀治疗；对照组 患者采用左卡尼汀治疗。两组疗程均为3 个月。比较两组治疗疗效；比较两组治疗前后主要症状积分、肾功 能、炎症因子和免疫功能指标变化；比较两组不良反应发生情况。结果 观察组治疗总有效率（87.10%）高于 对照组（58.07%）（P <0.05）。观察组治疗前后气短懒言、倦怠无力、腰膝酸软和食少纳呆积分的差值高于对照 组（P <0.05）。观察组治疗前后尿素氮（BUN）和血肌酐（Scr）的差值高于对照组（P <0.05）。观察组治疗前 后肿瘤坏死因子-α（TNF-α）、超敏C 反应蛋白（hs-CRP）的差值高于对照组（P <0.05）。观察组治疗前后 CD3 +、CD4 + 和CD4 +/CD8 + 的差值高于对照组（P <0.05）。观察组不良反应率（6.45%）低于对照组（32.26%）（P <0.05）。 结论 健脾补肾法联合左卡尼汀治疗慢性肾衰竭疗效较好，可改善患者肾功能，减轻微炎症状态，提高患者免 疫功能。

Clinical study on the treatment of chronic renal failure with method of jianpi bushen combined with levocarnitine

Objective To investigate the curative effect of Jianpi Bushen combined with Levocarnitine on chronic renal failure patients and its effects on renal function, inflammatory factors and immune function. Methods Sixty two patients with stage 4 or 5 of chronic renal failure from January 2016 to December 2018 were randomly divided into observation group (31 cases) and control group (31 cases). The patients in the observation group were treated with the Jianpi Bushen combined with levocarnitine, while the patients in the control group were treated with levocarnitine alone. Both groups were treated for 3 months. The therapeutic effect, the changes of main symptom scores, renal function, inflammatory factors and immune function indexes, and the occurrence of adverse reactions were compared between the two groups before and after treatment. Result The total effective rate of the observation group (87.10%) was higher than that of the control group (58.07%) (P < 0.05). After treatment, the scores of shortness of breath, laziness, fatigue, weakness of waist and knee, and lack of appetite in the observation group were lower than those in the control group (P < 0.05). After treatment, the levels of BUN and Scr in the observation group were lower than those in the control group (P < 0.05). After treatment, the levels of TNF-a and hs-CRP in the observation group were lower than those in the control group (P < 0.05). After treatment, CD3+, CD4+, and CD4+/ CD8+ in the observation group were higher than those in the control group (P < 0.05). The adverse reaction rate of the observation group (6.45%) was lower than that of the control group (32.26%) (P < 0.05). Conclusion The Jianpi Bushen combined with Levocarnitine is effective in treating chronic renal failure patients. It can improve renal function, reduce microinflammation and improve immune function of patients.