肾衰康颗粒治疗慢性肾衰竭的临床与药理研究

目的:探讨肾衰康颗粒对慢性肾衰竭(CRF)的治疗作用及疗效机制.方法:随机将80例CRF患者分为治疗组和对照组.对照组在常规治疗的基础上予爱西特和开同;治疗组在常规处理基础上予肾衰康颗粒治疗8周.观察患者临床症状和体征的变化,肌酐倒数与时间关系斜率的变化,以及肾功能等生化指标.结果:治疗组总有效率85%,明显优于对照组70%(P<0.05);治疗组治疗前后肌酐倒数与时间关系斜率变化有显著意义;治疗组治疗后Scr、BUN明显降低,且优于对照组的降幅;Hb、Hct、Alb显著升高,Hb、Hct的升高幅度显著大于对照组;治疗后治疗组血清纤维化标志蛋白C-Ⅳ、PC-Ⅲ、LN显著降低,而对照组无明显变化;治疗后,治疗组LPO含量下降,SOD活性提高,而对照组无明显变化;治疗组治疗后,血Cho、TG、LDL-C明显下降,而HDL-C明显升高,与对照组比较有统计学差异.观察结果显示:治疗组无明显不良反应.结论:肾衰康颗粒具有明显改善肾功能,纠正贫血,改善CRF营养状态作用.     

肾衰康胶囊联合中药保留灌肠治疗慢性肾衰竭效果观察

目的观察肾衰康胶囊口服联合中药保留灌肠治疗慢性肾衰竭的临床疗效。方法按入院顺序将118例慢性肾衰竭患者分为对照组58例,观察组60例。两组均予以常规对症治疗并口服肾衰康胶囊,观察组在此基础上采用中药保留灌肠。治疗1个周期评价效果。结果观察组治疗效果显著优于对照组(P0.01)。结论肾衰康胶囊口服联合中药保留灌肠可显著提高慢性肾衰竭的治疗效果;严谨的疗效观察及适时护理可保障治疗顺利进行。     

肾衰胶囊治疗慢性肾衰竭的临床和实验研究

慢性肾衰竭(CRF)是临床常见的危重病症，预后极差。血液净化疗法和肾移植使慢肾衰的治疗有很大进展，但费用高昂，经济负担严重，绝大部分患者仍需内科治疗。CRF早、中期向晚期尿毒症发展阶段是该病治疗的关键时期，研究如何延缓肾衰竭，改善症状，具有十分重要的普遍意义。我们采用肾衰胶囊为主，中西医结合治疗CRF早中期，可使病情较长期稳定，对延缓CRF病程进展有较明显作用，并取得较好疗效，报道如下。     

黄虎肾衰散在慢性肾衰竭中的应用

如何延缓慢性肾衰竭(CRF)进展速度是广大肾内科医师的重要课题，近年来以中西医结合为基础的非透析疗法治疗CRF日益受到重视，笔者以自拟的黄虎肾衰散对32例CRF患者进行了前瞻性研究，取得了较好的效果，现报告如下。     

肾衰方治疗慢性肾衰竭疗效分析

目的:探讨肾衰方(叶任高教授的经验方)治疗慢性肾衰竭的疗效。方法:126例慢性肾衰竭患者随机分为对照组和治疗组各63例,对照组用单纯西医方法治疗,治疗组在同样西医治疗的基础上加用肾衰方治疗,治疗3个月为1个疗程,分析治疗后血尿素氮(BUN)及血清肌酐(Scr)的变化,并对血清肌酐浓度的倒数(1/Scr)和时间的关系进行回归分析。结果:治疗组治疗后BUN、Scr明显下降,与治疗前比较有显著差异(P<0.05),1/Scr与时间的回归关系其统计斜率b值为正值;而对照组则相反。结论:以肾衰方为主的中西医结合治疗方法能阻止慢性肾衰竭的进展。     

虫草制剂对延缓慢性肾衰竭进展的实验研究

目的：为观察中药治疗慢性肾衰竭(CRF)的疗效。方法：采用5／6肾切除大鼠CRF模型，对肾衰大鼠用中药治疗后的肾功能等血液生化指标及残余肾组织病理情况进行了检查。结果：发现中药可降低CRF大鼠的死亡率，降低血Scr和BUN水平，具有明显的延缓CRF进展的作用。在肾组织病理学改变上，中药能延缓肾小球硬化的进展。结论：中药能有效控制慢性肾衰竭的进展。     

氯沙坦加肾衰宁治疗慢性肾衰竭的疗效观察

慢性肾衰竭 (CRF)的终末期主要靠透析或肾移植来维持生命 ,此时费用昂贵 ,副反应多 ,病人难耐受 ,而且随时危及生命。延长CRF的非透析期 ,保护肾功能是关键。CRF时除常规处理外 ,应用ACEI类和AngⅡ受体拮抗剂(ARA) [1,2 ] 或护肾中药已取得一定疗效 ,作者对 90例CRF早中期的患者随机分为 3组用氯沙坦和肾衰宁及二者组合进行临床观察比较 ,疗效良好 ,现报道如下。资料与方法1　病例选择　本院 1999年 6月～ 2 0 0 2年 5月住院和门诊患者共 90例。女 37例 ,男 5 3例 ,年龄 2 6岁～ 74岁 ,为肾功能不全失代偿期和肾衰竭期[3 ] 。其中…     

复方红景天延缓慢性肾衰竭进展的临床研究

慢性肾衰竭(CRF)是由各种慢性肾脏病持续进展、加重所致的不可逆性大量肾单位丧失和各种代谢紊乱所构成的复杂的临床综合征。主要的形态学改变是肾小球硬化、肾小管间质的纤维化等。它将以不同速度进行性发展到终末期肾衰竭。近年来,虽然强化了透析前的综合治疗,以达到“保护肾     

肾衰宁胶囊治疗慢性肾衰竭38例疗效观察

我科采用肾衰宁胶囊治疗慢性肾衰竭（CRF）患者38例获得较好疗效，现报道如下。[第一段]     

缬沙坦延缓慢性肾衰竭进展的临床研究

肾素-血管紧张素-醛固酮系统(RAS)在非糖尿病性肾脏病的进展中起着重要的作用,这已成为共识。它能通过血流动力学以及各种其他非血流动力学变化影响肾功能并加速肾损害,因此阻断或抑制RAS被认为是治疗肾脏病的关键之一。随着血管紧张素转化酶抑制剂(ACEI)的广泛研究应     

同种肾组织移植治疗慢性肾功能衰竭性贫血的实验研究

以Ｗｉｓｔａｒ雄性大鼠为受体，建立慢性肾功能衰竭动物模型，将鼠婴肾组织声多点植入受体双侧后肢皮下和筋膜下。结果表明，３０天后移植物的体积由１ｍｍ＾３增至４ｍｍ＾３大小，表面血管网丰富；光镜下见肾小球、肾小管结构正常。促红细胞生成素（ＥＰＯ）着色颗粒主要分布在肾小球区，移植组着色程度明显增高。血红蛋白和４促红细胞生成素随移植的时间延长而逐渐升高，实验结果提示，此方法有可能为治疗慢性肾功能衰竭性贫血提     

Somatic and renal effects of growth hormone in rats with chronic renal failure

Recombinant human growth hormone (rhGH) has been widely used to improve growth in children with chronic renal failure (CRF). However, there has been great concern that GH may aggravate renal disease and hasten the progression to end-stage renal failure. We therefore investigated the effect of prolonged administration of rhGH at various doses on somatic growth and renal function and structure in rats with CRF, divided into four groups based on rhGH dose (vehicle, 0.4, 2.0, and 10.0 IU/day). rhGH was administered subcutaneously daily for 8 weeks. The mean growth was significantly greater in rats treated with high-dose rhGH (10.0 IU) than those treated with low-dose rhGH (P = 0.0089) or vehicle (P = 0.0011). Body weight gain increased in parallel with body length (Creatinine clearance at the end of the experiment was significantly lower in rats on high or medium-dose rhGH than those on low-dose rhGH and controls (P <0.05). The glomerular sclerosing index was greater in rats treated with higher doses of rhGH. There were significant differences between rats treated with high-dose rhGH and controls (P = 0.0144) and also between rats on medium-dose rhGH and controls (P = 0.0065). Although there was no significant difference, rats treated with higher doses of rhGH tended to excrete more protein. Renal insulin-like growth factor-I (IGF-I) content and circulating IGF-I and IGF-II levels did not significantly differ among groups. We conclude that: (1) GH improves somatic growth failure in rats with CRF, but prolonged administration of GH dose-dependently induces deterioration in renal function and structure and (2) this effect was induced neither via circulating IGF-I and IGF-II nor by local production of IGF-I, but seems to be direct. Received June 7, 1996; received in revised form and accepted November 19, 1996     

生血肾灵对慢性肾衰竭大鼠肾小球硬化的影响

目的 :观察生血肾灵对慢性肾衰竭 (CRF)大鼠肾小球硬化和肾小球病理改变的影响。方法 :选用 2月龄Wistar雄性大鼠 ,分为正常对照组、模型对照组和治疗组。用 4/6肾大部切除术建立CRF模型。治疗组给予生血肾灵 ,连续 2个月。用免疫组化法测定肾小球内Ⅳ型胶原和纤维连接蛋白 (FN) ,根据染色程度做半定量分析。在光镜下根据肾小球的病理改变程度进行分级 ,做半定量分析。结果 :治疗组肾小球内Ⅳ型胶原和FN的沉积显著少于模型对照组 (P <0 .0 5 ) ,肾小球病理改变明显轻于模型对照组 (P <0 .0 1) ,血肌酐显著低于模型对照组 (P <0 .0 1)。结论 :生血肾灵能够抑制CRF大鼠肾小球内Ⅳ型胶原和FN的沉积 ,减缓肾小球的硬化和肾衰的发展     

冬虫夏草制剂延缓慢性肾衰竭的机理研究

目的：为探讨冬虫夏草制剂治疗慢性肾衰竭的机理。方法：采用5／6肾切除大鼠CRF模型,观察治疗后的大鼠血脂、中分子物质等。结果：发现可降低CRF大鼠血膦、升高血钙、降低中分子物质、改善贫血状态、纠正脂质代谢紊乱。结论：冬虫夏草制剂延缓慢性肾衰竭进展的机理可能与降低中分子物质、纠正脂质代谢紊乱、改善贫血有关。     

Etiology of chronic renal failure in Turkish children

The etiology of chronic renal failure (CRF) was studied in 459 Turkish children (205 girls, 254 boys) for the period January 1979-December 1993. Their mean age at onset of CRF was 9.5±4.2 years (range 1–16 years); CRF was defined as a glomerular filtration rate (GFR) below 50 ml/min per 1.73 m² for at least 6 months. When a GFR determination was not available, the serum creatinine concentration was used: greater than 1 mg/dl for children aged 1–3 years, greater than 1.5 mg/dl for those 3–10 years and greater than 2 mg/dl for those 10–16 years. Primary renal disorders were as follows: reflux nephropathy 32.4% glomerular diseases 22.2%, hereditary renal disorders 11.4%, amyloidosis 10.6%, urinary stones 8% and other renal disorders 15.4%. Twenty-three cases of reflux nephropathy (15.4%) were associated with neural tube defects (NTD) and 20 (13.4%) were caused by infravesical obstruction. CRF caused vesicoureteral reflux associated with NTD and amyloidosis are more frequent in our series compared with west European and Nordic countries.     

The effects of chronic renal failure on siblings

It is well recognised that chronic illness in children can have a significant effect upon siblings, but their viewpoints need to be sought if we are to change our practice. We conducted semi-structured interviews at home with 15 siblings (8 males) aged 8–12 years whose brother/sister were on chronic dialysis or had received or were waiting for a renal transplant. The interviews were analysed using a grounded theory approach. The children also completed the Spence Childrens Anxiety Scale (SCAS), which revealed no statistically significant evidence that they were exhibiting chronic clinical anxiety. Qualitative data indicated that siblings had a variety of concerns concerning their own health and that of their siblings and worried about the effects on family routine and separation from parents. The siblings felt more protective towards their chronically ill sibling and felt that they themselves needed to be more grown up. The study has implications for our clinical practice in that our psychosocial assessment of families needs to include an assessment of sibling needs and siblings should be involved when preparing patients for chronic renal failure treatment. The importance of maintaining family routines should be emphasised, as well as trying to involve siblings in unit activities.     

慢性肾功能衰竭患者细胞内外氨基酸水平的改变

目的观察游离氨基酸在正常人体细胞内外液中的浓度及其在慢性肾功能衰竭(CRF)时的代谢变化.方法对15例CRF患者和10例健康志愿者的血浆、红细胞内、骨骼肌细胞内的游离氨基酸浓度进行了比较.结果正常人体红细胞内天冬氨酸(Asp)、谷氨酸(Glu)和丝氨酸(Ser)浓度较血浆内高(P＜0.05),而胱氨酸(Cys)、精氨酸(Arg)和蛋氨酸(Met)浓度较血浆内低(P＜0.05),其余大多数游离氨基酸浓度与血浆基本一致;骨骼肌细胞内游离氨基酸浓度普遍较高.CRF时血浆中缬氨酸(Val)、亮氨酸(Leu)、异亮氨酸(Ile)、赖氨酸(Lys)、苏氨酸(Thr)、苯丙氨酸(Phe)、Ser、Cys、酪氨酸(Tyr)浓度和红细胞内Val、Tvr浓度明显降低(P＜0.05),而部分非必需氨基酸浓度升高;骨骼肌细胞内除Val、Thr、Lys浓度降低(P＜0.05)外余变化不显著.结论正常人体血浆、红细胞、骨骼肌细胞内游离氨基酸浓度不完全相同;CRF时这3种介质中的游离氨基酸代谢均发生改变,主要表现为一些必需氨基酸浓度明显降低,然而降低的幅度3者并不平行.     

Children with chronic renal failure in Sweden 1978–1985

A survey of chronic renal failure (CRF) in Swedish children was carried out for the period 1978–1985, using age-related cut-off levels for creatinine concentrations corresponding approximately to a glomerular filtration rate of 30 ml/min per 1.73 m². The mean annual incidence of CRF was 6.9 and of terminal renal failure (TRF) 4.4/million children. The prevalence increased during the study period, for preterminal renal failure from 14.1 (1978) to 26.1 (1985) and for TRF from 12.4 to 16/million children. The main groups of primary renal disease were malformations (42%), hereditary disorders (27%), and glomerular diseases (14%), while pyelonephritis with vesico-ureteral reflux only made up 5%.     

Reversibility of adenine-induced renal failure in rats

Background. A renal failure model prepared from rats fed on an adenine diet provides valuable information about the pathomechanism of various complications associated with a persistent uremic state. To establish an animal experimental model in which the animals survive in a persistent uremic state, it is essential to settle a point of no return, i.e., an irreversible point. We investigated an irreversible point using the rat renal failure model induced by adenine treatment. Methods. Rats were fed on a diet containing 0.75% adenine for 2, 4, or 6 weeks, and they were then fed an adenine-free diet for an additional 4 weeks to evaluate the degree of recovery from renal dysfunction. Results. The rats fed on the adenine diet for 2 weeks showed a decrease in mean serum creatinine(s-Cr) from 1.8 mg/dl before to 0.7 mg/dl after the observation period, with mild anemia. The rats fed on the adenine diet for 4 weeks showed persistent renal dysfunction. Although the mean s-Cr decreased from 2.7 to 2.0 mg/dl, it continued to be higher than the normal range, and the anemia worsened. In the rats fed on the adenine diet for 6 weeks, the mean s-Cr increased from 3.4 to 3.6 mg/dl. Hypoproteinemia was also observed and some animals died. Conclusion. Based on the above results, it was concluded that to prepare a model of chronic renal failure in rats compatible to chronic renal failure seen clinically, the administration of a 0.75% adenine diet for 4 weeks is most appropriate. Received: April 24, 1998 / Accepted: October 12, 1998     

Early-onset chronic renal failure as a presentation of infantile nephropathic cystinosis

We report an 18-month-old girl who presented in chronic renal failure after an illness characterised by protracted diarrhoea, poor weight gain and anaemia. There were no symptoms and signs suggestive of a renal Fanconi syndrome, but a diagnosis of nephropathic cystinosis was suggested by renal biopsy and confirmed by an elevated leucocyte cystine concentration. We suggest that the diagnosis of cystinosis should be considered in any child with chronic renal failure of unknown aetiology.