肾通丸对慢性肾脏病患者肾脏纤维化进程影响研究简

目的：观察中药制剂肾通丸（由黄芪、土茯苓、丹参、当归等组成）对慢性肾脏病（chronickidnevdisease．CKD）患者的临床疗效及其阻抑肾纤维化进展的作用。方法：用随机化、前瞻性的研究方法，将60例CKD患者按1：1分为治疗组和对照组。两组均给予低蛋白饮食、血压控制、纠正水电和酸碱平衡等基本治疗，治疗组在基本治疗的基础上加服肾通丸，对照组在基本治疗基础上加服肾衰宁片，两组均以4周为1个疗程，连续治疗6个疗程后统计结果。分别观察两组病人治疗前后相关指标：（1）临床表现：水肿、血压（BP）、24h尿蛋白总量、血红蛋白（Hb）、红细胞压积（HCT）、血清白蛋白（ALB）。（2）肾功能：血肌酐（Scr）、尿素氮（BUN）、光抑素（CysC）、肾小球滤过率（GFR）。（3）双肾皮质厚度：以B超测定不同阶段肾脏皮质厚度、肾大小及回声等。（4）纤维化指标：三型前胶原（PC—III）、四型胶原（Col-IV）、层黏蛋白（LN）和透明质酸（HA）。结果：和对照组相比，治疗组主要I】名床表现均有减轻（P〈0．05或P〈0．01），总体疗效均高于对照组（P〈0．05或P〈0．01l肾通丸能提高CKD患者血清ALB、GFlK水平，降低Scr、PC—III、Col-IV、LN及HA水平（P〈0．05或P〈0．01），但对Hb、HCT的升高作用与对照组比较无显著性差异（P〉0．05）。结论：肾通丸不仅能改善患者临床症状，而且能改善患者的肾功能；对肾纤维化指标也有明显改善作用，提示该药具有较好的抗’肾脏纤维化作用。同时发现，肾脏变薄程度有不同程度的延缓倾向，但改善不明显，可能与治疗时间短有关。另外，本研究未发现该药有明显毒副作用。

Clinical Study on Effect of Shentong Pill on Renal Fibrosis of Patients with Chronic Kidney Disease

Objective ： To observe the therapeutic effect of Shentong Pill （ STP ） which has the actions of lifting clear Qi and purging turbidity for chronic kidney disease （ CKD ） and to investigate its influence on renal function, fibrosis parameters and thickness of the renal cortex. Methods ： A prospective study was carried out in 60 CKD patients. The patients were equally randomized into two groups. Besides the basic treatment of feeding with lower-dose protein, controlling blood pressure, maintaining water-electrolyte and acid-base balance, comparative group received Shenshuaining Tablet （ SST ） and treatment group received STP. Four weeks constituted one treatment course and the treatment lasted 6 courses. Before and after treatment, the main clinical manifestations, laboratory parameters such as 24-hr urine protein, hematoglobin （ Hb ）, hematoerit （ HCT ）, serum creatinine （ Scr ）, blood urea nitrogen （ BUN ）, glomerular fihrateion rate （ GFR ）, albumin （ ALB ）, serum precollagen- III （ PC- III ）, collagen IV （ Col-IV ）, laminin （ LN ）, hyaluronie acid （ HA ） and the thickness of the renal cortex were assayed. Results ： The effect on the clinical manifestations and total therapeutic effect were better in treatment group than those in comparative group （ P〈0.05 or P〈0.01 ）. STP increased serum ALB and GFR levels, and reduced 24-hr urine protein, Ser, BUN, PC- III, Col-IV, LN and HA （ P〈0.05 or P〈0.01 ）. However, the effect of STP on the increase of Hb and HCT was insignificant （ P〉0.05 ）. Conclusion ： STP has an effect on relieving symptoms of CKD, and improving renal function and kidney fibrosis parameters, indicating that STP exerts a better eounteraction on kidney fibrosis.