黄芪注射液治疗慢性肾脏病基础上急性肾损伤的临床研究

目的：探讨黄芪注射液治疗慢性肾脏病基础上急性肾损伤的临床疗效,为治疗该症寻找最佳途径。方法：采用单中心、前瞻性、随机对照研究。将符合纳入标准的96例患者,随机分为对照组和黄芪治疗组,对照组予口服包醛氧化淀粉,碳酸氢钠,生理盐水静脉滴注治疗;黄芪治疗组在常规治疗的基础上,生理盐水加黄芪注射液20ml静脉滴注治疗,每日液体量与对照组相同,维持治疗28d。观察治疗前后肾功能、尿蛋白、血常规、血脂、C反应蛋白、尿微量蛋白等变化,对比两组患者临床短期预后。结果：两组患者基础的24h尿蛋白、尿NAG、血清白蛋白、血脂、血红蛋白、eGFR等指标差异无统计学意义;治疗后,黄芪治疗组血清肌酐、血胱抑素C、C反应蛋白、尿白蛋白和尿IgG较对照组显著降低（P〈0.01）。且黄芪治疗组治疗后血清肌酐、血胱抑素C、C反应蛋白、尿白蛋白和尿IgG均显著低于治疗前基础值（P〈0.01）。而对照组治疗前后各指标差异无统计学意义。结论：在基础治疗上加用黄芪注射液治疗慢性肾脏病基础上急性肾损伤疗效显著,值得临床推广使用。

Clinical Study of Astragalus Injection on Acute-on-chronic Kidney Injury

Objective:To investigate the clinical efficacy of Astraglus injection on treating acute-on-chronic kidney injury,it aims to find an optimum way to treat acute-on-chronic kidney injury.Methods:The 96 patients who met the inclusion criteria were randomly divided into the control group and Astragalus injection group.Patients from control group were given basic regular western medicine;while patients from Astragalus injection group accepted Astragalus injection 20 ml intravenously per day for 28 days.Before and after treatment,the alteration of symptom,24 h urinary protein and serum albumin,urinary NAG,renal and liver function,blood lipids and GFR were observed.Results:The 24 h urinary protein,urinary NAG,serum albumin,blood lipids,hemoglobin,GFR had no significant change before and after treatment.Astragalus injection significantly decreased serum creatinine,Cys C,urinary albumin,urinary IgG,and significantly increased GFR(P<0.01).Conclusion:The combination of regular basic western medicine and Astragalus injection had significant effect on treating acute-on-chronic kidney injury,which deserves a widen clinical use.