| 李东洋；陈小永；庞欣欣；张鸽.温肾汤治疗慢性肾功能不全脾肾阳虚证的临床疗效及对肾脏纤维化的影响[J].中医药信息,2024,41(3):52-55 |
| 温肾汤治疗慢性肾功能不全脾肾阳虚证的临床疗效及对肾脏纤维化的影响 |
| Clinical Effects of Wenshen Decoction on Chronic Renal Insufficiency with Spleen and Kidney Yang Deficiency Syndrome and Its Impact on Renal Fibrosis |
| 投稿时间：2023-09-13 录用日期：2023-11-25 |
| DOI：10.19656/j.cnki.1002-2406.20240308 |
| 中文关键词: 温肾汤 慢性肾功能不全 脾肾阳虚 纤维化 |
| 英文关键词: Wenshen Decoction Chronic renal insufficiency Spleen and kidney yang deficiency Fibrosis |
| 基金项目:河南省中医药科学研究专项课题 编号2022JDX139 |
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| 中文摘要: |
| 目的：探究温肾汤治疗慢性肾功能不全脾肾阳虚证的效果及其对肾脏纤维化的影响。方法：选择符合纳入标准的慢性肾功能不全脾肾阳虚证患者96例，依据随机数字表随机分为对照组和观察组。对照组采用常规西药治疗，观察组在对照组基础上口服温肾汤治疗，2周为1个疗程，两组均治疗2个疗程。比较治疗前后两组患者中医症状评分（畏寒肢冷、面浮肢肿、神疲乏力、食少纳呆、腰膝畏寒和脘腹胀痛）、肾功能相关损伤指标（24 h Pro、BUN、Ccr和GFR）及肾纤维化相关指标（CTGF、CIV、PCⅢ和BMP-7）变化情况及临床疗效。结果：对照组临床总有效率为77.1%(37/48)，观察组临床总有效率为91.7%(44/48)，差异有统计学意义（P <0.05）；治疗后两组患者畏寒肢冷、面浮肢肿、神疲乏力、食少纳呆、腰膝畏寒和脘腹胀痛的中医症状评分均较治疗前显著降低（P <0.05），且观察组改善程度优于对照组（P <0.05）；治疗后两组患者24 h Pro、BUN水平均较治疗前显著降低（P <0.05）,Ccr、GFR水平显著升高（P <0.05），且观察组改善程度优于对照组（P<0.05）；治疗后两组患者CTGF、CIV及PCⅢ水平较治疗前明显降低（P <0.05）,BMP-7水平明显升高（P <0.05），且观察组改善程度优于对照组（P <0.05）。结论：温肾汤可以有效改善慢性肾功能不全脾肾阳虚证患者的肾功能，降低蛋白尿，显著抑制肾脏纤维化。 |
| 英文摘要: |
| Objective： To explore the effect of Wenshen Decoction in the treatment of chronic renal insufficiency patients with spleen and kidney yang deficiency syndrome and its impact on renal fibrosis. Methods： Ninety-six chronic renal insufficiency patients with spleen and kidney yang deficiency syndrome who met the inclusion criteria were selected and randomly divided into a control group and an observation group based on a random number table. The control group was treated with conventional Western medicine， while the observation group was treated the same in addition to orally taking Wenshen Decoction，2 weeks as a course of treatment， and both groups were treated for 2 courses. Traditional Chinese medicine symptom score （fear of cold， cold limbs， puffy face， swelling of limbs， fatigue， low and torpid food intake， fear of cold in the waist and knee， distention and pain in the epigastrium）， renal function related injury indexes （24 h Pro， BUN， Ccr and GFR）， renal fibrosis related indexes （CTGF， CIV， PCIII and BMP-7）， as well as clinical efficacy were compared between the two groups before and after treatment. Results： The total clinical effective rate in the control group was 77.1% （37/48）， while in the observation group it was 91.7% （44/48）， with a statistically significant difference （P < 0.05）. After treatment， the traditional Chinese medicine symptom scores of fear of cold， cold limbs， puffy face， swelling of limbs， fatigue， low and torpid food intake， fear of cold in the waist and knee， distention and pain in the epigastrium in the two groups were significantly reduced compared with those before treatment （P < 0.05）， and the improvement degree of the observation group was better than that of the control group （P < 0.05）. The 24 h Pro and BUN levels of both groups significantly decreased （P < 0.05）， and the Ccr and GFR levels significantly increased （P < 0.05）， and the improvement degree of the observation group was better than that of the control group （P < 0.05）. The levels of CTGF， CIV and PCIII in the 2 groups significantly decreased （P < 0.05）， and the level of BMP-7 significantly increased （P < 0.05）， and the improvement degree of observation group was better than that of control group （P < 0.05）. Conclusion： Wenshen Decoction can effectively improve the renal function of chronic renal insufficiency patients with spleen and kidney yang deficiency， reduce proteinuria， and significantly inhibit renal fibrosis. |
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