川黄方联合前列腺素E1对60例2~4期CKD合并AKI患者的疗效观察

摘要

Objective:Observe the clinical efficacy of Chuanhuang Fang combined with Lipo PGE1 in treating acute kidney injury ( AKI) on phase 2-4 Chronic Kidney Disease ( CKD) patients. Methods:60 patients who were outpatient and hospitalized in Shanghai Municipal Hospital of Traditional Chinese Medicine were randomly divided into 2 groups, including treatment group (29 ca-ses) and control group (31 cases). All patients were given the same diet care and basic treatment. Treatment group treated with Chuanhuang Fang decoction combined with Lipo PGE1 while control group treated with Lipo PGE1, and continuous observation for two weeks. TCM symptom scores, serum creatinine ( Scr) , blood urea nitrogen ( BUN) , uric acid ( UA) , and glomerular filtration rate ( GFR, MDRD equation) was observed and compared before and after treatment, furthermore, total efficiency was calculated and ana-lyzed. Results:After two weeks treatment, two groups reduced Scr, BUN, UA and TCM symptom scores (P<0. 05 or P<0. 01), increase the glomerular filtration rate (P<0. 05), while treatment group showed better efficiency (P<0. 05). Treatment group a-chieved 75. 86% of the total efficiency, superior Lipo PGE1 group (35. 48%) (P<0. 01). Conclusion:Treatment group can relieve TCM symptoms and protecting renal function in acute kidney injury on phase 2-4 CKD patients, which is better than control group, and thus Chuanhuang Decoction might be a potentially useful method for A on C patients clinical treatment.%目的：观察川黄方联合前列腺素E1(凯时)治疗脾肾气虚、毒瘀互结型2~4期慢性肾脏病( chronic kidney disease,CKD)合并急性肾损伤( acute kidney injury,AKI)的临床疗效。方法：符合纳入标准病例60例,随机分为2组,其中川黄方加凯时组(治疗组)29例、凯时组(对照组)31例,疗程均为2周。观察两组治疗前后的中医证候积分、血肌酐( Scr)、血尿素氮( BUN)、血尿酸( UA)、肾小球滤过率( eGFR),并统计临床总有效率。结果：与治疗前相比,两组均能有效降低Scr、BUN、UA(P<0.05或P<0.01),提高eGFR(P<0.05),但治疗组较对照组在Scr、BUN、eGFR改善方面更为明显(P<0.05或P<0.01)。另外,治疗组取得75.86%的总有效率,显著优于对照组(35.48%,P<0.01),中医证候积分改善方面治疗组亦优于对照组(P<0.01)。结论：川黄方联合凯时能有效减轻A on C患者肾损伤、促进肾功能恢复,并改善中医证候群,优于单用凯时治疗。