中药治疗慢性肾脏病3期的随机对照临床研究

摘要

Objective To observe the effect of Chinese medicine on chronic kidney disease (CKD). Methods 40 patients in stage 3 of CKD were divided into Chinese medicine group ( group one) , Benazepril group (group two) randomly, with 20 patients in each group. All the patients were given Chinese medicine, Benazepri double - blindly for 24 weeks. The scores of TCM syndrome and laboratory indexes were compared at Oth, 12th, 24th weeks. Result At 24th week, scores of TCM syndromes in two groups decreased significantly comparing to Oth (P <0.01). At 12th, the 24h urinary protein in group two decreased significantly than group one (P <0. 05). At 12th week, HGB decreased significantly in group two than that before treatment (P <0.05). At 24thweek, ALB in group two was significantly higher than that before treatment (P <0.05). At 24th week, BUN in group two increased significantly than that before treatment, and Scr increased significantly than group one (P<0.05). At 12th week, eGFR declined significantly in group two than group one (P<0.01). At 24th week, according to the criterion of Chinese medicine syndrome therapeutical effect, the effective rate in group one and group two was 65% and 40% respectively with extremely significant difference ( P <0.01). However, the effective rate to Western medicines standards was 85% in group two and 75% in group one, with significant difference between the two groups(P <0. 05). Conclusion Chinese medicine was better than benazepril alone to improve clinical syndrome, to improve HGB and to slow the progress of renal failure.%目的 观察中药治疗慢性肾脏病(CKD)的疗效.方法 将40例CKD(3期)患者随机分为中药组、西药组,每组20例；采用双盲法给予中药、苯那普利治疗,疗程24周；对患者在投药初始以及12、24周的实验室指标及中医症状积分进行对照分析.结果 中医症状积分:24周两组较治疗前均下降(P＜0.01).24h尿蛋白定量:12周西药组下降较中药组有显著性差异(P＜0.05).血红蛋白(HGB):24周西药组较治疗前明显下降(P＜0.05).血清白蛋白(ALB):24周西药组较治疗前明显升高(P＜0.05).血尿素氮(BUN):24周西药组较治疗前明显升高(P＜0.05).血肌酐(Scr):24周西药组较中药组升高明显(P＜0.05).肾小球滤过率(eGFR):12周西药组较中药组明显降低(P＜0.01).总疗效比较:在24周,依据中医证候疗效标准判定,中药组为65%,西药组为40%,组间比较(P＜0.01)；根据西医疗效标准判定,西药组为85%,中药组为75%,组间比较(P＜0.05).结论 中药较苯那普利能更好的改善CKD的临床症状,升高HGB,延缓肾功能减退.