| 季景.参芪地黄汤加减联合一体化方案治疗慢性肾衰竭微炎症状态气阴两虚兼湿热证的临床研究[J].浙江中西医结合杂志,2025,35(4): |
| 参芪地黄汤加减联合一体化方案治疗慢性肾衰竭微炎症状态气阴两虚兼湿热证的临床研究 |
| Clinical Study on the Combination of Modified Shenqi Dihuang Decoction and Integrated Treatment for Chronic Renal Failure with Micro Inflammatory State of Qi and Yin Deficiency and Damp Heat Syndrome |
| 投稿时间：2024-07-05 修订日期：2025-03-08 |
| DOI： |
| 中文关键词: 慢性肾衰竭 微炎症状态 参芪地黄汤 一体化方案 肝肾功能 炎症反应 |
| 英文关键词:Chronic renal failure Microinflammatory state Shen Qi Di Huang Tang Integrated solution Liver and kidney function inflammatory reaction |
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| 中文摘要: |
| 目的 通过前瞻性研究观察参芪地黄汤加减联合一体化方案治疗慢性肾衰竭(CRF)微炎症状态气阴两虚兼湿热证患者的临床效果。方法 按随机数字表法将本院收治的90例CRF微炎症状态气阴两虚兼湿热证患者分为观察组与对照组,各45例,最终观察组完成研究42例(剔除3例),对照组完成研究43例(剔除2例)。观察组给予参芪地黄汤加减联合一体化方案治疗,对照组仅给予一体化方案治疗,完成2周治疗后评估2组临床疗效、中医症状量化积分、血常规[血红蛋白(Hb)、红细胞(RBC)、红细胞比容(HCT)]、肝肾功能[谷丙转氨酶(ALT)、谷草转氨酶(AST)、血尿素氮(BUN)、肌酐(Scr)、内生肌酐清除率(Ccr)、尿酸(UA)]、微炎症指标[C反应蛋白(CRP)、白细胞介素-6(IL-6)]水平,并统计药物不良反应情况。结果 按疗程完成治疗后,观察组总有效率(90.48%)优于对照组(72.09%)(P＜0.05)；治疗后,2组中医症状各项评分及总积分均降低,观察组低于对照组(P＜0.05)；治疗后,2组Hb、RBC、HCT水平均提高,观察组3项指标水平均高于对照组(P＜0.05)；治疗后,2组血清ALT、AST水平较治疗前均无明显差异(P＞0.05),2组血清BUN、Scr、UA水平均降低,观察组3项指标水平均低于对照组(P＜0.05),2组血清Ccr水平均提高,观察组高于对照组(P＜0.05)；治疗后,2组血清CRP、IL-6水平均降低(P＜0.05),观察组2项指标水平低于对照组(P＜0.05)；观察组、对照组不良反应发生率比较无明显差异(9.52% vs 6.98%)(P＞0.05)。结论 采用参芪地黄汤加减联合一体化方案治疗CRF微炎症状态气阴两虚兼湿热证患者疗效显著,可有效缓解患者中医症状,减轻患者微炎症反应,改善患者肺功能及贫血状态,药物不良反应少,安全性高,值得推广实施。 |
| 英文摘要: |
| Objective: To observe the clinical effect of the combination of modified Shenqi Dihuang decoction and integrated treatment in the treatment of patients with chronic renal failure (CRF) with micro inflammatory state of Qi and Yin deficiency and damp heat syndrome through a prospective study. Method: Using a random number table method, 90 patients with CRF micro inflammatory status and Qi Yin deficiency combined with damp heat syndrome admitted to our hospital were divided into an observation group and a control group, with 45 cases in each group. The final observation group completed the study with 42 cases (excluding 3 cases), while the control group completed the study with 43 cases (excluding 2 cases). The observation group was treated with a combination of modified Shenqi Dihuang Tang and an integrated treatment plan, while the control group was only treated with an integrated treatment plan. After completing two weeks of treatment, the clinical efficacy, TCM symptom quantification score, blood routine [hemoglobin (Hb), red blood cell (RBC), hematocrit (HCT)], liver and kidney function [alanine aminotransferase (ALT), aspartate aminotransferase (AST), blood urea nitrogen (BUN), creatinine (Scr), endogenous creatinine clearance rate (Ccr), uric acid (UA)], and levels of microinflammatory markers [reactive protein (CRP), interleukin-6 (IL-6)] were evaluated in both groups. Statistics on adverse drug reactions.Result:After completing the treatment according to the course of treatment, the total effective rate of the observation group (90.48%) was better than that of the control group (72.09%) (P<0.05); After treatment, the scores and total points of traditional Chinese medicine symptoms in both groups decreased, and the observation group was lower than the control group (P<0.05); After treatment, the levels of Hb, RBC, and HCT in both groups increased, and the levels of three indicators in the observation group were higher than those in the control group (P<0.05); After treatment, there was no significant difference in serum ALT and AST levels between the two groups compared to before treatment (P>0.05). The serum BUN, Scr, and UA levels in both groups decreased, and the levels of three indicators in the observation group were lower than those in the control group (P<0.05). The serum Ccr levels in both groups increased, and the observation group was higher than the control group (P<0.05); After treatment, the serum CRP and IL-6 levels in both groups decreased on average (P<0.05), and the levels of two indicators in the observation group were lower than those in the control group (P<0.05); There was no significant difference in the incidence of adverse reactions between the observation group and the control group (9.52% vs 6.98%) (P>0.05). Conclusion: The combination of modified Shenqi Dihuang Tang and integrated treatment has a significant therapeutic effect on patients with CRF micro inflammatory status of Qi Yin deficiency and damp heat syndrome. It can effectively alleviate traditional Chinese medicine symptoms, alleviate micro inflammatory reactions, improve lung function and anemia status, reduce adverse drug reactions, and have high safety. It is worth promoting and implementing. |
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