补肾活血排毒方延缓慢性肾功能衰竭患者肾衰竭进程的临床研究.docVIP

补肾活血排毒方延缓慢性肾功能衰竭患者肾衰竭进程的临床研究 作者：钟宏琳,李德干,蒋 翎,欧伟宁,杨朝品,张源琪 【摘要】 目的 观察补肾活血排毒方治疗慢性肾功能衰竭临床疗效及其对肾纤维化指标的影响。方法 将76例慢性肾功能衰竭患者随机分为观察组和对照组,每组38例。2组均予相对统一的常规肾内科饮食及西药治疗,观察组除基础治疗外加用补肾活血排毒方中药汤剂治疗,共3个月。观察2组临床疗效及血清层粘连蛋白(LN)、纤维连接蛋白(FN)、Ⅲ型前胶原(PC-Ⅲ)、Ⅳ型胶原(Ⅳ-C)的变化。结果 2组总有效率(81.58%与55.26%)比较,差异有统计学意义(P＜0.01)；观察组患者血清LN、PC-Ⅲ、C-Ⅳ明显降低,FN升高,与对照组比较,差异有统计学意义(P＜0.01)。结论 补肾活血排毒方能改善慢性肾功能衰竭患者的肾纤维化、延缓肾衰竭进程。 【关键词】 慢性肾功能衰竭；肾纤维化；补肾活血排毒方 Abstract：Objective To observe the clinical curative effect of Bushen Huoxie Paidu decoction in delaying the renal fibrosis progression and retarding the course of chronic renal failure (CRF). Methods Seventy-six patients with CRF were randomly divided into the test group (38 cases) and the control group (38 cases). Both groups were treated with relatively unified fundamental treatment, experienced prescription of Bushen Huoxie Paidu decoction was given additionally to the test group. Treatment course of each group was 3 months. The curative effect was observed and the plasma levels of laminin (LN), fibronectin (FN), procollagen type Ⅲ (PC-Ⅲ) and collagen type Ⅳ (Ⅳ-C) in both groups were determined. Results The statistic analysis showed that the total effect of two groups (81.58% and 55.26%) had a significant difference (P＜0.01). The statistic analysis also showed that the test group could decrease LN, PC-Ⅲ, Ⅳ-C and increase FN, and was significantly different from that of control group respectively (P＜0.01). Conclusion Bushen Huoxie Paidu decoction could markedly delay the renal fibrosis progression and retard the progression of CRF. Key words：chronic renal failure；renal fibrosis；Bushen Huoxie Paidu decoction 慢性肾功能衰竭(chronic renal failure,CRF)是多种慢性肾脏疾病的晚期,由于肾功能逐渐恶化所引起的一系列以蛋白质代谢产物潴留为主及水、电解质和酸碱平衡失调的临床综合征。CRF发病率在不断上升,其治疗费用在持续增长,给患者家庭、社会带来的经济负担成为不可忽视的问题。因此,如何防止肾衰竭进程成为近年来肾脏病领域的热点。补肾活血排毒方为治疗CRF的经验方,为观察其疗效并探讨其可能机理,笔者对其进行了临床研究。现将结果报道如下。 　　1 资料与方法 　　1.1 诊断标准 参照《中华内科杂志》编委会肾脏病专业组1993年标准[1]制定：血清肌酐(SCr)＞133 μmol/L；内生肌酐清除率(CCr)＜80 mL/min；有慢性肾脏疾病或累及肾脏的系统疾病病史。 　　1.2