摘要
目的探讨芪参固肾汤结合厄贝沙坦治疗2~3期慢性肾脏病临床效果。方法研究总计纳入110例2~3期慢性肾脏病患者,采取随机数字表法将患者分为汤剂组与西药组,每组55例,西药组患者采取厄贝沙坦等西药常规治疗,汤剂组患者在西药组用药基础上结合中药芪参固肾汤治疗,治疗过程中西药组脱落1例,汤剂组脱落2例。观察各组数据情况:疗效、治疗前后中医证候(主症、次症)积分变化、肾功能相关指标变化、炎症因子指标变化以及肠道菌群变化、T淋巴细胞亚群等免疫功能指标变化、不良反应。结果汤剂组治疗总有效率显著高于西药组(P<0.05);治疗后各组患者中医证候(主症、次症)积分、24 h尿蛋白定量(24-hour urinary protein quantification,24 h-UTP)、血肌酐(blood creatinine,SCr)、尿素氮(urea nitrogen,BUN)、白蛋白(albumin,ALB)、肾小球过滤率估计值(estimated glomerular filtration Rate,eGFR)等肾功能相关指标、白细胞介素-6(interleukin 6,IL-6)及白细胞介素-17(interleukin 17,IL-17)、超敏C反应蛋白(hypersensitive C-reactive protein,hs-CRP)等炎症因子指标、嗜酸乳杆菌及双歧杆菌、大肠杆菌等肠道菌群指标、T淋巴细胞亚群(CD3^(+)、CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+))等免疫指标均改善,而汤剂组患者治疗后中医证候(主症、次症)积分、肾功能相关指标(24 h-UTP、SCr、BUN、ALB、eGFR)、炎症因子指标(IL-6、IL-17、hs-CRP)、肠道菌群(嗜酸乳杆菌及双歧杆菌、大肠杆菌)、T淋巴细胞亚群(CD3^(+)、CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+))等指标均优于西药组,P<0.05;汤剂组治疗总不良反应率比西药组更低(P<0.05)。结论芪参固肾汤结合厄贝沙坦治疗2~3期慢性肾脏病可调节患者免疫功能,改善患者肾功能及免疫功能、炎症反应,提升治疗效果,且降低不良反应,治疗安全可靠。
Objective To explore the clinical effect of Qisheng Gushen Decoction(芪参固肾汤)combined with irbesartan in the treatment of chronic kidney disease at stage 2~3.Methods A total of 110 patients with chronic kidney disease at stage 2~3(admitted from August 2021 to October 2023)were divided into decoction group and western medicine group by random number table method,with 55 cases in each group.The western medicine group received irbesartan and other western medicines,and the decoction group was treated with Qisheng Gushen Decoction on the basis of the western medicine group.In the course of treatment,1 case was shed in the western medicine group and 2 cases were shed in the decoction group.The data of each group was observed as follows:curative effect,integral changes of TCM symptoms(main disease and secondary disease)before and after treatment,changes of renal function indicators,changes of inflammatory factors indicators,changes of intestinal flora,changes of T lymphocyte subsets and other immune function indicators,adverse reactions.Results The total effective rate of the decoction group was significantly higher than that of the western medicine group(P<0.05).After treatment,the scores of TCM syndrome(main disease and secondary disease),24-hour urinary protein quantification(24 h-UTP),serum creatinine(SCr),urea nitrogen(BUN),albumin(ALB),estimated glomerular filtration rate(eGFR),interleukin-6(IL-6),interleukin-17(IL-17)and hypersensitive C-reactive protein(hs-CRP),intestinal flora indicators such as Lactobacillus acidophilus,bifidobacterium and Escherichia coli,and immune indicators such as T lymphocyte subsets(CD3^(+),CD4^(+),CD8^(+),CD4^(+)/CD8^(+))were improved.In the decoction group,these indexes were all better than those in western medicine group(P<0.05).The total adverse reaction rate of the decoction group was lower than that of the western medicine group(P<0.05).Conclusion Qisheng Gushen Decoction combined with irbesartan in the treatment of chronic kidney disease at stage 2~3 can regulate the immune function,improve the renal function,immune function and inflammatory response of patients,enhance the therapeutic effect,and reduce adverse reactions,and the treatment is safe and reliable.
作者
田卫
隽晨霞
王求利
王东济
TIAN Wei;JUN Chenxia;WANG Qiuli;WANG Dongji(Lianyungang Traditional Chinese Medicine Hospital,Lianyungang 222000,Jiangsu,China)
出处
《中华中医药学刊》
北大核心
2025年第8期40-43,共4页
Chinese Archives of Traditional Chinese Medicine
基金
国家自然科学基金项目(82100753)。
关键词
2~3期慢性肾脏病
厄贝沙坦
芪参固肾汤
肾功能
免疫功能
疗效
不良反应
chronic kidney disease at stage 2-3
irbesartan
Qisheng Gushen Decoction(芪参固肾汤)
kidney function
immune function
curative effect
adverse reaction
