芪黄益肾汤联合复方α酮酸治疗慢性肾脏病3-5期脾肾亏虚证的临床疗效分析OA
Clinical Efficacy of Qihuang Yishen Decoction Combined with Compound α-Ketoacid in the Treatment of Patients with Stages 3 to 5 Chronic Kidney Disease of Spleen-Kidney Deficiency Syndrome
目的:探讨芪黄益肾汤联合复方 α 酮酸治疗对慢性肾脏病(CKD)3-5 期脾肾亏虚证患者的临床疗效.方法:选取 2023年 3 月至 2025 年 4 月该院收治的 CKD 3-5期患者 80 例,依据随机数字表法将其分为观察组与对照组,每组 40 例.对照组患者接受常规西医基础治疗并口服复方 α 酮酸,观察组患者在对照组的基础上加用芪黄益肾汤.两组患者的治疗周期均为 2 个月.比较两组患者的临床疗效,中医证候积分、肾病相关生活质量评分(KDTA),炎症因子水平[C 反应蛋白(CRP)、白细胞介素-6(IL-6)]、肾功能[尿素氮(BUN)、血肌酐(SCr)和估算肾小球滤过率(eGFR)]、血管内皮生长因子(VEGF)、矿物质与骨代谢指标[钙(Ca)、磷(P)、成纤维细胞生长因子 23(FGF23)和 klotho 蛋白]以及安全性.结果:观察组患者的总有效率达 87.5%(35/40),高于对照组的 65.0%(26/40),差异有统计学意义(P<0.05).治疗后,观察组患者中医证候积分,CRP、IL-6、VEGF、BUN、SCr、P 和 FGF23 水平较治疗前降低,且观察组低于对照组,差异均有统计学意义(P<0.05);KDTA 评分、eGFR、Ca、klotho 蛋白均较治疗前升高,且观察组高于对照组,差异均有统计学意义(P<0.05).观察组、对照组患者的不良反应发生率分别为 5.0%(2/40)、5.0%(2/40),差异无统计学意义(P>0.05).结论:芪黄益肾汤联合复方 α 酮酸可有效改善脾肾亏虚型 CKD3-5 期患者的临床症状,降低肾功能损伤指标水平,减轻炎症反应,提升患者生活质量,且具有良好的安全性.
OBJECTIVE:To probe into the clinical efficacy of Qihuang Yishen decoction combined with compound α-ketoacid in the treatment of patients with stages 3 to 5 chronic kidney disease(CKD)of spleen-kidney deficiency syndrome.METHODS:Eighty patients with stages 3 to 5 CKD in the hospital from Mar.2023 to Apr.2025 were randomly assigned to the observation group and control group via the random number table method,with 40 cases in each group.The control group received conventional Western medicine treatment combined with compound α-ketoacid,while the observation group was additionally treated with Qihuang Yishen decoction.The treatment lasted for two months in both groups.Clinical efficacy,traditional Chinese medicine(TCM)syndrome scores,Kidney Diseases Targeted Areas(KDTA)Quality of Life scores,inflammatory factors[C-reactive protein(CRP),interleukin-6(IL-6)],renal function indices[blood urea nitrogen(BUN),serum creatinine(SCr),estimated glomerular filtration rate(eGFR)],vascular endothelial growth factor(VEGF),mineral and bone metabolism markers[calcium(Ca),phosphorus(P),fibroblast growth factor 23(FGF23),and klotho protein],and safety were compared between two groups.RESULTS:The total effective rate in observation group was 87.5%(35/40),higher than 65.0%(26/40)in the control group,with statistically significant difference(P<0.05).Compared with before treatment,the observation group showed significant reductions in TCM syndrome scores,CRP,IL-6,VEGF,BUN,SCr,P,and FGF23 levels after treatment,and the observation group was lower than the control group,with statistically significant difference(P<0.05).Meanwhile,KDTA scores,eGFR,Ca,and klotho protein levels increased significantly compared with before treatment,and the observation group was higher than the control group,with statistically significant difference(P<0.05).The incidence of adverse drug reactions in observation group and control group was respectively 5.0%(2/40)and 5.0%(2/40),the difference was not statistically significant(P>0.05).CONCLUSIONS:Qihuang Yishen decoction combined with compound α-ketoacid can effectively alleviate clinical symptoms,reduce renal impairment markers,mitigate inflammatory responses,and improve the quality of life in patients with stages 3 to 5 CKD of spleen-kidney deficiency syndrome,demonstrating a favorable safety profile.
张梓祥;宣建宗;丁仁华;张海银;吴亮亮;王义元
天长市中医院药剂科,安徽 天长 239300天长市中医院肾病科,安徽 天长 239300天长市中医院肾病科,安徽 天长 239300天长市中医院肾病科,安徽 天长 239300天长市中医院肾病科,安徽 天长 239300天长市中医院肾病科,安徽 天长 239300
医药卫生
芪黄益肾汤复方α酮酸慢性肾脏病脾肾亏虚证疗效
Qihuang Yishen decoctionCompound α-ketoacidChronic kidney diseaseSpleen-kidney deficiency syndromeEfficacy
《中国医院用药评价与分析》 2026 (5)
567-571,5
安徽省中医药传承创新科研项目(No.2024CCCX056)安徽省卫生健康科研项目(No.AHWJ2024Aa20294)滁州市卫生健康科研项目(No.CZWJ2024B004)滁州市临床重点专科建设项目(肾脏病学)(No.滁卫健函[2024]47号)安徽省中医药传承创新科研项目(No.2022CCYB12)
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