中西醫結合治療慢性腎功能衰竭臨床分析

[摘要] 目的 探討中西醫結合治療慢性腎功能衰竭(CRF)的臨床療效。方法 100例慢性腎功能衰竭患者，分中西醫治療組(A組)50例和西藥治療組(B組)50例，療程均為8周，觀察兩組臨床療效及治療前后血尿素氮(BUN)、血肌酐(Scr)、內生肌酐清除率(Ccr)，尿β2微球蛋白(β2-M)、N-乙酰β-D氨基葡萄糖苷酶(NAG)及血清纖維化標志蛋白[Ⅳ型膠原(C-Ⅳ)、Ⅲ型前膠原(PC-Ⅲ)和層黏蛋白(LN)]的含量變化。結果 A組總有效率為80.0%，明顯高于B組62.0%(χ2= 3.987，P<0.05);治療后A組Scr、BUN、Ccr、β2-M、NAG、C-Ⅳ、PC-Ⅲ和LN均較治療前明顯改善(t=2.125~2.745，P<0.05~0.01);治療后A組血清纖維化指標較治療前均明顯改善(t=2.175~2.578，P<0.05);治療后血清纖維化指標兩組比較，均有顯著性差異(t=2.105 ~2.478，P<0.05)。結論 中西醫治療慢性腎功能衰竭，能提高臨床療效，改善患者腎功能。

[關鍵詞] 腎功能衰竭;慢性;中西醫結合療法;療效

[中圖分類號] R256.51;R256.53 [文獻標識碼] A [文章編號] 1673-9701(2010)04-80-03

Combination of Traditional Chinese Medicine with Western Medicine for Chronic Renal Failure:A Clinical Analysis

YAO Yong

Department of Traditional Chinese Medicine，Huizhou Central Hospital，Huizhou 516001，China

[Abstract] Objective To explore the therapeutic effect of combination of Traditional Chinese Medicine(TCM) with Western medicine in the treatment of chronic renal failure(CRF). Methods We divided 100 cases CRF into combined therapy group(Group A，50 cases)and Western medicine group(Group B，50 cases)，and the treatment of both groups lasted 8 weeks. The therapeutic effect in the two groups was compared，and the blood urea nitrogen(BUN)，serum creatine(Scr)，endogenous creatine clearance rate(Ccr)，urinary β2 microglobulin(β2-M)，β-N-acetyglucosamidase(NAG)，serum fibrosis-associated proteins of type Ⅳ collagen(C-Ⅳ)，type Ⅲ precollagen(PC-Ⅲ)and laminin(LN)levels were detected after and after treatment. Results The total effective rate of Group A was 80.0%，significantly higher than that(62.0%) of Group B(χ2=3.987，P<0.05). The levels of SCr，BUN，Ccr，β2-M，NAG，C-Ⅳ，PC-Ⅲ and LN after treatment were significantly improved compared with those before treatment in Group A(t=2.125~ 2.745， P<0.05 ~ 0.01). The post-treatment serum fibrosis markers were significantly improved compared with pre-treatment in Group A(t=2.175~2.578， P<0.05). The post-treatment serum fibrosis markers in both groups showed a significantly difference(t=2.105 ~2.478，P<0.05). Conclusion TCM treatment for chronic renal failure can improve the clinical efficacy and renal function.

[Key words] Renal failure;Chronic;Combined therapy of Chinese and western medicine;Curative effect

慢性腎功能衰竭(chronic renal failure，CRF)是腎臟內科的常見病，為一組進行性惡化的難治性臨床綜合癥候群，在中醫上屬“水腫”、“癃閉”、“關格”、“溺毒”、“虛勞”等病證的范疇[1]。目前西醫保守療法效果不理想，通常采用血液透析療法和腎移植，但此兩種方法的治療費用昂貴，加之穿刺和手術的痛苦令許多患者和家屬難以接受。近幾年，我們在中西醫結合治療CRF方面取得了顯著療效，現報道如下。

1資料與方法

1.1 一般資料

收集2004年5月～2008年10月我院慢性腎功能衰竭住院患者100例(男55例，女45例)，所有入選對象均符合美國心腎學會CRF診斷標準[2]，排除嚴重原發病或精神病患者。臨床分期:腎功能衰竭代償期30例、腎功能衰竭失代償期70例;腎功能衰竭期65例、尿毒癥期35例。……