肾衰方加减治疗慢性肾脏病3期合并甲状腺功能减退症气虚血瘀证临床研究

Clinical research of chronic kidney disease stage 3 with hypothyroidism qi deficiency and blood stasis syndrome treated by Shenshuai Decoction

关键词:  慢性肾脏病3期  甲状腺功能减退症  肾衰方  疗效  安全性

Key words:  chronic kidney disease stage 3  hypothyroidism  Shenshuai Decoction  curative efficiency  security

摘要:

目的 本研究旨在观察张大宁教授经验方“肾衰方”加减治疗慢性肾脏病3期（CKD3）合并甲状腺功能减退症气虚血瘀证患者临床疗效。方法 选取CKD3合并期甲状腺功能减退症气虚血瘀证的患者60例，按随机分组法将患者分为治疗组和对照组，每组30例。对照组予以西医常规治疗，治疗组在西医常规治疗基础上予以“肾衰方”加减治疗。观察两组试验前后的临床疗效、肾小球滤过率（eGFR）、血肌酐（SCr）、同型半胱氨酸（Hcy）、游离甲状腺素（FT4）、促甲状腺激素（TSH）水平，并进行安全性评价。结果 治疗组的总有效率达89.30%，显著高于对照组53.80%（P＜0.01），治疗组在eGFR、SCr、Hcy、FT4、TSH水平方面与对照组比较均有改善（P＜0.05）且无不良反应。结论 “肾衰方”加减可明显改善患者临床症状，不仅能改善肾功能、内分泌及脂代谢等相关临床指标，而且能缓解患者临床症状和体征，从而达到改善肾脏纤维化、调整内分泌的作用。

Abstract:

Objective To observe the clinical efficacy of the modified "Shenshuai Decoction" of Professor ZHANG Daning's experience in the treatment of chronic kidney disease stage 3 (CKD3) patients with hypothyroidism ofqi deficiency and blood stasis.Methods The 60 patients with chronic kidney disease stage 3 combined with hypothyroidism of qi deficiency and blood stasis syndrome was selected, and the patients were divided into a treatment group and a control group by random grouping method, with 30 cases in each group. The control group was treated with conventional Western medicine, while the treatment group was added additionally with Shenshuai Decoction on the basis of conventional Western medicine. The clinical efficacy, glomerular filtration rate(eGFR), serum creatinine(SCr), homocysteine (Hcy), free thyroxine (FT4), thyroid-stimulating hormone (TSH) levels before and after the experiment were observed intwo groups, and the safety was evaluated.Results The total effective rate of the treatment group was 89.30%, which was significantly higher than 53.80% of the control group(P < 0.01). The levels of EGFR, SCR, Hcy, FT4 and TSH in treatment group were improved compared with those in control group (P < 0.05), and there was no adverse reaction.Conclusion The modified Shenshuai Decoction can significantly improve the clinical symptoms of patients, which not only improve the renal function, endocrine and lipid metabolism and other related clinical indicators, but also relieve the clinical symptoms and signs of patients, so as to improve renal fibrosis and adjust endocrine.