目的 探討至靈膠囊聯(lián)合復(fù)方α-酮酸治療老年慢性腎功能衰竭的臨床療效。方法 選取2020年1月-2022年1月河北北方學(xué)院附屬第一醫(yī)院腎內(nèi)科治療的66例老年慢性腎功能衰竭患者,按照隨機(jī)數(shù)字表法分為對(duì)照組和治療組,每組各33例。對(duì)照組患者口服復(fù)方α-酮酸片,4片/次,1次/d。治療組在對(duì)照組基礎(chǔ)上口服至靈膠囊,3粒/次,3次/d。兩組均連續(xù)用藥30 d。觀察兩組臨床療效和癥狀改善時(shí)間,比較兩組腎功能指標(biāo)、血清總蛋白(TP)、血清白蛋白(Alb)、血紅蛋白(Hb)、血清炎癥因子指標(biāo)。結(jié)果 治療后,治療組總有效率是96.97%,顯著高于對(duì)照組的72.73%(P<0.05)。經(jīng)治療,治療組出現(xiàn)乏力、氣短、體力下降、食欲不振等癥狀改善時(shí)間均顯著短于對(duì)照組(P<0.05)。治療后,治療組尿白蛋白排泄率(UAER)、肌酐(Scr)、尿素氮(BUN)水平均較治療前顯著降低,而腎小球?yàn)V過(guò)率(GFR)顯著升高(P<0.05);治療后,治療組腎功能指標(biāo)改善優(yōu)于對(duì)照組(P<0.05)。治療后,兩組血清總蛋白(TP)、血清白蛋白(Alb)、血紅蛋白(Hb)水平均高于同組治療前(P<0.05);治療后,治療組TP、Alb、Hb水平高于對(duì)照組(P<0.05)。治療后,兩組患者血清白細(xì)胞介素-6(IL-6)、同型半胱氨酸(Hcy)、腫瘤壞死因子-α(TNF-α)、C反應(yīng)蛋白(CRP)水平均較治療前顯著降低(P<0.05);治療后,治療組血清學(xué)指標(biāo)低于對(duì)照組(P<0.05)。結(jié)論 至靈膠囊聯(lián)合復(fù)方α-酮酸治療慢性腎功能衰竭具有顯著效果,改善明顯患者癥狀,促進(jìn)腎功能恢復(fù),降低炎性反應(yīng),值得臨床借鑒。

Objective To investigate the therapeutic effect of Zhiling Capsules combined with compound α-ketoacid in treatment of elderly chronic renal failure.Methods Sixty-six elderly patients with chronic renal failure treated in the Department of Nephrology of The First Affiliated Hospital of Hebei North University from January 2020 to January 2022 were selected and divided into control group and treatment group according to random number table method, with 33 cases in each group. Patients in the control group were po administered with Compound α-Ketoacid Tablets, 4 tablets/time, once daily. Patients in the treatment group were po administered with Zhiling Capsules on the basis of the control group, 3 grains/time, three times daily. Patients in two groups were treated for 30 d. After treatment, the clinical efficacy was evaluated, and the renal function indexes, serum total protein (TP), serum albumin (Alb), hemoglobin (Hb) and serological indexes of the two groups were compared.Results After treatment, the total effective rate of the treatment group was 96.97%, significantly higher than that of the control group (72.73%) (P < 0.05). After treatment, the improvement time of fatigue, shortness of breath, decreased physical strength, anorexia and other symptoms in treatment group was significantly shorter than that in control group (P < 0.05). After treatment, the levels of UAER, Scr and BUN in treatment group were significantly decreased compared with before treatment, while GFR was significantly increased (P < 0.05). After treatment, the renal function index of the treatment group improved better than that of the control group (P < 0.05). After treatment, the levels of TP, Alb and Hb in two groups were higher than before (P < 0.05). After treatment, TP, Alb and Hb levels in the treatment group were higher than those in the control group (P < 0.05). After treatment, the serum levels of IL-6, Hcy, TNF-α and CRP in 2 groups were significantly decreased compared with before treatment (P < 0.05). After treatment, the serum index of the treatment group was lower than that of the control group (P < 0.05).Conclusion Zhiling Capsules combined with compound α-ketoacid has a significant effect in treatment of elderly chronic renal failure, and can improve the symptoms of patients, promote the recovery of renal function and reduce the inflammatory reaction, which is worthy of clinical reference.

R983

河北省衛(wèi)生健康計(jì)劃項(xiàng)目(20200542)