[關(guān)鍵詞]
[摘要]
目的 探究益腎化濕顆粒聯(lián)合復(fù)方α-酮酸治療非透析慢性腎臟病的臨床療效。方法 選取2021年7月—2024年7月香港中文大學(xué)(深圳)第二附屬醫(yī)院86例非透析慢性腎臟病患者,根據(jù)使用藥物方案差異將患者分為對(duì)照組和治療組,每組各43例。對(duì)照組口服復(fù)方α-酮酸片,5片/次,3次/d,進(jìn)餐時(shí)用藥。治療組在對(duì)照組治療基礎(chǔ)上口服益腎化濕顆粒,1袋/次,3次/d,溫水沖服。兩組均連續(xù)治療4個(gè)月。觀察兩組的臨床療效和臨床癥狀消失時(shí)間,比較兩組腎功能指標(biāo)、腸道菌群、運(yùn)動(dòng)耐力和疲乏相關(guān)指標(biāo)的變化情況。結(jié)果 治療后,治療組總有效率是86.05%,顯著高于對(duì)照組的67.44%(P<0.05)。治療過(guò)程中,治療組水腫消退時(shí)間、多尿消失時(shí)間、血尿消失時(shí)間及腰痛消失時(shí)間均顯著短于對(duì)照組(P<0.05)。治療后,兩組血肌酐(Scr)、尿酸(UA)、血尿素氮(BUN)、24 h尿蛋白定量(24 h Upro)均較同組治療前顯著降低(P<0.05);且治療后,治療組腎功能指標(biāo)低于對(duì)照組(P<0.05)。治療后,兩組大腸桿菌均較治療前顯著降低,而糞腸球菌、雙歧桿菌、乳酸桿菌顯著升高(P<0.05);且治療后,治療組腸道菌群改善優(yōu)于對(duì)照組(P<0.05)。治療后,兩組無(wú)氧閾(AT)、峰值攝氧量(VO2peak)、峰值氧脈搏(VO2/HRpeak)均顯著高于治療前,而運(yùn)動(dòng)耐力指標(biāo)、慢性病治療功能評(píng)估-疲勞量表(FACIT-F)評(píng)分低于治療前,且治療組運(yùn)動(dòng)耐力指標(biāo)、FACIT-F評(píng)分改善優(yōu)于對(duì)照組(P<0.05)。結(jié)論 益腎化濕顆粒聯(lián)合復(fù)方α-酮酸治療能增加非透析慢性腎臟病患者獲益,緩解臨床癥狀,改善腎功能和運(yùn)動(dòng)耐力,糾正腸道菌群失衡,減輕疲乏,安全性較高。
[Key word]
[Abstract]
Objective To investigate the therapeutic effect of Yishen Huashi Granules combined with compound α-ketoacid in treatment of non-dialysis chronic kidney disease. Methods A total of 86 patients with non-dialysis chronic kidney disease in the Second Affiliated Hospital of the Chinese University of Hong Kong (Shenzhen) from July 2021 to July 2024 were selected and divided into control group and treatment group according to the difference in drug use regimen, with 43 cases in each group. Patients in control group were po administered with Compound α-Ketoacid Tablets, 5 tablets/time, three times daily. Patients in treatment group were po administered with Yishen Huashi Granules with warm water on the basis of the control group, 1 bag/time, three times daily. Both groups were treated continuously for 4 months. The clinical efficacy and duration of clinical symptoms were observed, and the changes of renal function indexes, intestinal flora, exercise endurance and fatigue related indexes were compared between two groups. Results After treatment, the total effective rate of the treatment group was 86.05%, significantly higher than that of the control group (67.44%) (P < 0.05). In the course of treatment, the disappearance time of edema, polyuria, hematuria, and low back pain in treatment group were significantly shorter than those in control group (P < 0.05). After treatment, serum creatinine (Scr), uric acid (UA), blood urea nitrogen (BUN) and 24 h urinary protein quantity (24 h Upro) in two groups were significantly decreased compared with before treatment (P < 0.05). After treatment, the renal function indexes of treatment group was lower than those of control group (P < 0.05). After treatment, Escherichia coli in both groups was significantly lower than that before treatment, but Enterococcus faecalis, Bifidobacterium and Lactobacillus were significantly increased (P < 0.05). After treatment, the improvement of intestinal flora in treatment group was better than that in control group (P < 0.05). After treatment, anaerobic threshold (AT), peak oxygen uptake (VO2peak) and peak oxygen pulse (VO2/HRpeak) in both groups were significantly higher than those before treatment, but exercise endurance indexes and FACIT-F score were lower than those before treatment. The improvement of exercise endurance indexes and FACIT-F score in treatment group were better than those in control group (P < 0.05). Conclusion Yishen Huashi Granules combined with compound α-ketoacid can increase the benefit of non-dialysis chronic kidney disease patients, and can alleviate clinical symptoms, improve renal function and exercise endurance, correct intestinal flora imbalance, reduce fatigue with high safety.
[中圖分類(lèi)號(hào)]
R983
[基金項(xiàng)目]
香港中文大學(xué)(深圳)院校聯(lián)合基金重點(diǎn)項(xiàng)目(HUUF-ZD-202301)