[1]王立媛,王亿平,金　华,等.清肾颗粒对慢性肾脏病湿热证患者临床症状及血清胃泌素水平的影响[J].新乡医学院学报,2020,37(7):661-665.[doi:10.7683/xxyxyxb.2020.07.015]
　WANG Liyuan,WANG Yiping,JIN Hua,et al.Effect of Qingshen granule on clinical symptoms and serum gastrin level in patients with chronic kidney disease with dampness-heat syndrome[J].Journal of Xinxiang Medical University,2020,37(7):661-665.[doi:10.7683/xxyxyxb.2020.07.015]
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清肾颗粒对慢性肾脏病湿热证患者临床症状及血清胃泌素水平的影响
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《新乡医学院学报》[ISSN:1004-7239/CN:41-1186/R]

卷:
37
期数:
2020年7
页码:
661-665
栏目:
临床研究
出版日期:
2020-07-05

文章信息/Info

Title:
Effect of Qingshen granule on clinical symptoms and serum gastrin level in patients with chronic kidney disease with dampness-heat syndrome
作者:
王立媛; 王亿平; 金　华; 任克军
（安徽中医药大学第一附属医院肾病科，安徽　合肥　230000）
Author(s):
WANG Liyuan; WANG Yiping; JIN Hua; REN Kejun
（Department of Nephrology,the First Affaliated Hospital of Anhui University of Traditional Chinese Medicine，Hefei 230000，Anhui Province,China）
关键词:
慢性肾脏病; 湿热证; 清肾颗粒; 血清胃泌素; 不良反应
Keywords:
chronic kidney disease; damp-heat syndrome; Qingshen granules; gastrin; adverse reactions
分类号:
R256.5
DOI:
10.7683/xxyxyxb.2020.07.015
文献标志码:
A
摘要:
目的　观察清肾颗粒对慢性肾脏病（CKD）湿热证患者临床症状及血清胃泌素-17（GAS-17）水平的影响，探讨清肾颗粒的作用机制。方法　选择2018年4月至2019年6月安徽中医药大学第一附属医院收治的80例CKD湿热证患者为研究对象，根据入选顺序的单双号随机分为对照组（n=40）和观察组（n=37，治疗过程中失访3例）。对照组患者给予西医基础治疗及中药保留灌肠；观察组患者在对照组治疗基础上给予清肾颗粒10 g，温水冲服，每日3次；疗程均为12周。比较2组患者治疗前后中医症候积分、临床疗效、不良反应发生情况；观察2组患者治疗前后血清GAS-17、尿素氮（BUN）、血肌酐（Scr）、白蛋白（ALB）水平及肾小球滤过率（GFR）变化。结果　2组患者治疗前各项中医症候积分比较差异无统计学意义（P> 0.05）；2组患者治疗后各项中医证候积分均较治疗前显著下降（P<0.05），且治疗后观察组患者各项中医症候积分均低于对照组（P<0.05）。2组患者治疗前血清GAS-17、BUN、Scr、ALB水平及GFR比较差异均无统计学意义（P> 0.05）；2组患者治疗后血清GAS-17、BUN、Scr水平均较治疗前显著下降（P<0.05），GFR及ALB水平均较治疗前显著升高（P<0.05）；治疗后观察组患者血清GAS-17、BUN、Scr水平显著低于对照组（P<0.05），GFR、ALB水平显著高于对照组（P<0.05）。对照组患者临床控制2例（5.00%），显效10例（25.00%），有效17例（42.50%），无效11例（27.50%），总有效率为72.50%（29/40）；观察组患者临床控制8例（21.62%），显效15例（40.54%），有效12例（32.43%），无效2例（5.40%），总有效率为94.60%（35/37）；观察组患者总有效率显著高于对照组（χ2=6.687，P<0.05）。对照组患者治疗期间发生恶心呕吐1例（2.50%）、皮疹1例（2.50%），不良反应发生率为5.00%（2/40）；观察组患者治疗期间发生恶心呕吐1例（2.70%）、皮疹1例（2.70%）、腹痛腹泻1例（2.70%），不良反应发生率为8.10%（3/37）；2组患者不良反应发生率比较差异无统计学意义（χ2=0.305，P> 0.05）。结论　清肾颗粒能够改善CKD湿热证患者的肾功能，提高GFR，降低血清GAS-17、BUN、Scr水平，有效降低患者各项中医证候积分，缓解临床症状，改善胃肠功能，且不良反应较轻。
Abstract:
Objective　To observe the effect of Qingshen granule on the clinical symptoms and gastrin 17 (GAS-17) level in patients with chronic kidney disease (CKD) with dampness-heat syndrome and to explore the mechanism of Qingshen granule.Methods　Eighty patients with CKD with damp-heat syndrome admitted to the First Affiliated Hospital of Anhui University of Traditional Chinese Medicine from April 2018 to June 2019 were selected as observation objects.According to the order of inclusion,the patients were randomly divided into control group (n=40) and observation group (n=37,3 patients lost to follow-up during treatment).The patients in the control group were given basic western medicine treatment and Chinese medicine retention enema.On the basis of the treatment in the control group,the patients in the observation group were given Qingshen granule 10 g,3 times a day.The course of treatment of both groups was 12 weeks.The TCM symptom scores,clinical efficacy and adverse reactions of the two groups of patients were compared before and after treatment;and the changes of the serum GAS-17,urea nitrogen (BUN),serum creatinine (Scr),albumin (ALB) and globular filtration rate (GFR) were observed.Results　There was no significant difference in the scores of TCM syndromes between the two groups before treatment(P>0.05);the scores of TCM syndromes in the two groups after treatment were significantly lower than those before treatment (P<0.05),and the scores of TCM syndromes in the observation group were lower than those in the control group after treatment (P<0.05).There was no significant difference in serum GAS-17,BUN,Scr,ALB levels and GFR between the two groups before treatment (P>0.05).The serum levels of GAS-17,BUN and Scr after treatment were lower than those before treatment in both groups (P<0.05),and the GFR and ALB levels after treatment were significantly higher than those before treatment (P<0.05).After treatment,the serum levels of GAS-17,BUN and Scr in the observation group were significantly lower than those in the control group (P<0.05);the GFR and ALB levels in the obserration group were significantly higher than those in the control group (P<0.05).The patients in the control group were clinically controlled in 2 cases (5.00%),markedly effective in 10 cases (25.00%),effective in 17 cases (42.50%),ineffective in 11 cases (27.50%),and the total effective rate was 72.50% (29/40).The patients in the observation group were clinically controlled in 8 cases (21.62%),markedly effective in 15 cases (40.54%),effective in 12 cases (32.43%),ineffective in 2 cases (5.40%),and the total effective rate was 94.60% (35/37);the total effective rate in the observation group was significant higher than that in the control group (χ2=6.687,P<0.05).In the control group,nausea and vomiting occurred in 1 case (2.50%) and rash occurred in 1 case (2.50%),and the incidence of adverse reactions was 5.00% (2/40).In the observation group,nausea and vomiting occurred in 1 case (2.70%),skin rash in 1 case (2.70%),abdominal pain and diarrhea in 1 case (2.70%),and the incidence of adverse reactions was 8.10% (3/37).There was no significant difference in the incidence of adverse reactions between the two groups (χ2=0.305,P>0.05).Conclusion　Qingshen granule can improve renal function in patients with dampness-heat syndrome of CKD,increase GFR,reduce the serum levels of GAS-17,BUN and Scr,effectively reduce the score of TCM syndromes of patients,relieve clinical symptoms and improve gastrointestinal function,and the adverse reactions are relatively mild.

参考文献/References:

［1］　王亿平,王东,金华,等.清肾颗粒对慢性肾衰竭湿热证患者免疫炎症的干预作用［J］.中国中西医结合杂志,2016,36(12):1425-1429.
［2］　XU T,ZUO L,SUN Z,et al.Chemical profiling and quantification of Shenkang injection,a systematic quality control strategy using ultra high performance liquid chromatography with Q Exactive hybrid quadrupole orbitrap high-resolution accurate mass spectrometry［J］.J Sep Sci,2017,40(24):4872-4879.
［3］　王东,王亿平,余敏,等.清热化湿祛瘀法对慢性肾衰竭湿热证患者瘦素介导的JAK/STAT信号通路的影响［J］.北京中医药大学学报,2017,40(9):777-782.
［4］　中国中西医结合学会肾脏疾病专业委员会.慢性肾衰竭中西医结合诊疗指南［J］.中国中西医结合杂志,2015,38(9):1029-1033.
［5］　徐佩,魏雪菲,李菡,等.不同肾小球滤过率估算公式对估算慢性肾脏病患者肾小球滤过率的差异比较［J］.现代医学,2018,46(9):978-983.
［6］　徐亚赟，何峥，周圆，等.肾衰Ⅱ号方联合西药对原发性慢性肾脏病3、4期患者肾功能及肾血流灌注的影响［J］.中医杂志,2018,59(17):45-49.
［7］　袁保荣.尿毒清颗粒联合羟苯磺酸钙治疗慢性肾衰竭的疗效及对结缔组织生长因子、骨形态发生蛋白-7的影响［J］.药物评价研究,2018,41(9):1684-1688.
［8］　方敬，马雪莲，闫翠环，等.健脾温肾、祛湿泄浊中药治疗阳虚湿阻型慢性肾衰竭临床疗效研究［J］.河北中医药学报,2018,33(4):17-19.
［9］　胡泳,方立明,韦玲.肾衰宁联合α-酮酸对慢性肾功能不全患者营养状况、超敏C反应蛋白及肾功能的影响［J］.中医学报,2017,32(12):2497-2500.
［10］　沈水娟,胡作祥,李青华,等.肾衰宁颗粒联合羟苯磺酸钙对慢性肾脏病疗效的观察［J］.中华全科医学,2016,14(7):1147-1148.
［11］　张金林,郭增玉,王超民,等.肾衰宁颗粒联合血液透析对尿毒症患者肾功能及全身炎症应激反应的影响［J］.海南医学院学报,2018.24(3):311-314.
［12］　薛薇.中药保留灌肠联合尿毒清颗粒对慢性肾衰竭患者肾功能及肾纤维化的影响［J］.现代中西医结合杂志,2017,26(21):85-87.
［13］　殷娜,孙秀丽,吴红梅,等.前列地尔联合尿毒清颗粒对慢性肾衰竭患者血清甲状旁腺激素、同型半胱氨酸水平及临床疗效的影响［J］.现代生物医学进展,2017,17(10):1945-1948.
［14］　刘宁，黄雯．尿毒症胃肠动力和胃肠激素水平变化［J］.医学综述，2007，13(11)：853-855.
［15］　杨波,邓薇,颜天铭,等.普罗布考对甲基胍加重残余肾功能损害的干预研究［J］.中国现代医学杂志,2013,23(17):35-39.
［16］　袁仲飞,刘先燕,邹里彬.化湿降浊中药辅助血液透析治疗慢性肾衰竭疗效及对营养状态、胃肠激素水平的影响［J］.现代中西医结合杂志,2018,27(3):245-248，252.
［17］　胡天晓,牛凯,刘冰.慢性肾衰竭大鼠血清和尿液血管紧张素原与肾功能指标及病理改变的相关性［J］.中国老年学杂志,2015,35(5):1328-1331.
［18］　金华，王亿平，王东,等.清肾颗粒对慢性肾衰竭湿热证患者氧化应激介导的NF-kB信号通路活化的影响［J］.时珍国医国药，2017，28（12）：2841-2843.

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更新日期/Last Update: 2020-07-05