健脾益肾排毒方联合常规疗法对CKD4期脾肾气虚证患者血钾和肾功能的影响

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目的:观察健脾益肾排毒方联合常规疗法对CKD 4期脾肾气虚证患者血钾和肾功能的影响。方法:选取80例CKD 4期脾肾气虚证患者为研究对象,随机分为对照组和治疗组各40例。其中,对照组退出7例,余33例;治疗组退出6例,余34例。对照组给予营养饮食、改善钙磷代谢紊乱、调节酸碱代谢平衡、纠正贫血以及降压、降血糖等对症治疗,治疗组在对照组治疗基础上予健脾益肾排毒方治疗。2组均治疗6月。观察2组治疗前后的血钾浓度和肾功能指标[血肌酐(SCr)、血尿素氮(BUN)]的变化。结果:治疗前,2组血钾浓度比较,差异无统计学意义(P>0.05)。治疗2、4周和3、6月后,2组血钾浓度均较治疗前无变化(P>0.05);组间比较,差异均无统计学意义(P>0.05)。治疗前,2组患者SCr和BUN水平比较,差异均无统计学意义(P>0.05)。治疗2周后,2组SCr水平较治疗前均上升(P<0.05)。治疗4周、3月后,2组SCr水平虽较治疗前均有下降趋势,但差异均无统计学意义(P<0.05)。治疗6月后,2组SCr水平均较治疗前下降(P<0.05);治疗组的SCr水平低于对照组(P<0.05)。治疗2、4周和3月后,对照组的BUN水平先有小幅度上升而后下降,治疗组的BUN水平均有小幅度下降,但差异均无统计学意义(P>0.05)。治疗6月后,2组BUN水平均较治疗前下降(P<0.05);治疗组的BUN水平低于对照组(P<0.05)。结论:健脾益肾排毒方联合常规疗法治疗CKD 4期脾肾气虚证,能进一步改善患者的肾功能,且治疗过程中仅有个别患者发生高血钾症,临床用药较为安全。 Objective: To observe the effect of combined therapy of invigorating the spleen, the kidney and the kidney and detoxification on serum potassium and renal function in CKD stage 4 patients with spleen-kidney-qi deficiency syndrome. Methods: Eighty patients with CKD, 4 spleen and kidney qi deficiency syndrome were selected and randomly divided into control group and treatment group of 40 cases. Among them, the control group quit in 7 cases, more than 33 cases; treatment group quit in 6 cases, more than 34 cases. The control group was given nutrition diet, improving the disorder of calcium and phosphorus metabolism, regulating the balance of acid-base metabolism, correcting anemia, and reducing blood pressure and lowering blood pressure. The treatment group was given Jianpi Yishen detoxification treatment on the basis of the control group. Both groups were treated for 6 months. The changes of serum potassium concentration and renal function indexes (serum creatinine (SCr) and blood urea nitrogen (BUN)] were observed before and after treatment. Results: Before treatment, there was no significant difference in serum potassium concentration between the two groups (P> 0.05). After treatment for 2, 4 weeks and 3 and 6 months, the serum potassium levels in both groups were not changed before treatment (P> 0.05). There was no significant difference between the two groups (P> 0.05). Before treatment, there was no significant difference in SCr and BUN levels between the two groups (P> 0.05). After 2 weeks of treatment, SCr levels in both groups increased compared with that before treatment (P <0.05). After 4 weeks and 3 months, the SCr levels in both groups showed a decreasing trend compared with that before treatment, but the difference was not statistically significant (P <0.05). After 6 months of treatment, the levels of SCr in both groups decreased compared with those before treatment (P <0.05). The SCr level in the treatment group was lower than that in the control group (P <0.05). The levels of BUN in the control group increased slightly and then decreased after treatment for 2, 4 and 3 months. The levels of BUN in the treatment group decreased slightly, but the differences were not statistically significant (P> 0.05). After 6 months of treatment, the levels of BUN in both groups decreased compared with those before treatment (P <0.05). The BUN level in the treatment group was lower than that in the control group (P <0.05). Conclusion: The combination of Jianpi Yishen detoxification and conventional therapy for the treatment of CKD stage 4 spleen and kidney qi deficiency syndrome can further improve renal function, and only some patients in the course of treatment of hyperkalemia, clinical medication is more safe.
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