益肾健脾方对中重度慢性肾脏病患者骨代谢的影响

白云; 邱楚雄; 薛伟新; 毛辉

doi:10.13422/j.cnki.syfjx.2014190202

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益肾健脾方对中重度慢性肾脏病患者骨代谢的影响

临床 | 更新时间：2024-01-04

- 益肾健脾方对中重度慢性肾脏病患者骨代谢的影响
- Effect of Yishen Jianpi Decoction on Bone Metabolism in Patients with Moderate and Severe Chronic Kidney Disease
- 中国实验方剂学杂志 2014年20卷第19期页码：202-205
- 作者机构：
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- 基金信息：
- DOI：10.13422/j.cnki.syfjx.2014190202
  中图分类号： R277.5
- 纸质出版日期：2014
- 稿件说明：
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白云, 邱楚雄, 薛伟新, 等. 益肾健脾方对中重度慢性肾脏病患者骨代谢的影响[J]. 中国实验方剂学杂志, 2014,20(19):202-205.

BAI Yun, QIU Chu-xiong, XUE Wei-xin, et al. Effect of Yishen Jianpi Decoction on Bone Metabolism in Patients with Moderate and Severe Chronic Kidney Disease[J]. Chinese journal of experimental traditional medical formulae, 2014, 20(19): 202-205.
白云, 邱楚雄, 薛伟新, 等. 益肾健脾方对中重度慢性肾脏病患者骨代谢的影响[J]. 中国实验方剂学杂志, 2014,20(19):202-205. DOI： 10.13422/j.cnki.syfjx.2014190202.

BAI Yun, QIU Chu-xiong, XUE Wei-xin, et al. Effect of Yishen Jianpi Decoction on Bone Metabolism in Patients with Moderate and Severe Chronic Kidney Disease[J]. Chinese journal of experimental traditional medical formulae, 2014, 20(19): 202-205. DOI： 10.13422/j.cnki.syfjx.2014190202.

摘要

目的：探讨益肾健脾方对慢性肾脏病脾肾气虚证3，4期（CKD 3，4期）肾功能和骨代谢的影响。方法：将80例 CKD 3，4期患者随机按数字表法分为对照组和益肾健脾组各40例。对照组给予西医常规治疗，口服骨化三醇胶丸，0.25 μg/次，1次/d；维D2乳酸钙片，0.16 g/次，1次/d。益肾健脾组在对照组治疗的基础上采用益肾健脾方内服，1剂/d，两组疗程均为3个月。检测治疗前后尿素氮（BUN）、血肌酐（SCr）和24 h尿蛋白定量（24 h Upr），并计算肾小球滤过率（eGFR）；每月对脾肾气虚证进行评分；检测治疗前后全段甲状旁腺激素（iPTH）、血清Ca、血清磷（P）、骨钙素（BGP）、骨碱性磷酸酶（bAP）和瘦素（LP）水平。结果：益肾健脾组临床疗效总有效率为52.5%，优于对照组30%（P<0.05）；益肾健脾组BUN，SCr和24 h Upr比治疗前下降（P<0.05），治疗后益肾健脾组Scr低于对照组（P<0.05）；治疗后2，3个月益肾健脾组脾肾气虚证积分均低于对照组（P<0.05或P<0.01）；治疗后益肾健脾组血清Ca高于对照组，iPTH、血清磷P和BGP低于对照组（P<0.05）；治疗后两组bAP和LP水平均比治疗前下降（P<0.01），益肾健脾组低于对照组（P<0.01）。结论：益肾健脾方能改善CKD 3，4期患者肾功能，并对骨代谢紊乱有一定的调节作用。

Abstract

Objective: To discuss the effect of Yishen Jianpi decoction on renal function and bone metabolism in patients with chronic kidney diseases stages 3 and 4 (CKD stages 3 and 4) combined with deficiency of spleen and kidney in Chiese medicial syndrome. Method: Eighty patients were randomly divided into control group and Yishen Jianpi group of 40 patients each. Patients in control group received 0.25 μg of calcitriol pills plus 0.16 g of vitamin D2 calcium lactate tablets po. Once daily for a total of 3 months as conventional western medicine treatment. Based on the conventional western medicine treatment

patients in Yishen Jianpi group received a modified Yishen Jianpi decoction one dose daily. Blood urea nitrogen(BUN)

serum creatinine(SCr) and 24-hours urine protein ration(24 h) were detected before and after 3 month treatment. Glomerular filtration rate (eGFR) was calculated. Deficiency syndrome of spleen and kidney was graded every month. Levels of intact parathyroid hormone (iPTH)

blood calcium

serous phosphorus (P)

bone gla protein (BGP)

bone alkaline phosphatase (BAP) and leptin (LP) were detected.Before and after treatment. Result: The total clinical effective rate of 52.5% in Yishen Jianpi group was better than 30% in control group with a significant difference between the two groups(P<0.05). The levels of BUN

SCr and 24 h Upr after treatment in Yishen Jianpi group had a decrease than before treatment (P<0.05)

and the SCr in Yishen Jianpi group were lower than those in control group(P<0.05). The spleen and kidney deficiency scores in Yishen Jianpi group were significantly lower as compared with those after two or three month treatment in control group (P<0.05 or P<0.01). The level of serum Ca in Yishen Jianpi group were higher (P<0.05) and iPTH

serum P

BGP in Yishen Jianpi group were lower after treatment than those in control group (P<0.05). The levels of serum BAP and LP had a decrease in two groups than before (P<0.01)

which was lower in Yishen Jianpi group than in control group (P<0.01). Conclusion: Yishen Jianpi decoction can improve the renal function of patients with CKD stages 3 and 4 Meanwhile

Yishen Jianpi decoction exerts certain adjustment to bone metabolic disorders.

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