曹慧 周恩超

[摘要] 目的 探討固肾方在慢性肾脏病3～4期脾肾气虚证患者中的应用。 方法 选取2018年1—12月在苏州市中西医结合医院肾病科门诊就诊以及住院治疗的慢性肾脏病3～4期脾肾气虚证患者60例为研究对象，随机数字法分为，对照组和研究组，每组各30例。对照组应用常规治疗，研究组在此基础上应用固肾方治疗，对比两组应用不同方法治疗后对患者血肌酐、24 h蛋白尿、血清胱抑素C、肾小球过滤指标、治疗有效率及不良反应发生的影响。 结果 研究组治疗后血肌酐为（124.85±14.08）μmol/L、24 h蛋白尿为（1.87±0.74）g及血清胱抑素C为（0.75±0.19）mg/L指标均低于对照组血肌酐为（136.14±13.72）μmol/L、24 h蛋白尿为（2.63±0.55）g及血清胱抑素C为（0.99±0.21）mg/L（P<0.05），肾小球过滤为（50.83±7.48）（min·1.73 m2）指标高于对照组肾小球过滤为（45.13±8.04）（min·1.73 m2）（P<0.05）;研究组治疗总有效率（90.0%）高于对照组（70.0%）（P<0.05）。 结论 在对慢性肾脏病3～4期脾肾气虚证的治疗过程中，固肾方的治疗效果理想，能够有效改善患者的肾功能，提高治疗效果，同时加用固肾方也没有出现不良反应，用药的安全性较高，临床上应当进一步推广应用。

[关键词] 固肾方;慢性肾脏病3～4期;脾肾气虚证;肾功能

[Abstract] Objective To explore the application of Gushen Recipe in patients with spleen and kidney qi deficiency syndrome of chronic kidney disease stage 3 and 4. Methods Sixty outpatients and inpatients with spleen and kidney qi deficiency syndrome who were treated in the department of the nephrology department of Suzhou Hospital of Integrated Traditional Chinese and Western Medicine for chronic kidney disease stage 3 and 4 were selected as the research objects from January to December 2018. The patients were divided into two groups according to the random number method， including the control group（n=30） and the study group（n=30）. The control group was treated with conventional treatment， and the study group was treated with Gushen Recipe on this basis. The effects of different treatment methods on patients' serum creatinine， 24 h proteinuria， serum cystatin C， glomerular filtration indicators， treatment efficiency and adverse reactions between the two groups were compared. Results After treatment， the serum creatinine was （124.85±14.08） μmol/L， 24 h proteinuria was （1.87±0.74） g and serum cystatin C was（0.75±0.19） mg/L indexes of the study group were lower than those of the control group （[136.14±13.72]μmol/L， [2.63±0.55] g and [0.99±0.21] mg/L， P<0.05）. The glomerular filtration was （50.83±7.48） （min·1.73 m2） index was higher than that（[45.13±8.04] [min·1.73 m2]） in the control group（P<0.05）. The effective rate of treatment in the study group was 90.0% higher than that in the control group（70.0%）（P<0.05）. Conclusion During the treatment of spleen-kidney qi deficiency syndrome of chronic kidney disease stage 3 and 4， Gushen Recipe has an ideal therapeutic effect， which can effectively improve the patient's renal function and improve the therapeutic effect. At the same time， the addition with Gushen Recipe has no adverse reactions. It is safe and should be further promoted and applied clinically.

[Key words] Gushen Recipe; Chronic kidney disease stage 3 and 4; Spleen-kidney Qi deficiency syndrome; Renal function

脾肾气虚证是慢性肾脏病的一种临床综合征，其发病与多种因素相关。据有关数据统计，在我国慢性肾脏病的发病率高达10.8%，而且呈逐年上升的趋势发展[1]。早期慢性肾脏病的临床症状并不明显，随着疾病的进展最终引起终末期肾病的发生，不仅会影响患者的身体健康，而且加重了患者家庭的经济负担，因此对慢性肾脏病3～4期患者疾病进行有效的延缓是目前临床关注的热点话题[2]。随着中医学的推进，中医药治疗不仅能够延缓慢性肾脏病的进展，而且成本较低[3]。本文为探讨固肾方在慢性肾脏病3～4期脾肾气虚证患者中的应用，现报道如下。

1 资料与方法

1.1 一般资料

选取2018年1—12月在苏州市中西医结合医院肾病科门诊就诊以及住院治疗的慢性肾脏病3～4期脾肾气虚证患者60例为研究对象，随机数字法分为对照组和研究组，每组各30例。……