【摘要】 目的:观察慢性肾衰竭(Chronic renal failure,CRF)急剧加重湿热证患者血清肌酐(Serum creatinine,Scr)、血清超敏-C反应蛋白(High-sensitivity C-reactive protein,hs-CRP)及同型半胱氨酸(Hemocysteine,Hcy)等指标的变化,研究清肾颗粒对上述指标的干预作用,了解CRF急剧加重时机体内环境的紊乱状态,探究中医药对这种紊乱状态的纠正作用及作用机理。方法:选择60例CRF急剧加重湿热证患者随机分为治疗组和对照组,并设正常对照组20例。治疗组与对照组均用解毒泄浊Ⅱ号保留灌肠,每日1次,并根据导致CRF急剧加重的诱因,分别以相应西药降血压、纠正电解质紊乱及酸碱失衡、纠正钙磷代谢紊乱等治疗。治疗组服用清肾颗粒,每日3次,每次1袋(每袋颗粒剂10 g,约含生药34g),对照组不服用清肾颗粒,两组均不服用其他影响肾功能的药物,疗程均为4周。分别于治疗前和治疗4周后取静脉血检测Scr、hs-CRP、Hcy水平以及观察治疗前后中医证候积分值变化。结果:治疗组临床疾病总有效率为90%,优于对照组60%,两组临床疾病疗效有显著性差异(P<0.05);治疗组中医证候总有效率90%,优于对照组63.33%,差异有高度统计学意义(P<0.01)。CRF急剧加重湿热证患者血清hs-CRP、Hcy水平明显升高;治疗后两组血清hs-CRP、Hcy水平均有所下降,治疗后两组比较,治疗组血清hs-CRP、Hcy下降较对照组差异显著(P<0.05)。结论:CRF急剧加重湿热证患者血清hs-CRP、Hcy水平升高,清肾颗粒可降低患者血清hs-CRP、Hcy水平,改善肾功能,减轻临床症状,其机理之一可能与其降低患者血清hs-CRP、Hcy水平有关。更多还原

【Abstract】 Objectives:To observe the changes of serum creatinine(Scr),blood plasm high-sensitivity c-reactive protein(hs-CRP) and hemocysteine(Hcy) in sharp deterioration damp-heat syndrome(DHS) of chronic renal failure(CRF) and the curative efficacy of Qingshen granule(QSG,清肾颗粒).Methods: Sixty cases of DHS of CRF were randomly divided into treatment group(n=30) and control group(n=30),normal control group(n=20) was set up too.The treatment group and control group were treated with conventionally therapeutic methods of western medicine and Traditional Chinese Medicine(TCM) for four weeks.Beside these QSG was added into treatment group and no other medicine which can affect the renal function was applied in the two groups.The levels of blood plasm hs-CRP,Hcy,Scr and the score of TCM were observed in sixty cases before and after therapy.Results: The total effective rate of clinical effect in the treatment group was 90%,which was better than that in the control group 60%,the difference was significant(P<0.05).The total effective rate of syndrome of Traditional Chinese Medicine in the treatment group was 90%,and obviously higher than the control group′s 63.33%,the difference was particularly significant(P<0.01).The levels of blood plasm hs-CRP and Hcy in DHS of CRF were obviously higher as compared to the normal control group(P<0.01),and these indexes were no significant diversity between the treatment group and the control group(P>0.05).After therapy with QSG the levels of blood plasm hs-CRP and Hcy were markedly decreased(P<0.01) in the treatment group,but the changes in control group are not so much(P<0.05),there is significant diversity in the two groups(P<0.05).Conclusions: The cases with sharp deterioration DHS of CRF exist the state of high blood plasm hs-CRP and Hcy.QSD could reduce the levels of blood plasm hs-CRP and Hcy,improve renal function,ease clinical symptoms,its mechanism might be related with the lowering of blood plasm hs-CRP and Hcy.更多还原