中药内服及穴位敷贴对慢性肾衰竭肾脏动脉血流动力学的影响

目的观察益气清利化瘀方内服及利湿化瘀降浊方穴位敷贴对慢性肾衰竭肾脏动脉血流动力学的影响。方法将61例病例随机分为治疗组（31例）和对照组（30例）,对照组予西医常规疗法,治疗组在此基础上同时予益气清利化瘀方内服合利湿化瘀降浊方穴位敷贴,两组疗程均为60天;观察两组临床综合疗效,治疗后临床症状积分、肌酐、血清胱抑素C、肾小球滤过率、24h尿蛋白定量及肾脏动脉血流动力学变化情况。结果治疗组、对照组总有效率分别为67.7%、43.3%;组间临床综合疗效比较,差异有统计学意义（P〈0.05）。治疗组治疗后脾肾气虚型、脾肾阳虚型患者临床症状积分均明显降低（P〈0.05）,对照组无明显变化（P〉0.05）;组间治疗后比较,差异有统计学意义（P〈0.05）。治疗组治疗后肌酐、血清胱抑素C、24h尿蛋白定量水平均显著下降（P〈0.05）,肾小球滤过率明显上升（P〈0.05）;组间治疗后比较,肌酐、血清胱抑素C、24h尿蛋白定量及肾小球滤过率差异均有统计学意义（P〈0.05）。治疗组治疗后舒张末期血流速度显著提高（P〈0.05）,肾动脉阻力指数（RI）显著降低（P〈0.05）,对照组各指标治疗前后差异均无统计学意义（P〉0.05）;组间治疗后比较,各指标差异均有统计学意义（P〈0.05）。结论益气清利化瘀方内服结合利湿化瘀降浊方穴位敷贴可明显改善慢性肾衰竭肾脏动脉血流动力学。

Influences of internal and acupoint application of Chinese herbs on arteriorenal hemodynamic in chronic renal failure patients

Objective To observe the effects of internal and acupoint application of Chinese herbs on arteriorenal hemodynamic in chronic renal failure.Methods Sixty-one subjects were randomly divided into two groups：treatment group in which 31 cases were given routine modality and oral administration and acupoint application of Chinese herbs,and control group in which 30 cases were given routine modality,with a course of 60 days.The symptom score,serum creatinine,cystatin C,24h urinary albumin excretion,glomerular filtration rate and color doppler flow imaging were observed before and after treatment.Results The total effective rate was 67.7% in treatment group and 43.3% in control group,with a difference between them（P0.05）.After treatment,the symptom score decreased obviously in the treatment group（P0.05） and decreased little in the control group（P0.05）,with a difference between them（P0.05）;the serum creatinine,cystatin C and 24h urinary albumin excretion in the treatment group decreased significantly（P0.05） and the glomerular filtration rate increased significantly（P0.05）,and there were significant differences in serum creatinine,cystatin C,24h urinary albumin excretion and glomerular filtration rate between the two groups（P0.05）.The late diastolic renal blood flow was remarkably increased and resistance index was reduced in the treatment group（P0.05）;however,there was no statistical difference in the control group（P0.05）.There were statistical differences in the diastolic renal blood flow and resistance index between the two groups（P0.05）.Conclusion Internal and acupoint application of Chinese herbs can improve the arteriorenal hemodynamic in chronic renal failure.