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目的:为探讨中药联合苯那普利治疗慢性肾脏病(CKD)的疗效。方法:将60例CKD(3期)患者随机分为中药(简称1组)、西药(简称2组)、中西治疗组(简称3组),每组20例;采用双盲法给予中药、苯那普利、中药联合苯那普利治疗,疗程24周;对患者在投药初始以及12、24周的实验室指标及中医症状积分进行对照分析。结果:中医症状积分:在24周,各组较治疗前均下降(P<0.01),其中,3组下降较1、2组差异有统计学意义(P<0.05)。24h尿蛋白定量:在12周,2、3组下降较1组差异有统计学意义(P<0.05);在24周,3组下降较1组差异有统计学意义(P<0.05)。血红蛋白(Hb):在24周,2、3组较治疗前明显下降(P<0.05)。血清白蛋白(Alb):在24周,2、3组较治疗前明显升高(P<0.05),而2组较3组升高明显(P<0.05)。血尿素氮(BUN):在24周,2组较治疗前明显升高(P<0.05)。血肌酐(Scr):在24周,2组较1组及3组升高明显(P<0.05)。肾小球滤过率(eGFR):在12周,2组较1组明显降低(P<0.01)。总疗效比较:在24周,依据中医证候疗效标准判定,3组有效率为89%、1组为65%、2组为40%,组间比较(P<0.01);根据西医疗效标准判定,3组有效率为94%、2组为85%、1组为75%,组间比较(P<0.05)。结论:中药联合苯那普利较单纯中药或苯那普利能更好的改善CKD的临床症状,降低尿蛋白,延缓肾功能减退。
Objective: To investigate the curative effect of traditional Chinese medicine combined benazepril on chronic kidney disease (CKD). Methods: Sixty patients with CKD (stage 3) were randomly divided into two groups: Chinese medicine group (abbreviation: group 1), western medicine group (group 2) and Chinese and western medicine group (group 3) The combination of enalapril with traditional Chinese medicine and benazepril, the course of treatment was 24 weeks; and the control subjects were analyzed at the beginning of administration and the laboratory indexes of 12 and 24 weeks and the TCM symptom scores. Results: TCM symptom score: At 24 weeks, all groups decreased compared with those before treatment (P <0.01). The difference between the three groups was statistically significant (P <0.05). 24h urinary protein: at 12 weeks, 2,3 group decreased compared with the 1 group difference was statistically significant (P <0.05); at 24 weeks, 3 group decreased more than 1 group difference was statistically significant (P <0.05). Hemoglobin (Hb): At 24 weeks, 2,3 groups were significantly lower than before treatment (P <0.05). Serum albumin (Alb): At 24 weeks, 2,3 groups were significantly higher than those before treatment (P <0.05), while two groups were significantly higher than the three groups (P <0.05). Blood urea nitrogen (BUN): At 24 weeks, two groups were significantly higher than before treatment (P <0.05). Serum creatinine (Scr): At 24 weeks, two groups were significantly higher than the first and third groups (P <0.05). Glomerular filtration rate (eGFR): At 12 weeks, two groups were significantly lower than the first group (P <0.01). The total curative effect comparison: According to the curative effect of traditional Chinese medicine (TCM), the effective rate was 89% in group 3, 65% in group 1 and 40% in group 2 at 24 weeks (P <0.01) , The effective rate was 94% in group 3, 85% in group 2 and 75% in group 1 (P <0.05). Conclusion: The combination of benazepril and traditional Chinese medicine or benazepril can better improve the clinical symptoms of CKD, reduce urinary protein and delay renal dysfunction.