保元大黄汤治疗慢性肾功能衰竭的临床研究

作者	单位
沈壮雷	杭州市上城区人民医院
李乃英	浙江医科大学附属第二医院神经内科
葛小平	杭州市上城区中医院
陈雪帆	杭州市上城区中医院
赵文国	杭州市医学放免检测中心
宋如梅	杭州市第一人民医院检验科
沈咏慧	杭州市第四人民医院内科

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中文摘要:

用保元大黄汤（治疗组）治疗慢性肾功能衰竭３６例，与包醛氧化淀粉为主的西药综合治疗（对照组）２０例比较，两组血ＢＵＮ、Ｃｒ均有降低。但治疗组Ｈｂ明显提高，疲劳乏力、腰膝酸软、纳差、性功能障碍和精神抑郁症状显著改善（Ｐ＜０．０１），雌二醇、孕酮、睾酮、肌酸磷酸激酶（ＣＰＫ）比治疗前有明显调整（Ｐ＜０．０１）。对照组症状改善不明显，血红蛋白、性激素水平和ＣＰＫ治疗前后变化不大。认为保元大黄汤能改善慢性肾功能衰竭患者的生活质量和生活能力，其作用机理与纠正贫血、调整膜功能有关。

英文摘要:

The quality of life of 56 chronic renal failure (CRF) patients using two kinds of treatment has been observed.36 of them were taken as Group A with BUN 21.62±5.96 mmol/L,Cr 528.63±176.3μmol/L and Hb 65±13g/L were treated with Baoyuan Dahuang Decoction consisted of Panax ginseng,Astragalus membranaceus,Cassia cinnamomi,Glycyrrhiza uralensis and Rheum palmatum.Result:Six symptoms were observed,that were:fatigue,lassitude in loin and legs, adversion of cold,anorexia,sexual dysfunction and mental depression.Five of them improved markedly,from 12.5±2.91 before treatment to 5.58±4.68 after treatment in terms of symptom scores,p<0.001.Furthmore,dihydrothelin (E2),testosterone (T) and pregnendione (p) were regulated significantly,the elevated level of creatine phosphokinase (CPK) before treatment lowered to near normal.The other 20 patients, BUN 20.24±6.57 mmol/L,Cr 487.08±238.68μmol/L and Hb 68±13g/L formed Group B using comprehensive treatment of Western medicine as control.The main drug was coated aldehyde oxystarch.After treatment,the symptoms didn’t show marked improvement,symptom scores being 12.55±2.0 compared with 10.05±2.72 before treatment,P>0.05.E2,T,P and CPK were of insignificant differences (P>0.05), Hb remained almost unchanged,even though BUN and Cr lowered for 22% and 29% respectively.It is assumed that Baoyuan Dahuang decoction could improve CRF patients’ quality of life,and the mechanism of which was not only to reduce the urea nitrogen, but also to adjust the anemia and regulate the membrane function.

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