目的 探讨至灵胶囊联合复方α-酮酸治疗老年慢性肾功能衰竭的临床疗效。方法 选取2020年1月-2022年1月河北北方学院附属第一医院肾内科治疗的66例老年慢性肾功能衰竭患者,按照随机数字表法分为对照组和治疗组,每组各33例。对照组患者口服复方α-酮酸片,4片/次,1次/d。治疗组在对照组基础上口服至灵胶囊,3粒/次,3次/d。两组均连续用药30 d。观察两组临床疗效和症状改善时间,比较两组肾功能指标、血清总蛋白(TP)、血清白蛋白(Alb)、血红蛋白(Hb)、血清炎症因子指标。结果 治疗后,治疗组总有效率是96.97%,显著高于对照组的72.73%(P<0.05)。经治疗,治疗组出现乏力、气短、体力下降、食欲不振等症状改善时间均显著短于对照组(P<0.05)。治疗后,治疗组尿白蛋白排泄率(UAER)、肌酐(Scr)、尿素氮(BUN)水平均较治疗前显著降低,而肾小球滤过率(GFR)显著升高(P<0.05);治疗后,治疗组肾功能指标改善优于对照组(P<0.05)。治疗后,两组血清总蛋白(TP)、血清白蛋白(Alb)、血红蛋白(Hb)水平均高于同组治疗前(P<0.05);治疗后,治疗组TP、Alb、Hb水平高于对照组(P<0.05)。治疗后,两组患者血清白细胞介素-6(IL-6)、同型半胱氨酸(Hcy)、肿瘤坏死因子-α(TNF-α)、C反应蛋白(CRP)水平均较治疗前显著降低(P<0.05);治疗后,治疗组血清学指标低于对照组(P<0.05)。结论 至灵胶囊联合复方α-酮酸治疗慢性肾功能衰竭具有显著效果,改善明显患者症状,促进肾功能恢复,降低炎性反应,值得临床借鉴。

Objective To investigate the therapeutic effect of Zhiling Capsules combined with compound α-ketoacid in treatment of elderly chronic renal failure.Methods Sixty-six elderly patients with chronic renal failure treated in the Department of Nephrology of The First Affiliated Hospital of Hebei North University from January 2020 to January 2022 were selected and divided into control group and treatment group according to random number table method, with 33 cases in each group. Patients in the control group were po administered with Compound α-Ketoacid Tablets, 4 tablets/time, once daily. Patients in the treatment group were po administered with Zhiling Capsules on the basis of the control group, 3 grains/time, three times daily. Patients in two groups were treated for 30 d. After treatment, the clinical efficacy was evaluated, and the renal function indexes, serum total protein (TP), serum albumin (Alb), hemoglobin (Hb) and serological indexes of the two groups were compared.Results After treatment, the total effective rate of the treatment group was 96.97%, significantly higher than that of the control group (72.73%) (P < 0.05). After treatment, the improvement time of fatigue, shortness of breath, decreased physical strength, anorexia and other symptoms in treatment group was significantly shorter than that in control group (P < 0.05). After treatment, the levels of UAER, Scr and BUN in treatment group were significantly decreased compared with before treatment, while GFR was significantly increased (P < 0.05). After treatment, the renal function index of the treatment group improved better than that of the control group (P < 0.05). After treatment, the levels of TP, Alb and Hb in two groups were higher than before (P < 0.05). After treatment, TP, Alb and Hb levels in the treatment group were higher than those in the control group (P < 0.05). After treatment, the serum levels of IL-6, Hcy, TNF-α and CRP in 2 groups were significantly decreased compared with before treatment (P < 0.05). After treatment, the serum index of the treatment group was lower than that of the control group (P < 0.05).Conclusion Zhiling Capsules combined with compound α-ketoacid has a significant effect in treatment of elderly chronic renal failure, and can improve the symptoms of patients, promote the recovery of renal function and reduce the inflammatory reaction, which is worthy of clinical reference.

R983

河北省卫生健康计划项目(20200542)