清肾颗粒治疗慢性肾脏病合并脂代谢异常湿热证疗效观察

目的 观察清肾颗粒治疗慢性肾脏病（chronic kidney disease，CKD）合并脂代谢异常湿热证患者的疗效。方法 将60例CKD合并脂代谢异常患者随机分为对照组30例和治疗组30例，两组患者均根据具体情况给予常规治疗，治疗组在此基础上加用清肾颗粒口服，8周为1个疗程。采用血清肌酐（serum creatinine，SCr）、血尿素氮（blood urea nitrogen，BUN）、估算的肾小球滤过率（estimated glomerular filtration rate，eGFR）评价治疗前后肾功能改善情况；采用三酰甘油（triglyceride，TG）、高密度脂蛋白（high- density lipoprotein cholesterol，HDL- C）评价患者治疗前后脂代谢相关指标变化，采用同型半胱氨酸（homocysteine，Hcy）、C反应蛋白（C- reactive protein，CRP）评价患者治疗前后血管功能状态及炎症反应，并比较两组中医症状评分及临床疗效。结果 与治疗前比较，两组患者治疗后SCr、BUN、TG、Hcy、CRP水平显著降低，eGFR、HDL- C水平显著升高（P＜0.05）；治疗组患者SCr、BUN、TG、Hcy、CRP降低程度显著大于对照组（P＜0.05），eGFR、HDL- C升高程度显著大于对照组（P＜0.05）。两组患者治疗后中医症状评分均显著降低（P＜0.05），且治疗组降低程度大于对照组（P＜0.05）。治疗组临床疗效优于对照组（P＜0.05）。结论 清肾颗粒能够改善CKD患者肾功能、脂代谢及微炎症状态，有利于保护血管，缓解患者临床症状，提高临床疗效。

Clinical Effect of Qingshen Granule in Treatment of Chronic Kidney Disease with Abnormal Lipid Metabolism and Damp- Heat Syndrome

Objective To investigate the clinical effect of Qingshen Granule in the treatment of patients with chronic kidney disease (CKD), abnormal lipid metabolism, and damp- heat syndrome.Methods A total of 60 patients with CKD and abnormal lipid metabolism were enrolled and randomly divided into control group and treatment group, with 30 patients in each group. The patients in both groups were given conventional treatment based on actual conditions, and in addition, those in the treatment group were given oral administration of Qingshen Granule; each course of treatment was 8 weeks. Serum creatinine (SCr), blood urea nitrogen (BUN), and estimated glomerular filtration rate (eGFR) were used to evaluate the improvement in renal function after treatment; triglyceride (TG) and high- density lipoprotein cholesterol (HDL- C) were used to evaluate the changes in lipid metabolism indices after treatment; homocysteine (Hcy) and C- reactive protein (CRP) were used to evaluate vascular function and inflammatory response before and after treatment; traditional Chinese medicine (TCM) symptom score and clinical outcome were compared between the two groups. Results After treatment, both groups had significant reductions in SCr, BUN, TG, Hcy, and CRP and significant increases in eGFR and HDL- C (P<0.05), and compared with the control group, the treatment group had significantly greater reductions in SCr, BUN, TG, Hcy, and CRP and significantly greater increases in eGFR and HDL- C (P<0.05). After treatment, both groups had a significant reduction in TCM symptom score (P<0.05), and the treatment group had a significantly greater reduction than the control group (P<0.05). The treatment group had a significantly better clinical outcome than the control group (P<0.05). Conclusion For patients with CKD, Qingshen Granule can improve renal function, lipid metabolism, and microinflammatory state, protect vessels, alleviate clinical symptoms, and improve clinical outcome.