24 h. P > h. R doi /j. issn

Transcription

1 Vol. 38 No. 4 Apr Journal of Beijing University of Traditional Chinese Medicine ~ 3 * # ~ h 2 P > P < P < h P < P > ~ 3 R doi /j. issn Safety and effectiveness of Qilu Xiaobai formula on chronic kidney disease patients at second to third stage with syndrome of spleen-kidney deficiency and phlegm-stasis obstructing collateral * SU Zhong-hao 1 YANG Xue-jun 2 GAO Jian-dong 2 WANG Chen 2 LIU Wei-fang 2 LI Ying-qiao 2 YE Jin 1# 1 School of Preclinical Medicine Shanghai University of Traditional Chinese Medicine Shanghai Shanghai Shuguang Hospital Abstract Objective To study the effectiveness and safety of Qilu Xiaobai formula QLXB a Chinese herbal compound formulated by the TCM principle of invigorating spleen and restoring virility with dredging collateral and removing damp on chronic kidney disease CKD patients at stage 2 ~ 3 with syndrome of spleen-kidney deficiency and phlegm-stasis obstructing collateral. Methods 55 outpatients were divided randomly into Western medicinal group n = 18 and QLXB group n = 37. All the patients in two groups were treated basic therapy besides those in Western medicinal group took orally losartan while QLXB group took QLXB formula for 24 weeks. At the time point of and 24 week score of symptoms and score of syndrome were calculated by completing a questionnaire serum creatinine Scr blood urea nitrogen BUN urinary protein in 24-hour 24UP and glomerular filtration rate eg- FR were measured. Results There was no statistical difference of each index between two groups be- # yjdjzfy@ sh163. net * No. 12ZLJ

2 fore treatment P > After treatment symptom scores of QLXB group were significantly lower than those in the Western medicinal group P < The score of soreness of loins and fatigue was significantly decreased in QLXB group than that in Western medicinal group P < The concentration of Scr Bun 24 UP and egfr was significantly lower in QLXB group than Western medicinal group P < Conclusion QLXB was safe and effective for treatment of CKD patients at stage 2 ~ 3. Key words Qilu Xiaobai formula QLXB chronic kidney disease safety effectivness chronic kidney disease CKD CKD eGFR 90 ml /min egfr 29 ml /min CKD 2 2 ~ h 24 h 24UP Scr BUN ALB 7 egfr P > KF DOQI / ~ 3 egfr 30 ~ 89 ml /min ~ 35 kcal / kg d 0. 8 ~ kg /d > 50% ~ ~ 130 /60 ~ 80 mmhgk ~ /80 mm- Hg 30 g 15 g 15 g 15 g

3 4 2 ~ g 9 g 200 ml / egfr 5% 50 mg /d ALB BUN Scr 24 h 24UP egfr MDRD t P < > 70% 30% ~ 70% 30% UP 0. 3 g 24UP 50% egfr 5% 24UP 25% ~ 50% 2. 4 SPSS x 珋 ± s P < Table x 珋 ± s Comparison of scores of symptoms and syndrome of patients between two groups x 珋 ± s Item Fatigue Soreness of loins Edema Frequent nocturnal urination Poor appetite Epigastric fullness Darkish complexion QLXB group n = 37 Western medicinal group n = 18 Before ± ± > After ± * # ± < Before ± ± > After ± * # ± < Before ± ± > After ± * # ± < Before ± ± > After ± * # ± < Before ± ± > After ± ± > Before ± ± > After ± * # ± < Before ± ± > After ± * # ± < t P * P < #P < Note * P < before treatment compared with after treatment within QLXB group #P < after treatment in QLXB group compared with that in Western medicinal group P < P <

4 Table x 珋 ± s Comparison of Symptom scores of patient of two groups at different time points 珋 x ± s Group n 0 0 week 8 8 week week week QLXB group ± ± ± * ± * # Western medicinal group ± ± ± ± t P > > > < * P < #P < Note * P < before treatment compared with after treatment within QLXB group #P < compared with Western Medicine group P < Scr BUN P < P < P < ALB 16 P > egfr P < egfr P < UP Table UP Scr BUN ALB egfr x 珋 ± s Comparison of 24UP Scr BUN ALB and egfr S of patient of two groups at different time points x 珋 ± s Index 24 UP g Scr μmol /L BUN mmol /L ALB g /L egfr Group n 0 0 week 8 8 week week week QLXB group ± ± ± * ± * Western medicinal group ± ± ± ± t P > > > > QLXB group ± ± * # ± * # ± * # Western medicinal group ± ± ± ± t P > < < < QLXB group ± ± * # ± * # ± * # Western medicinal group ± ± ± ± t P > < < < QLXB group ± ± ± ± Western medicinal group ± ± ± ± t P > > > > QLXB group ± ± ± * ± * Western medicinal group ± ± ± ± F P > > > > * P < #P < Note * P < week compared with 0 week within QLXB group #P < the same time point compared between two groups % % P < 0. 05

5 4 2 ~ % 66. 7% P < IgA IgA CKD 2 ~ UP ALT AST K + Na d 5 ~ 6 /d CKD 24UP 4 CKD CKD 4 CKD CKD MDRD CKD CKD 2 CKD IgA

6 FENG YL LEI P TIAN T et al. Diuretic activity of some fractions of the epidermis of Poria cocos J. J Ethnopharmacol YOON JJ LEE YJ LEE SM et al. Poria cocos inhibits CKD high glucose - induced proliferation of rat mesangial cells 1 BAILIE GR UHLIG K LEVEY AS. Clinical practice guidelines in nephrology evaluation classification and stratifica- 15. tion of chronic kidney disease J. Pharmacotherapy 2005 J M. J LEE MH LEE JM JUN SH et al. The anti - inflammatory effects of Pyrolae herba extract through the J. inhibition GLASSOCK RJ. Uremia end - stage renal disease how cost - effective are preventive strategies J. J Ren Nutr Suppl S131 - S SU GB LIU XS WENG JX. A survey and analysis of Chinese patent medicine for outpatients with chronic kidney disease J. Zhong Guo Zhong Xi Yi Jie He Za Zhi J J J. 8. J WU HM TANG JL CAO L et al. Interventions for preven- IgA J. ting infection in nephrotic syndrome J /OL. Cochrane Database Syst Rev http / /www. ncbi. gov / pubmed / WANG SG XU Y CHEN JD et al. Astragaloside IV stimulates angiogenesis and increases nitric oxide accumulation via JAK2 /STAT3 and ERK1 /2 pathway J. Molecules TAN S WANG G GUO Y et al. Preventive Effects of a Natural Anti - Inflammatory Agent Astragaloside IV on Ischemic Acute Kidney Injury in Rats J /OL. Evid Based Complement Alternat Med http / /www. hindawi. com /journals /ecam /2013 / J. Am J Chin Med YIN JJ YANG Y WANG QB et al. Effect of Chinese herbal medicine with Supplement Qi and Activating Blood Circulation on tubular reabsorption function of diabetic nephropathy rats J. Zhong Yao Cai of the expression of inducible nitric oxidesynthase inos and NO production J. J Ethnopharmacol J J J u - PA /PAI - 1 J FENG M YUAN W ZHANG R et al. Chinese herbal medicine Huangqi type formulations for nephrotic syndrome J /OL. Cochrane Database Syst Rev http / /onlinelibrary. wiley. com /doi / / CD pub3 /pdf