肾安汤对慢性肾功能不全患者免疫、肾功能及脂代谢的影响

doi:10.11958/20252256

天津医药 ›› 2025, Vol. 53 ›› Issue (12): 1309-1314.doi: 10.11958/20252256

肾安汤对慢性肾功能不全患者免疫、肾功能及脂代谢的影响

黄叶妮¹(), 董扬洲¹, 胡苗青², 李卫³, 刘杨⁴

¹ 湖南中医药大学第二附属医院医务部（邮编410005）
² 湖南中医药大学第二附属医院肾病内分泌科
³ 湖南中医药大学第二附属医院骨伤康复科
⁴ 湖南中医药大学第二附属医院质控中心

收稿日期:2025-06-13 修回日期:2025-07-09 出版日期:2025-12-15 发布日期:2025-12-08
作者简介:黄叶妮（1986），女，主治医师，主要从事肾脏及脾胃疾病的中西医诊治方面研究。E-mail：huangyeninnn@163.com
基金资助:
湖南省中医药管理局项目(C2023048);湖南省中医药管理局项目(A2023027);湖南省中医药管理局项目(W20243268)

Effects of Shen 'an decoction on immunity, renal function and lipid metabolism in patients with chronic renal insufficiency

HUANG Yeni¹(), DONG Yangzhou¹, HU Miaoqing², LI Wei³, LIU Yang⁴

¹ Department of Medical Affairs, the Second Affiliated Hospital of Hunan University of Traditional Chinese Medicine, Changsha 410005, China
² Department of Nephrology and Endocrinology, the Second Affiliated Hospital of Hunan University of Traditional Chinese Medicine, Changsha 410005, China
³ Department of Orthopedic Rehabilitation, the Second Affiliated Hospital of Hunan University of Traditional Chinese Medicine, Changsha 410005, China
⁴ Quality Control Center, the Second Affiliated Hospital of Hunan University of Traditional Chinese Medicine, Changsha 410005, China

Received:2025-06-13 Revised:2025-07-09 Published:2025-12-15 Online:2025-12-08

黄叶妮, 董扬洲, 胡苗青, 李卫, 刘杨. 肾安汤对慢性肾功能不全患者免疫、肾功能及脂代谢的影响[J]. 天津医药, 2025, 53(12): 1309-1314.

HUANG Yeni, DONG Yangzhou, HU Miaoqing, LI Wei, LIU Yang. Effects of Shen 'an decoction on immunity, renal function and lipid metabolism in patients with chronic renal insufficiency[J]. Tianjin Medical Journal, 2025, 53(12): 1309-1314.

摘要/Abstract

摘要：

目的探讨肾安汤治疗慢性肾功能不全的临床疗效，并系统评价其对患者免疫调节、肾功能及脂代谢的影响。方法采用前瞻性随机对照研究设计，选取102例慢性肾功能不全患者，随机分为对照组与观察组各51例，对照组接受西医常规治疗，观察组在对照组治疗基础上加用肾安汤治疗。评估2组患者中医证候积分、临床疗效；于治疗前、治疗8周后采用免疫透射比浊法检测免疫球蛋白（Ig）G、IgM、IgA水平；24 h尿蛋白定量（24 hUP）、血胱抑素（Cys C）、血肌酐（Scr）、血钙、血磷、三酰甘油（TG）及总胆固醇（TC）；酶联免疫吸附试验（ELISA）测定活性氧（ROS）、晚期蛋白氧化产物（AOPPs）；记录治疗期间出现的恶心、腹泻、头晕及皮疹等不良反应发生情况。结果治疗8周后，2组的中医证候积分、24 hUP、Cys C、Scr、血磷、TG、TC、ROS、AOPPs均较治疗前降低，且观察组更低（P<0.05）；2组的IgG、IgM、IgA、血钙均较治疗前均升高，且观察组更高（P<0.05）。观察组临床总有效率高于对照组（94.12% vs. 80.39%，P<0.05）。观察组出现恶心1例、头晕1例、皮疹1例；对照组出现恶心1例、腹泻1例、头晕2例，2组不良反应发生率比较差异无统计学意义。结论在西医常规治疗基础上加用肾安汤治疗慢性肾功能不全患者可提高临床疗效，并改善免疫功能、肾功能、脂代谢及氧化应激指标，安全性良好。

关键词: 肾功能不全，慢性, 脾肾两虚, 湿热, 肾安汤, 免疫功能, 肾功能, 脂质代谢

Abstract:

Objective To explore the clinical efficacy of Shen'an decoction in treating chronic renal insufficiency and systematically assess its effects on immune regulation, renal function and lipid metabolism. Methods A prospective randomized controlled study was conducted, and 102 patients with chronic renal insufficiency were selected. Patients were randomly divided into the control group (51 cases, receiving conventional Western medical treatment) and the observation group (51 cases, receiving conventional Western medical treatment combined with Ren'an decoction). The traditional Chinese medicine (TCM) syndrome scores, clinical efficacy, levels of immunoglobulin (Ig) G, IgM, IgA, 24-hour urine protein quantification (24 hUP), cystatin C (Cys C), serum creatinine (Scr), blood calcium, blood phosphorus, triglycerides (TG) and total cholesterol (TC) were evaluated before treatment and 8 weeks after treatment. The levels of reactive oxygen species (ROS) and advanced oxidation protein products (AOPPs) were measured by enzyme-linked immunosorbent assay (ELISA). Adverse reactions such as nausea, diarrhea, dizziness and rash during the treatment period were recorded. Results After 8 weeks of treatment, the TCM syndrome scores, 24 hUP, Cys C, Scr, blood phosphorus, TG, TC, ROS and AOPPs were significantly lower in both groups than those before treatment, and the observation group was significantly lower than that of the control group (P<0.05). The levels of IgG, IgM, IgA and blood calcium were significantly higher in both groups than those before treatment, and the observation group was significantly higher than those of the control group (P<0.05). The total clinical effective rate of the observation group was higher than that of the control group (94.12% vs. 80.39%, P<0.05). There was one case of nausea, one case of dizziness and one case of rash in the observation group, and one case of nausea, one case of diarrhea and two cases of dizziness occurred in the control group. There was no significant difference in the incidence of adverse reactions between the two groups. Conclusion The addition of Shen'an decoction in the treatment of patients with chronic renal insufficiency on the basis of conventional Western medical treatment can improve the clinical efficacy, enhance immune function, renal function, lipid metabolism and oxidative stress indicators, with good safety.

Key words: renal insufficiency, chronic, deficiency of spleen and kidney, dampness heat, Shen'an decoction, immune function, renal function, lipid metabolism

中图分类号:

R969

图/表 6

参考文献 27

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组别	性别		年龄/岁	体质量指数/（kg/m²）	病程/年	原发病				CKD分期
组别	男	女	年龄/岁	体质量指数/（kg/m²）	病程/年	高血压性肾病	糖尿病肾病	慢性肾小球肾炎	其他	3期	4期
对照组	28（54.90）	23（45.10）	55.35±4.85	23.14±1.48	5.79±1.50	15（29.41）	12（23.53）	18（35.29）	6（11.76）	32（62.75）	19（37.25）
观察组	30（58.82）	21（41.18）	56.12±5.05	22.87±1.53	6.05±1.62	14（27.45）	11（21.57）	21（41.48）	5（9.80）	29（56.86）	22（43.14）
χ²或t	0.160		0.780	0.875	0.871	0.400				0.367

组别	性别		年龄/岁	体质量指数/（kg/m²）	病程/年	原发病				CKD分期
组别	男	女	年龄/岁	体质量指数/（kg/m²）	病程/年	高血压性肾病	糖尿病肾病	慢性肾小球肾炎	其他	3期	4期
对照组	28（54.90）	23（45.10）	55.35±4.85	23.14±1.48	5.79±1.50	15（29.41）	12（23.53）	18（35.29）	6（11.76）	32（62.75）	19（37.25）
观察组	30（58.82）	21（41.18）	56.12±5.05	22.87±1.53	6.05±1.62	14（27.45）	11（21.57）	21（41.48）	5（9.80）	29（56.86）	22（43.14）
χ²或t	0.160		0.780	0.875	0.871	0.400				0.367

组别	次症			主症			总分
组别	治疗前	治疗后	t	治疗前	治疗后	t	治疗前	治疗后	t
对照组	9.26±1.37	5.16±0.92	18.906^＊＊	19.14±2.47	11.48±1.93	16.648^＊＊	28.39±2.74	16.63±2.15	24.150^＊＊
观察组	8.92±1.55	4.08±0.69	20.328^＊＊	18.78±2.63	9.01±1.45	27.507^＊＊	27.71±3.20	13.08±1.56	31.050^＊＊
t	1.152	6.682^＊＊		0.699	7.420^＊＊		1.164	9.531^＊＊

组别	次症			主症			总分
组别	治疗前	治疗后	t	治疗前	治疗后	t	治疗前	治疗后	t
对照组	9.26±1.37	5.16±0.92	18.906^＊＊	19.14±2.47	11.48±1.93	16.648^＊＊	28.39±2.74	16.63±2.15	24.150^＊＊
观察组	8.92±1.55	4.08±0.69	20.328^＊＊	18.78±2.63	9.01±1.45	27.507^＊＊	27.71±3.20	13.08±1.56	31.050^＊＊
t	1.152	6.682^＊＊		0.699	7.420^＊＊		1.164	9.531^＊＊

组别	IgG			IgM			IgA
组别	治疗前	治疗后	t	治疗前	治疗后	t	治疗前	治疗后	t
对照组	6.83±0.91	9.05±1.22	10.578^＊＊	0.69±0.17	1.02±0.24	8.186^＊＊	1.71±0.45	2.19±0.50	5.435^＊＊
观察组	6.75±0.86	11.49±1.53	19.686^＊＊	0.72±0.15	1.38±0.29	13.341^＊＊	1.67±0.43	2.59±0.56	9.555^＊＊
t	0.403	8.902^＊＊		1.033	6.637^＊＊		0.459	3.770^＊＊

肾安汤对慢性肾功能不全患者免疫、肾功能及脂代谢的影响

Effects of Shen 'an decoction on immunity, renal function and lipid metabolism in patients with chronic renal insufficiency

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组别	24 hUP/g			Cys C/（mg/L）			Scr/（μmol/L）
组别	治疗前	治疗后	t	治疗前	治疗后	t	治疗前	治疗后	t
对照组	1.92±0.50	1.37±0.35	6.052^＊＊	1.70±0.45	1.21±0.31	6.021^＊＊	294.62±22.71	247.88±17.54	12.656^＊＊
观察组	1.84±0.47	1.04±0.28	12.561^＊＊	1.67±0.43	0.83±0.23	10.997^＊＊	298.45±20.39	202.76±14.23	26.229^＊＊
t	0.833	5.332^＊＊		0.348	7.042^＊＊		0.899	14.269^＊＊

组别	24 hUP/g			Cys C/（mg/L）			Scr/（μmol/L）
组别	治疗前	治疗后	t	治疗前	治疗后	t	治疗前	治疗后	t
对照组	1.92±0.50	1.37±0.35	6.052^＊＊	1.70±0.45	1.21±0.31	6.021^＊＊	294.62±22.71	247.88±17.54	12.656^＊＊
观察组	1.84±0.47	1.04±0.28	12.561^＊＊	1.67±0.43	0.83±0.23	10.997^＊＊	298.45±20.39	202.76±14.23	26.229^＊＊
t	0.833	5.332^＊＊		0.348	7.042^＊＊		0.899	14.269^＊＊

组别	血钙			血磷			TG			TC
组别	治疗前	治疗后	t	治疗前	治疗后	t	治疗前	治疗后	t	治疗前	治疗后	t
对照组	1.97±0.43	2.21±0.52	2.464^＊	2.41±0.56	1.84±0.48	4.822^＊＊	2.11±0.51	1.72±0.43	4.020^＊＊	5.75±1.19	4.15±0.92	8.298^＊＊
观察组	2.02±0.41	2.53±0.57	5.371^＊＊	2.35±0.57	1.57±0.39	8.189^＊＊	2.07±0.54	1.43±0.39	6.748^＊＊	5.83±1.24	3.46±0.71	12.299^＊＊
t	0.601	2.963^＊＊		0.551	3.152^＊＊		0.383	3.566^＊＊		0.334	4.176^＊＊

组别	血钙			血磷			TG			TC
组别	治疗前	治疗后	t	治疗前	治疗后	t	治疗前	治疗后	t	治疗前	治疗后	t
对照组	1.97±0.43	2.21±0.52	2.464^＊	2.41±0.56	1.84±0.48	4.822^＊＊	2.11±0.51	1.72±0.43	4.020^＊＊	5.75±1.19	4.15±0.92	8.298^＊＊
观察组	2.02±0.41	2.53±0.57	5.371^＊＊	2.35±0.57	1.57±0.39	8.189^＊＊	2.07±0.54	1.43±0.39	6.748^＊＊	5.83±1.24	3.46±0.71	12.299^＊＊
t	0.601	2.963^＊＊		0.551	3.152^＊＊		0.383	3.566^＊＊		0.334	4.176^＊＊