芪参补肾方对慢性肾脏病3~5期(非透析)脾肾气虚兼血瘀证患者尿液TGF-β1和TIMP-1的影响
The Effect of Qishen Bushen Formula on TGF-β1 and TIMP-1 in Urine of Patients with Stage 3~5 Chronic Kidney Disease (Non-Dialysis) with Spleen-Kidney Qi Deficiency and Blood Stasis Syndrome
DOI: 10.12677/acm.2026.1651882, PDF,    科研立项经费支持
作者: 李淑菊*, 田 锋, 祝 铭：黑龙江省中医医院肾八科，黑龙江 哈尔滨；管艺如：北京中医医院内蒙古医院肾病科，内蒙古 巴彦淖尔；贺梓宸：博罗县公庄镇卫生院慢病管理科，广东 惠州
关键词: 芪参补肾方；慢性肾脏病3~5期；脾肾气虚兼血瘀证；肾间质纤维化；肾间质纤维化尿液相关指标；The Qishen Bushen Formula； Chronic Kidney Disease Stages 3~5； Spleen-Kidney Qi Deficiency and Blood Stasis Syndrome； Renal Interstitial Fibrosis； Urinary Biomarkers of Renal Interstitial Fibrosis
摘要: 目的：观察芪参补肾方对慢性肾脏病(CKD) 3~5期(非透析)脾肾气虚兼血瘀证患者肾功能以及肾间质纤维化尿液相关指标的影响。方法：收集2022年10月~2025年1月期间在黑龙江省中医医院肾八科门诊就诊的病例，将符合CKD 3~5期(非透析)且辨证为脾肾气虚兼血瘀证的患者，根据随机数字表，分为治疗组与对照组，每组各包含50例，共100例。治疗组给予芪参补肾方联合基础治疗，对照组给予尿毒清颗粒联合基础治疗。两组均连续治疗8周。待治疗完成后，对比两组临床疗效、中医证候总积分，以及肾功能(BUN、Cys-C、Scr、eGFR)、肾间质纤维化尿液相关指标(TGF-β1、TIMP-1)水平的变化。结果：治疗组临床疗效总有效率为82.22%，优于对照组(59.09%) (P < 0.05)；经治疗，治疗组中医证候总积分为(11.53 ± 4.37)分，显著低于对照组(19.45 ± 6.30分) (P < 0.01)；肾功能(BUN、Cys-C、Scr、eGFR)：与对照组相比，治疗组血清Cys-C均显著降低(P < 0.01)，BUN、Scr降低效果更优(P < 0.05)，eGFR升高(P < 0.05)；肾间质纤维化尿液相关指标：治疗组尿液TGF-β1、TIMP-1下降显著优于对照组(P < 0.01)。结论：芪参补肾方可改善CKD 3~5期(非透析)脾肾气虚兼血瘀证患者临床症状，降低血清Scr、BUN、Cys-C水平，升高eGFR；降低尿液TGF-β1、TIMP-1水平，可能通过改善肾间质纤维化，进而延缓CKD进展。
Abstract: Objective: To observe the effects of Qishen Bushen Formula on renal function and urine markers related to renal interstitial fibrosis in patients with stage 3~5 chronic kidney disease (CKD) (non-dialysis) presenting with spleen-kidney qi deficiency and blood stasis syndrome. Method: Cases were collected from the outpatient clinic of Nephrology Department VIII at Heilongjiang Provincial Hospital of Traditional Chinese Medicine between October 2022 and January 2025. Patients meeting the criteria for CKD stage 3~5 (non-dialysis) and diagnosed with the TCM pattern of spleen-kidney qi deficiency and blood stasis were divided into a treatment group and a control group according to a random number table, with 50 patients in each group, totaling 100 patients. The treatment group received Qishen Bushen Formula combined with basic treatment, while the control group received Niaoduqing Granules combined with basic treatment. Both groups underwent continuous treatment for 8 weeks. After treatment completion, the following were compared between the two groups: clinical efficacy rate, total TCM syndrome score, changes in renal function markers (BUN, Cys-C, Scr, eGFR), and changes in urine markers related to renal interstitial fibrosis (TGF-β1, TIMP-1). Result: The total effective rate in the treatment group was 82.22%, higher than that in the control group (59.09%) (P < 0.05). After treatment, the total TCM syndrome score in the treatment group was (11.53 ± 4.37) points, significantly lower than that in the control group (19.45 ± 6.30 points) (P < 0.01). Regarding renal function (BUN, Cys-C, Scr, eGFR): Compared with the control group, the treatment group showed significantly lower serum Cys-C (P < 0.01), superior reduction in BUN and Scr levels (P < 0.05), and higher eGFR (P < 0.05). For renal interstitial fibrosis-related urinary markers: The decrease in urinary TGF-β1 and urinary TIMP-1 were significantly superior in the treatment group compared to the control group (P < 0.01). Conclusion: Qishen Bushen Formula can improve clinical symptoms in CKD stage 3~5 (non-dialysis) patients with spleen-kidney qi deficiency and blood stasis syndrome. It reduces serum Scr, BUN, and Cys-C levels while increasing eGFR. It also lowers urinary TGF-β1 and TIMP-1 levels. This suggests the formula may delay CKD progression, potentially by ameliorating renal interstitial fibrosis.
文章引用：李淑菊, 管艺如, 田锋, 祝铭, 贺梓宸. 芪参补肾方对慢性肾脏病3~5期(非透析)脾肾气虚兼血瘀证患者尿液TGF-β1和TIMP-1的影响[J]. 临床医学进展, 2026, 16(5): 857-867. https://doi.org/10.12677/acm.2026.1651882

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