中医药学报

清补救肾方联合西医治疗气阴两虚兼湿热内蕴慢性肾脏病的疗效及对外周血Cystatin C、proGRP水平的影响

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孙国强 ¹ , 张艳茹 ¹ , 商洁琼 ¹ , 周春宇 ²

中医药学报 | 临床研究 2026,54(10): 95-100

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中医药学报 |临床研究 2026 , 54 (10) : 95 -100

清补救肾方联合西医治疗气阴两虚兼湿热内蕴慢性肾脏病的疗效及对外周血Cystatin C、proGRP水平的影响

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孙国强¹, 张艳茹¹, 商洁琼¹, 周春宇²

作者信息

^1.北京中医药大学东直门医院洛阳医院肾病科，河南　洛阳　471000

^2.郑州大学第一附属医院肾脏内科，河南　郑州　450000

作者简介:

孙国强（1976-），男，硕士，副主任中医师，研究方向：慢性肾衰竭的中西医结合治疗。

Efficacy of Qingbu Jiushen Formula Combined with Western Medicine on Clinical Efficacy and Peripheral Blood Levels of Cystatin C and proGRP in Chronic Kidney Disease Patients with Qi-Yin Deficiency and Damp-Heat Internal Retention

Guoqiang SUN¹, Yanru ZHANG¹, Jieqiong SHANG¹, Chunyu ZHOU²

Affiliations

^1.Department of Nephrology, Luoyang Hospital, Dongzhimen Hospital, Beijing University of Chinese Medicine, Luoyang 471000, China

^2.Department of Nephrology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450000, China

出版时间: 2026-10-20 doi: 10.19664/j.cnki.1002-2392.260209

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摘要

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目的：

观察清补救肾方联合西医治疗气阴两虚兼湿热内蕴慢性肾脏病（CKD）的疗效及对外周血Cystatin C、胃泌素前体释放肽（proGRP）水平的影响。

方法：

选取2022年1月—2024年10月北京中医药大学东直门医院洛阳医院肾病科收治的气阴两虚兼湿热内蕴CKD患者100例，采用信封法随机分为西医组和综合组，每组50例。西医组给予常规西医治疗，综合组在西医基础上联合清补救肾方治疗，连续治疗12周。检测两组治疗前后24 h尿蛋白定量（24 h Upro）、肾小球滤过率（eGFR）、Cystatin C、pro-GRP、尿素氮（BUN）、血肌酐（Scr）、核因子E2相关因子2-抗氧化反应元件（Nrf2-ARE）信号通路介导的相关因子水平，评估两组治疗前后中医症状评分，统计两组总有效率、不良反应发生率。

结果：

两组治疗前比较，24 h Upro、eGFR、UAER、Scr、Cystatin C、proGRP差异无统计学意义（P>0.05）；两组24 h Upro、UAER、Scr、Cystatin C、proGRP治疗12周后均低于治疗前（P<0.05），且综合组治疗12周后均低于西医组（P<0.05）。两组eGFR治疗12周后均高于治疗前（P<0.05），且综合组治疗12周后均高于西医组（P<0.05）。两组治疗前比较，Nrf2-ARE信号通路介导的相关因子差异无统计学意义（P>0.05）；两组过氧化氢酶（CAT）、超氧化物歧化酶（SOD）、血红素加氧酶-1（HO-1）、谷胱甘肽过氧化物酶（GSH-Px）治疗12周后均高于治疗前（P<0.05），且综合组治疗12周后均高于西医组（P<0.05）。两组治疗前比较，中医症状评分差异无统计学意义（P>0.05）；两组中医症状评分治疗12周后均低于治疗前（P<0.05），且综合组治疗12周后均低于西医组（P<0.05）。综合组总有效率为92.00%（46/50）低于西医组的76.00%（38/50），综合组不良反应发生率12.00%（6/50）与西医组的8.00%（4/50）比较，差异无统计学意义（P>0.05）。

结论：

清补救肾方联合西医治疗气阴两虚兼湿热内蕴CKD可改善肾功能，调节Nrf2-ARE信号通路，提高疗效。

关键词

清补救肾方 / 气阴两虚兼湿热内蕴 / 慢性肾脏病 / 肾功能 / Nrf2-ARE信号通路

Abstract

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Objective:

To observe the efficacy of Qingbu Jiushen Formula combined with Western medicine in treating chronic kidney disease (CKD) with Qi-Yin deficiency and damp-heat internal retention, and its effects on peripheral blood levels of Cystatin C and pro-gastrin-releasing peptide (proGRP).

Methods:

A total of 100 CKD patients with Qi-Yin deficiency and damp-heat internal retention admitted to the Department of Nephrology, Luoyang Hospital, Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine, from January 2022 to October 2024, were randomly divided into a Western medicine group and a combination group using the envelope method, with 50 cases in each group. The Western medicine group received routine Western medical treatment, while the combination group received Qingbu Jiushen Formula in addition to the same Western treatment, for 12 consecutive weeks. The following parameters were measured before and after treatment: 24-hour urinary protein (24 h Upro), estimated glomerular filtration rate (eGFR), urinary albumin excretion rate (UAER), serum creatinine (Scr), blood urea nitrogen (BUN), Cystatin C, proGRP, and factors related to the nuclear factor erythroid 2-related factor 2-antioxidant response element (Nrf2-ARE) signaling pathway. Traditional Chinese medicine (TCM) symptom scores were assessed before and after treatment, and the overall response rate and incidence of adverse reactions were recorded.

Results:

Before treatment, there were no significant differences between the two groups in 24 h Upro, eGFR, UAER, Scr, Cystatin C, or proGRP (P>0.05). After 12 weeks of treatment, 24 h Upro, UAER, Scr, Cystatin C, and proGRP decreased significantly in both groups compared with baseline (P<0.05), and the combination group showed significantly lower levels than the Western medicine group (P<0.05). eGFR increased significantly in both groups after treatment (P<0.05), with the combination group showing a higher eGFR than the Western medicine group (P<0.05). Regarding Nrf2-ARE pathway-related factors, no significant differences were found between the two groups at baseline (P>0.05). After 12 weeks, catalase (CAT), superoxide dismutase (SOD), heme oxygenase-1 (HO-1), and glutathione peroxidase (GSH-Px) all increased significantly in both groups (P<0.05), and the combination group had significantly higher levels than the Western medicine group (P<0.05). TCM symptom scores were comparable between groups before treatment (P>0.05), but after 12 weeks both groups showed significant reductions (P<0.05), with the combination group scoring lower than the Western medicine group (P<0.05). The overall response rate in the combination group was 92.00% (46/50), which was higher than that in the Western medicine group (76.00%, 38/50). The incidence of adverse reactions was 12.00% (6/50) in the combination group versus 8.00% (4/50) in the Western medicine group, with no statistically significant difference (P>0.05).

Conclusion:

Qingbu Jiushen Formula combined with Western medicine can improve renal function, regulate the Nrf2-ARE signaling pathway, and enhance therapeutic efficacy in CKD patients with Qi-Yin deficiency and damp-heat internal retention.

Key words

Qingbu Jiushen Formula / Qi-Yin deficiency with damp-heat internal retention / Chronic kidney disease / Renal function / Nrf2-ARE signaling pathway

引用本文

孙国强, 张艳茹, 商洁琼, 周春宇. 清补救肾方联合西医治疗气阴两虚兼湿热内蕴慢性肾脏病的疗效及对外周血Cystatin C、proGRP水平的影响. 中医药学报, 2026 , 54 (10) : 95 -100 . DOI: 10.19664/j.cnki.1002-2392.260209

Guoqiang SUN, Yanru ZHANG, Jieqiong SHANG, Chunyu ZHOU. Efficacy of Qingbu Jiushen Formula Combined with Western Medicine on Clinical Efficacy and Peripheral Blood Levels of Cystatin C and proGRP in Chronic Kidney Disease Patients with Qi-Yin Deficiency and Damp-Heat Internal Retention[J]. Acta Chinese Medicine and Pharmacology, 2026 , 54 (10) : 95 -100 . DOI: 10.19664/j.cnki.1002-2392.260209

基金

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2020年河南省医学科技攻关计划联合共建项目(LHGJ20200290)

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2026年第54卷第10期

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doi: 10.19664/j.cnki.1002-2392.260209

接收时间：2025-06-13
首发时间：2026-10-14
出版时间：2026-10-20

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收稿日期：2025-06-13
修回日期：2026-09-04

基金

2020年河南省医学科技攻关计划联合共建项目(LHGJ20200290)

作者信息

^1.北京中医药大学东直门医院洛阳医院肾病科，河南　洛阳　471000

^2.郑州大学第一附属医院肾脏内科，河南　郑州　450000

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2种不同金属材料的力学参数

科 Family	属数 Number of genus	种数 Number of species	占总种数比例 Percentage of total species (%)	属 Genus	种数 Number of species	占总种数比例 Percentage of total species (%)
鹅膏菌科Amanitaceae	2	11	5.26	鹅膏菌属 Amanita	10	4.78
小菇科 Mycenaceae	2	12	5.74	丝盖伞属 Inocybe	5	2.39
多孔菌科 Polyporaceae	8	14	6.70	蜡蘑属 Laccaria	5	2.39
红菇科 Russulaceae	3	23	11.00	小皮伞属 Marasmius	6	2.87
				小菇属 Mycena	11	5.26
				光柄菇属 Pluteus	5	2.39
				红菇属 Russula	17	8.13
				栓菌属 Trametes	5	2.39

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