中西醫結合治療慢性腎臟病對於腎絲球過濾率的影響

The association between Change of Glomerulus Filtration Rate and Integrated Traditional Chinese medicine and Western medicine therapy

10.7102/JTCIM.201712_15(2).0002

林軒名(Hsuan-Ming Lin)；陳淑嬌(Shu-Chiao Chen)；蘇麗惠(Li-Hui Su)；何宗融(Tsung-Jung Ho)；廖殷梓(Yin-Tzu Liao)

中西醫結合治療 ； 慢性腎臟病（CKD） ； 腎絲球過濾率（eGFR） ； 末期腎臟病前期（pre-ESRD） ； Traditional Chinese medicine(TCM) ； Chronic kidney disease(CKD) ； estimated glomerular filtration rate(eGFR) ； Integrative medicine ； Pre-end-stage renal disease (Pre-ESRD) program

中醫內科醫學雜誌

15卷2期（2017 / 12 / 01）

11 - 26

繁體中文

近年來研究顯示中西醫結合治療腎臟病與降低死亡率和降低罹患腎病風險相關，故本研究探討中西醫結合治療慢性腎臟病（CKD）對於腎絲球過濾率（eGFR）的影響。本研究採回溯性研究，收集臺南市立安南醫院於103年1月1日到104年12月31日「末期腎臟病前期（pre-ESRD）病人照護與衛教計畫」之病例資料，實驗組為規則接受中西醫治療者（需eGFR小於60 ml/min/1.73m^2，且中醫治療超過120天者），共30名；另選取可與實驗組配對者之對照組30名。經魏克森排序和檢定分析顯示，實驗組eGFR年變化量較對照組有顯著的上升，達統計學差異（p＜0.05）。以原發病為糖尿病的有無作為次群組分析，發現實驗組中糖尿病的病患其eGFR年變化量相較於無糖尿病者上升幅度較大，達統計學差異（p＜0.05）。本研究顯示中西醫結合治療CKD較一般標準西醫治療者，更能改善eGFR。而且，中西醫結合治療中，CKD原發病為糖尿病的患者比非糖尿病者改善eGFR的效果較好。本研究結果說明中西醫結合治療慢性腎臟病優於西醫治療，是值得推廣治療之模式。

Although several studies were reported the association between Traditional Chinese medicine(TCM) and reduction of mortality or risk of renal failure, there was no study of improvement in renal function test for TCM therapy in chronic kidney disease(CKD). This study is the first research to annual change of estimated glomerular filtration rate(eGFR) between Integrative medicine and Western medicine treatment in CKD patients. We collected patients who participated to Pre-end-stage renal disease (Pre-ESRD) program from 2014/1/1 to 2015/12/31 in Tainan Municipal Annan Hospital and GFR＜60 ml/min/1.73m^2. The study group (n=30) was Integrative medicine treatment which patients received regular TCM therapy over 120 days. The control group (n=30) was matched identical age, gender, initial eGFR and original etiology of CKD with the study group. Results revealed that an annual change of eGFR of the study group was significantly higher than the control group by Wilcoxon rank sum test (P＜0.05). In the study group. the sub-group analysis showed that in the patients who original etiology of CKD was diabetes mellitus, the annual change of eGFR was significantly higher than others (P＜0.05). In conclusion, Integrative medicine treatment had better improvement of eGFR than Western medicine only treatment in CKD patients. Integrative medicine treatment may be a new treatment choice of CKD.

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