北京中医药大学学报（中医临床版）
北京中醫藥大學學報（中醫臨床版）
북경중의약대학학보（중의림상판）
JOURNAL OF BEIJING UNIVERSITY OF TRADITIONAL CHINESE MEDICINE(CLINICAL MEDICINE)
2013年
5期
21-25
,共5页
吴雅冰%李响%张愚%吴振起%韩志友
吳雅冰%李響%張愚%吳振起%韓誌友
오아빙%리향%장우%오진기%한지우
肾移植%丹参%百令胶囊%存活率
腎移植%丹參%百令膠囊%存活率
신이식%단삼%백령효낭%존활솔
renal transplantation%Danshen (Radix Salviae Miltiorrhizae)%Bailing Capsules%survival rate
目的总结112例肾移植手术的临床经验，观察丹参及冬虫夏草制剂在肾移植中的临床效果。方法回顾性分析了2003-2007年的112例同种异体肾移植患者的临床资料。将术后患者（脱落10例）随机分为治疗组56例、对照组46例，2组均常规服用免疫抑制剂，治疗组加用丹参及虫草制剂。观察人、肾1，3，5年存活率，术后排斥反应及并发症情况，患者死亡的主要原因，2组人、肾5年存活率及出现肾功能异常情况，并发慢性移植肾肾病（CAN）后的治疗情况。结果112例中人、肾1，3，5年存活率（人、肾均存活）分别为96.4%，85.7%，74.1%。术后1例发生加速排斥反应，9例发生急性排斥反应，8例发生急性肾小管坏死，围手术期死亡人3例，1例出现外科并发症尿瘘。112例中术后失访6例，共死亡11例，除围手术期死亡3例外，其余8例均为带正常肾功能死亡。其中5例因恶性肿瘤死亡，占4.5%。人、肾5年存活率比较：治疗组56例中46例存活，存活率为82.1%，对照组46例中37例存活，存活率为80.4%，2组比较差异无统计学意义（P>0.05）。5年中治疗组56例中发生肾功能异常者9例，发生率为16.1%，对照组46例中发生肾功能异常者19例，发生率为41.3%，治疗组肾功能异常的发生率低于对照组（P<0.01）。2组患者术后因肾功能异常诊断为CAN者共28例。在免疫抑制剂减量或切换免疫抑制剂的同时采用丹参粉针静点治疗，连续2周静脉滴注，治疗前后血肌酐平均下降（84.3±24.5）μmol/L。结论在常规抗排异治疗的基础上加用丹参及冬虫夏草制剂对肾移植患者有较好的疗效，同时丹参制剂对于CAN有一定的治疗作用。
目的總結112例腎移植手術的臨床經驗，觀察丹參及鼕蟲夏草製劑在腎移植中的臨床效果。方法迴顧性分析瞭2003-2007年的112例同種異體腎移植患者的臨床資料。將術後患者（脫落10例）隨機分為治療組56例、對照組46例，2組均常規服用免疫抑製劑，治療組加用丹參及蟲草製劑。觀察人、腎1，3，5年存活率，術後排斥反應及併髮癥情況，患者死亡的主要原因，2組人、腎5年存活率及齣現腎功能異常情況，併髮慢性移植腎腎病（CAN）後的治療情況。結果112例中人、腎1，3，5年存活率（人、腎均存活）分彆為96.4%，85.7%，74.1%。術後1例髮生加速排斥反應，9例髮生急性排斥反應，8例髮生急性腎小管壞死，圍手術期死亡人3例，1例齣現外科併髮癥尿瘺。112例中術後失訪6例，共死亡11例，除圍手術期死亡3例外，其餘8例均為帶正常腎功能死亡。其中5例因噁性腫瘤死亡，佔4.5%。人、腎5年存活率比較：治療組56例中46例存活，存活率為82.1%，對照組46例中37例存活，存活率為80.4%，2組比較差異無統計學意義（P>0.05）。5年中治療組56例中髮生腎功能異常者9例，髮生率為16.1%，對照組46例中髮生腎功能異常者19例，髮生率為41.3%，治療組腎功能異常的髮生率低于對照組（P<0.01）。2組患者術後因腎功能異常診斷為CAN者共28例。在免疫抑製劑減量或切換免疫抑製劑的同時採用丹參粉針靜點治療，連續2週靜脈滴註，治療前後血肌酐平均下降（84.3±24.5）μmol/L。結論在常規抗排異治療的基礎上加用丹參及鼕蟲夏草製劑對腎移植患者有較好的療效，同時丹參製劑對于CAN有一定的治療作用。
목적총결112례신이식수술적림상경험，관찰단삼급동충하초제제재신이식중적림상효과。방법회고성분석료2003-2007년적112례동충이체신이식환자적림상자료。장술후환자（탈락10례）수궤분위치료조56례、대조조46례，2조균상규복용면역억제제，치료조가용단삼급충초제제。관찰인、신1，3，5년존활솔，술후배척반응급병발증정황，환자사망적주요원인，2조인、신5년존활솔급출현신공능이상정황，병발만성이식신신병（CAN）후적치료정황。결과112례중인、신1，3，5년존활솔（인、신균존활）분별위96.4%，85.7%，74.1%。술후1례발생가속배척반응，9례발생급성배척반응，8례발생급성신소관배사，위수술기사망인3례，1례출현외과병발증뇨루。112례중술후실방6례，공사망11례，제위수술기사망3예외，기여8례균위대정상신공능사망。기중5례인악성종류사망，점4.5%。인、신5년존활솔비교：치료조56례중46례존활，존활솔위82.1%，대조조46례중37례존활，존활솔위80.4%，2조비교차이무통계학의의（P>0.05）。5년중치료조56례중발생신공능이상자9례，발생솔위16.1%，대조조46례중발생신공능이상자19례，발생솔위41.3%，치료조신공능이상적발생솔저우대조조（P<0.01）。2조환자술후인신공능이상진단위CAN자공28례。재면역억제제감량혹절환면역억제제적동시채용단삼분침정점치료，련속2주정맥적주，치료전후혈기항평균하강（84.3±24.5）μmol/L。결론재상규항배이치료적기출상가용단삼급동충하초제제대신이식환자유교호적료효，동시단삼제제대우CAN유일정적치료작용。
Objective To sum up the clinical experiences and curative effects of preparations of Danshen (Radix Salviae Miltiorrhizae) and Dongchongxiacao (Cordyceps) applied in renal transplantation in 112 patients. Methods The clinical data of 112 patients with renal transplantation were retrospectively analyzed from 2003 to 2007. The patients were randomly divided into treatment group (n=56) and control group (n=46). The two groups were treated with immunosuppressant and treatment group was additionally given preparations of Danshen and Dongchongxiacao. The survival rates of both patients and kidneys after 1 year, 3 years and 5 years, postoperative rejection, complications, major causes of death, and abnormal renal function were observed respectively. The treatment of chronic allograft nephropathy (CAN) was observed too. Results The survival rates of both patients and kidneys were 96.4%, 85.7%and 74.1%in 112 patients, respectively, after 1 year, 3 years and 5 years. There was 1 Objective To sum up the clinical experiences and curative effects of preparations of Danshen (Radix Salviae Miltiorrhizae) and Dongchongxiacao (Cordyceps) applied in renal transplantation in 112 patients. Methods The clinical data of 112 patients with renal transplantation were retrospectively analyzed from 2003 to 2007. The patients were randomly divided into treatment group (n=56) and control group (n=46). The two groups were treated with immunosuppressant and treatment group was additionally given preparations of Danshen and Dongchongxiacao. The survival rates of both patients and kidneys after 1 year, 3 years and 5 years, postoperative rejection, complications, major causes of death, and abnormal renal function were observed respectively. The treatment of chronic allograft nephropathy (CAN) was observed too. Results The survival rates of both patients and kidneys were 96.4%, 85.7%and 74.1%in 112 patients, respectively, after 1 year, 3 years and 5 years. There was 1 case with accelerated rejection, 9 cases with acute rejection, 8 with acute tubular necrosis, 1 with urinary fistula, and 11 missed follow-up. There were totally 11 cases died, among them 3 died in perioperative period and 8 died with normal renal function including 5 died of cancer (4.5%). The comparison of survival rates of both patients and kidneys after 5 years showed that the survival rate was 82.1% (46/56) in treatment group and 80.4% (37/46) in control group (P>0.05), and incidence of abnormal renal function was 16.1%(9/56) in treatment group and 41.3%(19/46) in control group (P<0.01). There were 28 cases diagnosed as CAN in two groups. At the same time of reducing the dose of immunosuppressant or changing it, these cases were given intravenous drip of Danshenfen Injection for 2 weeks and the level of serum creatinine decreased averagely by (84.3 ± 24.5)μmol/L. Conclusion The additional application of the preparations of Danshen and Dongchongxiacao besides of routine anti-rejection treatment has a good curative effect in the patients with renal transplantation, and similarly preparation of Danshen has the therapeutic effect on CAN.
