基于真实世界百令片治疗慢性肾脏病疗效评价

Evaluation of the efficacy of Bailing tablets in the treatment of chronic kidney disease based on the real-world data

关键词:  真实事件，百令片，发酵冬虫夏草菌粉，慢性肾脏病，疗效

Key words:  real  event, Bailing  tablet, fermented  Cordyceps powder, chronic  kidney disease, efficacy

摘要:

目的 评价百令片（发酵冬虫夏草菌粉）在慢性肾脏病患者中的临床疗效。方法 收集2014年1月1日至2023年12月31日（连续样本）在杭州市中医院肾病科门诊或住院诊断为慢性肾脏病患者电子医疗数据，根据是否使用百令片分为观察组和对照组，应用倾向性评分匹配消除组间基线差异，统计两组患者疗效差异。结果 研究共纳入符合纳排标准的慢性肾脏病1-4期患者498例，经倾向性评分匹配后，观察组与对照组均为249例，两组基线无统计学差异。1年后观察组总有效率、24小时尿蛋白定量、肾小球滤过率（eGFR）均较对照组改善（P＜0.05）。亚组分析显示男性及对年龄、病程、CKD分期、尿蛋白定量及尿酸水平分层后患者治疗有效率仍高于对照组（P＜0.05）。结论 在中西医结合基础上长期联用百令片能延缓患者肾功能恶化，改善肾功能分期，并使患者尿蛋白减少，具有较好的肾保护作用。

Abstract:

ABSTRACT: OBJECTIVE To evaluate the clinical efficacy of Bailing tablet (fermented Cordyceps sinensis powder) in patients with chronic kidney disease (CKD). METHODS Electronic medical data were collected from patients diagnosed with chronic kidney disease in the Outpatient Department or Inpatient Department of Nephrology, Hangzhou Hospital of Traditional Chinese Medicine from January 1, 2014 to December 31, 2023 (consecutive samples). The patients were divided into treatment group and control group according to whether Bailing Tablets were used or not. The baseline differences between the two groups were eliminated using propensity score matching, and the efficacy differences between the two groups after 1 year treatment were statistically analyzed. RESULTS A total of 498 patients with stage 1-4 chronic kidney disease who met the inclusion and exclusion criteria were included in the study. After propensity score matching, 249 patients were in the treatment group and 249 patients were in the control group. There was no statistically significant difference in the baseline between the two groups. After 1 year treatment, the total effective rate, 24-hour urinary protein and glomerular filtration rate (eGFR) in the treatment group were improved compared with those in the control group (P < 0.05). Subgroup analysis showed that the effective rate of treatment was still better than the control group in male and after stratification for age, disease duration, CKD stage, urinary protein quantification and uric acid level. (P < 0.05). CONCLUSION Long-term combined use of Bailing tablet on the basis of integrated traditional Chinese and western medicine can delay the deterioration of renal function, improve the stage of renal function, and reduce urinary protein, which has a better renal protective effect.