本文關(guān)鍵詞：加味四妙丸基礎(chǔ)上應(yīng)用“青敷”治療CKD痛風(fēng)急性發(fā)作濕熱痹絡(luò)證的療效觀察　出處：《南京中醫(yī)藥大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

  更多相關(guān)文章： CKD 痛風(fēng)急性發(fā)作 濕熱痹絡(luò)證 加味四妙丸 青敷

【摘要】：目的:在西醫(yī)及加味四妙丸基礎(chǔ)上,觀察"青敷"治療CKD痛風(fēng)急性發(fā)作濕熱痹絡(luò)證的療效,探討外治法在CKD痛風(fēng)急性發(fā)作中的治療作用,為內(nèi)科臨床應(yīng)用中醫(yī)特色治療提供依據(jù)。方法:收集2015年01月至2016年12月江蘇省中醫(yī)院住院患者共53例,符合CKD及急性痛風(fēng)性關(guān)節(jié)炎濕熱痹絡(luò)證的診斷標(biāo)準(zhǔn),治療組32例,對照組21例。在低嘌呤飲食、堿化尿液、延緩腎功能進(jìn)展等西醫(yī)基礎(chǔ)治療上,治療組予內(nèi)服加味四妙丸聯(lián)合外敷青敷方,對照組予內(nèi)服加味四妙丸方。以1周期為1個(gè)觀察周期,觀察3～4個(gè)周期,比較兩組治療前后關(guān)節(jié)疼痛及功能評分(VAS視覺疼痛評分、關(guān)節(jié)腫痛指數(shù)、關(guān)節(jié)功能評分)、炎癥指標(biāo)(hsCRP、WBC、N)及腎功能(BUN、Scr、UA)等指標(biāo)的變化及不良反應(yīng)。結(jié)果:①治療組總有效率為96.86%,對照組總有效率為90.48%,差異無統(tǒng)計(jì)學(xué)意義(P0.05)。②治療組病情完全緩解最長16天,最短4天,平均(7.81 ±3.27)天;對照組病情完全緩解最長27天,最短3天,平均(11.33±6.04)天,治療組所需療程短于對照組差異有統(tǒng)計(jì)學(xué)意義(P0.05),提示治療組可縮短療程。③兩組在改善VAS視覺疼痛評分、關(guān)節(jié)腫痛指數(shù)、關(guān)節(jié)功能評分、腫痛關(guān)節(jié)周徑、腫痛關(guān)節(jié)皮溫方面,組內(nèi)比較差異有顯著統(tǒng)計(jì)學(xué)意義(P0.01);組間治療前后差值比較,治療組優(yōu)于對照組差異有統(tǒng)計(jì)學(xué)意義(P0.05),提示治療組可較好地緩解CKD痛風(fēng)紅腫熱痛的臨床癥狀。④兩組在改善炎癥指標(biāo)(hsCRP、WBC、N)、腎功能(BUN、Scr、UA)方面,組內(nèi)比較hsCRP、WBC、N、BUN差異有統(tǒng)計(jì)學(xué)意義(P0.05);組間治療前后差值比較無統(tǒng)計(jì)學(xué)意義(P0.05),提示兩組在改善炎癥反應(yīng)及延緩腎功能進(jìn)展方面療效相當(dāng)。⑤兩組治療期間均未見不良反應(yīng)發(fā)生,兩組肝功能指標(biāo)較治療前無變化差異無統(tǒng)計(jì)學(xué)意義(P0.05);兩組血小板較治療前升高,組內(nèi)比較差異有統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論:在西醫(yī)及加味四妙丸基礎(chǔ)上應(yīng)用"青敷"能有較好地緩解CKD痛風(fēng)急性發(fā)作濕熱痹絡(luò)證的臨床癥狀、縮短療程,并且無不良反應(yīng)。
[Abstract]:Objective: on the basis of western medicine and modified Simiao pills, to observe the curative effect of "Qingfu" in treating acute attack of CKD gout with damp-heat arthralgia syndrome, and to explore the therapeutic effect of external treatment method in acute attack of CKD gout. Methods: from January 2015 to December 2016, 53 inpatients in Jiangsu traditional Chinese Medicine Hospital were collected. According to the diagnostic criteria of CKD and acute gouty arthritis, 32 cases in treatment group and 21 cases in control group were treated with western medicine on low purine diet, alkalized urine and delayed progression of renal function. The treatment group was treated with modified Simiao Pill combined with external application of Qingfu recipe, while the control group was treated with Jiawei Simiao Pill recipe. The observation period was 1 cycle, and the observation period was 3 ~ 4 cycles. The scores of joint pain and function before and after treatment were compared. VAS visual pain score, joint swelling and pain index, joint function score, inflammation index and renal function bun were compared between the two groups before and after treatment. Results the total effective rate of the treatment group was 96.86 and the total effective rate of the control group was 90.48%. There was no significant difference in the treatment group (P0.052.The longest 16 days, the shortest 4 days, mean 7.81 鹵3.27) days; In the control group, the longest 27 days, the shortest 3 days, the average of 11.33 鹵6.04 days, the treatment group required a shorter course of treatment than the control group (P 0.05). It was suggested that the treatment group could shorten the course of treatment in improving VAS visual pain score, joint swelling and pain index, joint function score, peripheral diameter of swelling and pain joint, skin temperature of swelling and pain joint. The difference between the two groups was statistically significant (P 0.01). The difference between groups before and after treatment, the treatment group is better than the control group, the difference is statistically significant (P 0.05). It is suggested that the treatment group can relieve the clinical symptoms of CKD gout redness and swelling and heat pain. 4 both groups can improve the inflammation index of hsCRPG-WBCU and renal function. The difference of hsCRP- WBCnbun was statistically significant (P0. 05). There was no significant difference between the two groups before and after treatment, suggesting that the two groups in improving inflammatory reaction and delaying the progress of renal function, there was no adverse reaction occurred in both groups during the treatment period. 5. There was no significant difference in liver function between the two groups before treatment (P 0.05). Platelet levels in both groups were higher than those before treatment. Conclusion: on the basis of western medicine and modified Simiao pills, the application of "Qingfu" can relieve the clinical symptoms of acute attack of CKD gout with dampness-heat Bi collaterals. The course of treatment was shortened without adverse reaction.
【學(xué)位授予單位】：南京中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R259

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