本文關鍵詞：補氣祛風法治療膜性腎病的理論探討及臨床療效觀察　出處：《南京中醫(yī)藥大學》2017年碩士論文　論文類型：學位論文

  更多相關文章： 膜性腎病 補氣祛風法 臨床觀察

【摘要】：目的:探討補氣祛風法在膜性腎病治療中的理論基礎,并觀察補氣祛風法聯(lián)合常規(guī)療法對膜性腎病的臨床療效,為臨床綜合治療本病提供新的恩路和方案。方法:理論研究方面主要通過文獻檢索和閱讀,回顧膜性腎病的治療方法,總結(jié)周師治療膜性腎病的臨床經(jīng)驗,提出補氣祛風法治療膜性腎病的方案。臨床研究方面,共收集膜性腎病患者30例,隨機分為治療組與對照組各15例,對照組給予基礎治療聯(lián)合激素治療,治療組在對照組的基礎上配合補氣祛風法中藥方劑口服,療程為6個月,觀察治療前后兩組患者尿蛋白定量、血肌酐、尿素氮、癥候積分的變化并進行臨床療效分析。結(jié)果:(1)補氣祛風法治療膜性腎病符合膜性腎病氣虛風擾的病理特點,能夠針對膜性腎病的患者標本兼治,從而達到改善臨床癥狀和指標的作用。(2)治療前:治療組中醫(yī)癥候積分為(22.66±9.93),對照組中醫(yī)癥候積分為(23.71±8.86),p0.05,具有可比性;治療后:治療組中醫(yī)癥候積分為(8.00±6.26),對照組中醫(yī)癥候積分為(16.45士8.80),p0.05,差異有統(tǒng)計學意義。治療組各癥狀的積分中,肢體水腫、咽喉不適、食欲、睡眠方面改善最為明顯。(3)治療前:治療組尿蛋白定量均值為(6.82±2.06)g/d,對照組尿蛋白定量均值為(5.91±2.10)g/d,p0.05;治療后:治療組尿蛋白定量均值為(2.47±0.93)g/d,與同組治療前數(shù)值比較p0.05,差異有統(tǒng)計學意義;對照組尿蛋白定量均值為(3.58±2.23)g/d,p0.05,與同組治療前數(shù)值比較p0.05,差異有統(tǒng)計學意義;兩組治療后尿蛋白定量比較p0.05,差異有統(tǒng)計學意義。(4)兩組患者治療前后血肌酐、尿素氮指標對比無顯著差異。(5)兩組患者總療效的比較。兩組均有良好療效,治療組有效率為86.7%,對照組有效率60.0%。p0.05,差異有統(tǒng)計學意義。結(jié)論:補氣祛風法治療膜性腎病符合其中醫(yī)腎氣虛而風邪內(nèi)擾的病理特點。在臨床應用中,能夠顯著改善膜性腎病患者的臨床癥狀,尤其在肢體水腫、咽喉不適、食欲、睡眠方面改善最為明顯,對于蛋白尿的降低也起到積極的作用,聯(lián)合常規(guī)治療,能夠提高臨床療效,延緩腎病進展,臨床應推廣應用并進一步的研究探索。
[Abstract]:Objective: to explore the theoretical basis of tonifying qi and expelling wind in the treatment of membranous nephropathy, and to observe the clinical effect of tonifying qi and expelling wind combined with routine therapy on membranous nephropathy. Methods: through literature retrieval and reading, review the treatment of membranous nephropathy, summarize Zhou Shi's clinical experience in treating membranous nephropathy. In clinical study, 30 patients with membranous nephropathy were randomly divided into treatment group (n = 15) and control group (n = 15). Treatment group on the basis of the control group combined with tonifying qi and dispelling wind traditional Chinese medicine prescription oral, the course of treatment is 6 months, observed before and after treatment of two groups of patients urine protein quantitative, blood creatinine, urea nitrogen. Results the treatment of membranous nephropathy with tonifying qi and expelling wind accords with the pathological characteristics of qi deficiency and wind disturbance of membranous nephropathy, and can be used to treat both symptoms and symptoms of membranous nephropathy. So as to improve the clinical symptoms and indicators before treatment: the treatment group TCM symptom score is 22.66 鹵9.93, the control group TCM syndrome score is 23.71 鹵8.86). P0.05, comparable; After treatment, the TCM symptom score of the treatment group was 8.00 鹵6.26g, while that of the control group was 16.45 鹵8.80 / p0.05. The difference was statistically significant. In the treatment group, there were edema of limbs, discomfort of pharynx and larynx, appetite. Before treatment, the quantitative average of urinary protein in the treatment group was 6.82 鹵2.06 g / d, and that in the control group was 5.91 鹵2.10 g / d. P0.05; After treatment, the quantitative mean of urinary protein in the treatment group was 2.47 鹵0.93g / d, which was significantly higher than that before treatment (p0.05). The quantitative mean of urinary protein in the control group was 3.58 鹵2.23 g / d P 0.05, which was significantly different from that of the control group before treatment. Urine protein quantitative comparison between the two groups after treatment p0.05, the difference was statistically significant. 4) before and after treatment of the two groups of patients serum creatinine. There was no significant difference in urea nitrogen index between the two groups. There was good curative effect in both groups. The effective rate was 86.7 in the treatment group and 60.0.p0.05 in the control group. Conclusion: the treatment of membranous nephropathy by tonifying qi and expelling wind accords with the pathological characteristics of deficiency of kidney qi and internal disturbance of wind. In clinical application, it can significantly improve the clinical symptoms of patients with membranous nephropathy. Especially in limb edema, throat discomfort, appetite, sleep improvement is the most obvious, for the reduction of proteinuria also plays a positive role, combined with conventional treatment, can improve the clinical efficacy, delay the progression of nephropathy. Clinical application should be popularized and further research should be carried out.
【學位授予單位】：南京中醫(yī)藥大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R277.5

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