發(fā)布時(shí)間：2018-06-19 07:35

  本文選題：狼瘡性腎炎 + 健脾益腎方��； 參考：《廣西中醫(yī)藥大學(xué)》2017年碩士論文

【摘要】：目的:觀察健脾益腎方聯(lián)合西藥治療氣陰兩虛夾瘀型狼瘡性腎炎(LN)的臨床療效,為臨床治療狼瘡性腎炎提供新的方法。方法:將2014年10月1日至2016年8月31日在廣西中醫(yī)藥大學(xué)第一附屬醫(yī)院風(fēng)濕病科、腎病科門(mén)診及住院治療的辯證為氣陰兩虛夾瘀型的LN首診患者66例隨機(jī)分為治療組和對(duì)照組,兩組各33例。對(duì)照組給予醋酸潑尼松、環(huán)磷酰胺(CTX)治療,治療組在對(duì)照組治療基礎(chǔ)上服用健脾益腎方,兩組均連續(xù)治療12周。觀察兩組患者治療前后SLEDAI評(píng)分、中醫(yī)證候積分、血常規(guī)(HGB、WBC、PLT)、24小時(shí)尿蛋白定量、紅細(xì)胞沉降率(ESR)、肝功能(ALB)、腎功能(Sc r、BUN)、補(bǔ)體(C3、C4)、抗ds-DNA抗體指標(biāo)及不良反應(yīng)。結(jié)果:(1)兩組臨床療效的比較:治療組總有效率為87.10%,對(duì)照組總有效率為73.33%,治療組優(yōu)于對(duì)照組(P0.05)。(2)兩組中醫(yī)證候療效的比較:治療組總有效率為87.10%,對(duì)照組總有效率為66.67%,治療組優(yōu)于對(duì)照組(P0.01)。(3)兩組病情積分的比較:兩組治療后SLEDAI積分、中醫(yī)證候積分均較治療前下降,差異有統(tǒng)計(jì)學(xué)意義(P0.01),且治療組優(yōu)于對(duì)照組(P0.01或P0.05)。(4)兩組實(shí)驗(yàn)室指標(biāo)比較:血常規(guī):兩組治療后HGB均升高(P0.05),且治療組優(yōu)于對(duì)照組(P0.05)。兩組治療前后WBC、PLT均無(wú)明顯差異(P0.05)。24小時(shí)尿蛋白定量:兩組治療后24小時(shí)尿蛋白定量均較治療前降低,差異有統(tǒng)計(jì)學(xué)意義(P0.01),且治療組優(yōu)于對(duì)照組(P0.05)。ESR:兩組治療后ESR均下降(P0.01),但治療后組間比較差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。肝功能、腎功能:兩組治療后ALB均升高,Scr、BUN均下降,差異有統(tǒng)計(jì)學(xué)意義(P0.01或P0.05),且治療組優(yōu)于對(duì)照組(P0.05)。免疫指標(biāo):兩組治療后補(bǔ)體C3均上升,抗ds-DNA抗體均下降,差異有統(tǒng)計(jì)學(xué)意義(P0.01),且治療組優(yōu)于對(duì)照組(P0.05)。兩組治療前后補(bǔ)體C4均無(wú)明顯變化(P0.05)。(5)兩組患者不良反應(yīng)發(fā)生率比較:治療組感染、痤瘡的不良反應(yīng)發(fā)生率少于對(duì)照組,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論:健脾益腎方聯(lián)合西藥治療氣陰兩虛夾瘀型狼瘡性腎炎能提高療效,減輕臨床癥狀,改善貧血、腎功能,降低免疫炎癥指標(biāo)及疾病活動(dòng)度,減少感染、痤瘡不良反應(yīng)的發(fā)生。
[Abstract]:Objective: to observe the clinical effect of Jianpi Yishen recipe combined with western medicine in the treatment of lupus nephritis with deficiency of qi and yin and blood stasis, and to provide a new method for the treatment of lupus nephritis. Methods: from October 1, 2014 to August 31, 2016, 66 cases of LN with syndrome of Qi and Yin deficiency and stasis were randomly divided into treatment group and control group in the Department of Rheumatology, Department of Rheumatology, first affiliated Hospital of Guangxi University of traditional Chinese Medicine. There were 33 cases in each group. The control group was treated with prednisone acetate and cyclophosphamide (CTX), the treatment group was treated with Jianpi Yishen recipe on the basis of the control group, both groups were treated continuously for 12 weeks. The SLEDAI score, TCM syndromes score, 24 hour urine protein quantification, erythrocyte sedimentation rate (ESRR), liver function (ALB), renal function (SC rn) BUNN, complement C 3n C 4, anti-ds-DNA antibody index and adverse reactions were observed before and after treatment. Results comparison of clinical efficacy between the two groups: the total effective rate of the treatment group was 87.10, the total effective rate of the control group was 73.33, and the treatment group was superior to the control group (P0.05, P0.05.Y2) the total effective rate of the treatment group was 87.10, the total effective rate of the control group was 66.67, the total effective rate of the treatment group was 87.10, the total effective rate of the control group was 66.67, and the total effective rate of the treatment group was 73.33. The treatment group was better than the control group (P 0.01). The comparison between the two groups: after treatment, the SLEDAI score of the two groups, The scores of TCM syndromes were all decreased compared with those before treatment, and the difference was statistically significant (P 0.01 or P 0.05). The laboratory indexes of the treatment group were better than that of the control group (P 0.01 or P 0.05). The blood routine: the HGB of the two groups increased after treatment, and the treatment group was superior to the control group (P 0.05). There was no significant difference between the two groups before and after treatment. The difference was statistically significant (P 0.01), and the treatment group was superior to the control group (P 0.05). ESR was decreased in both groups after treatment, but there was no significant difference between the two groups after treatment (P 0.05). Liver function, renal function: after treatment, ALB increased and Scrn bun decreased in both groups, the difference was statistically significant (P 0.01 or P 0.05), and the treatment group was superior to the control group (P 0.05). Immunological index: after treatment, complement C3 increased and anti-ds-DNA antibody decreased in both groups, the difference was statistically significant (P 0.01), and the treatment group was superior to the control group (P 0.05). There was no significant change in complement C4 between the two groups before and after treatment. (P 0.05) the incidence of adverse reactions in the treatment group was lower than that in the control group, and the difference was statistically significant (P 0.05). Conclusion: Jianpi Yishen prescription combined with western medicine can improve the curative effect, alleviate clinical symptoms, improve anemia, renal function, reduce immune inflammation index and disease activity, and reduce infection in the treatment of lupus nephritis with Qi and Yin deficiency and blood stasis. The occurrence of acne adverse reactions.
【學(xué)位授予單位】：廣西中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類(lèi)號(hào)】：R593.242

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