發(fā)布時間：2018-02-09 09:59

  本文關(guān)鍵詞： 過敏性紫癜性腎炎 中醫(yī)辨證論治 臨床觀察 Meta分析　出處：《湖北中醫(yī)藥大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：目的:研究過敏性紫癜性腎炎(Henoch-schonlein purpura nephritis HSPN)中醫(yī)或中西醫(yī)結(jié)合治療的相關(guān)現(xiàn)代文獻(xiàn)中的辨證規(guī)律、方劑及藥物的使用規(guī)律。系統(tǒng)評價中西醫(yī)結(jié)合治療過敏性紫癜性腎炎的療效。方法:計算機(jī)檢索清華同方CNKI系列數(shù)據(jù)庫、萬方系列數(shù)據(jù)庫、維普網(wǎng)中文科技期刊數(shù)據(jù)庫,對符合納入標(biāo)準(zhǔn)的文獻(xiàn)進(jìn)行統(tǒng)計分析。運(yùn)用方劑計量學(xué)對所納入研究的中醫(yī)辨證分型、方劑、中藥及中藥四氣、五味、歸經(jīng)、功效等特點(diǎn)進(jìn)行統(tǒng)計,總結(jié)出現(xiàn)代醫(yī)家在治療過敏性紫癜性腎炎時的辨證方藥規(guī)律。并系統(tǒng)評價中西醫(yī)結(jié)合治療本病的臨床療效。其中,所選藥物的四氣、性味、歸經(jīng)、功效均依據(jù)新世紀(jì)(第二版)全國高等中醫(yī)藥院校規(guī)劃教材《中藥學(xué)》[1]。結(jié)果:1.共納入國內(nèi)2003年-2016年公開發(fā)表的期刊文獻(xiàn)71篇[2-72],共論及方劑(不包括自擬方)74首,中藥244味,統(tǒng)計中藥2990次。將71篇文獻(xiàn)中辨證分型予以匯總,基本可歸為血熱妄行、風(fēng)熱傷絡(luò)、濕熱內(nèi)蘊(yùn)、脾腎兩虛、氣陰兩虛、肝腎陰虛、脾虛不攝、血熱夾瘀、濕瘀互結(jié)、瘀血內(nèi)阻、衛(wèi)外不固11種,并將各個證型頻次進(jìn)行統(tǒng)計。2.各證型治療使用頻次最高的方劑分別是銀翹散、犀角地黃湯、三仁湯、參芪地黃湯、真武湯、知柏地黃湯、三仁湯和桃紅四物湯、犀角地黃湯、歸脾湯、玉屏風(fēng)散、補(bǔ)陽還五湯和桃紅四物湯。3.對本研究統(tǒng)計的各證型中使用頻次較高的藥物進(jìn)行四氣特性的統(tǒng)計分析提示,寒性藥物的使用頻次最多,熱性藥物使用頻次最少。對本研究統(tǒng)計的各證型中使用頻次較高的藥物進(jìn)行五味特性的統(tǒng)計分析提示,苦味藥物的使用頻次最多,甘味次之,咸味藥物頻次最少。對本研究統(tǒng)計的各證型中使用頻次較高的藥物進(jìn)行歸經(jīng)的統(tǒng)計分析提示,歸肝經(jīng)、心經(jīng)、腎經(jīng)、肺經(jīng)和脾經(jīng)的藥物較多。4.對納入研究的27篇[51,52,55,56,72-94]文獻(xiàn)進(jìn)行中西醫(yī)結(jié)合治療過敏性紫癜性腎炎療效的Meta分析示,在降低血肌酐、尿紅細(xì)胞計數(shù)水平、24小時尿蛋白定量和提高血清白蛋白水平方面中西醫(yī)結(jié)合治療均優(yōu)于單純西醫(yī)治療并可減少肝功能異常、感染和胃腸道反應(yīng)等不良反應(yīng)的發(fā)生。結(jié)論:1.本病證型分布特點(diǎn)、方藥的選用與中醫(yī)對本病病因病機(jī)的認(rèn)識基本一致。2.中醫(yī)治療本病常用方劑為銀翹散、犀角地黃湯、三仁湯、參芪地黃湯、真武湯、知柏地黃湯、桃紅四物湯、歸脾湯、玉屏風(fēng)散、補(bǔ)陽還五湯。3.Meta分析提示中西醫(yī)結(jié)合治療過敏性紫癜性腎炎優(yōu)于單純西醫(yī)治療。
[Abstract]:Objective: to study the syndromes differentiation of Henoch-schonlein purpura nephritis HSPNs in modern literature related to the treatment of Henoch-schonlein purpura nephritis. Systematic evaluation of the efficacy of combination of traditional Chinese and western medicine in the treatment of Henoch-Schonlein purpura nephritis. Methods: the database of Tsinghua Tongfang CNKI series, Wanfang series database, Weipu Web Chinese science and technology periodical database were searched by computer. Statistical analysis of the literature that meets the inclusion criteria. The characteristics of TCM syndrome differentiation, prescription, traditional Chinese medicine and four qi, five flavors, meridians, efficacy, etc., which are included in the study, are statistically analyzed by means of prescription metrology. This paper summarizes the law of TCM prescriptions in the treatment of Henoch-Schonlein purpura nephritis, and systematically evaluates the clinical efficacy of integrated traditional Chinese and western medicine in the treatment of this disease. Efficacy was based on the new century (the second edition) of the Chinese medicine college planning textbook < Pharmacology of Chinese Medicine] [1]. Results: 1. A total of 71 articles of periodicals published from 2003 to 2016 in China [2-72] were included, and the prescriptions (not including 74 prescriptions and 244 flavors of traditional Chinese medicine) were discussed. Statistics of Chinese herbal medicine 2990 times. 71 articles of syndrome differentiation and classification can be classified as blood heat, wind heat injury collaterals, damp-heat accumulation, spleen and kidney deficiency, qi and yin deficiency, liver and kidney yin deficiency, spleen deficiency, blood stasis, dampness and blood stasis, blood stasis, blood stasis, blood stasis, internal obstruction of blood stasis. The most frequently used prescriptions for each syndrome type are Yinqiao Powder, Rhino Corner Rehmannia decoction, Sanren decoction, Shenqi Dihuang decoction, Zhenwu decoction, Zhibai Dihuang decoction, Sanren decoction and Taohong Siwu decoction. Rhino Corner Rehmannia decoction, Guipi decoction, Yupingfeng Powder, Buyang Huanwu decoction and Taohong Siwu decoction .3.The statistical analysis of the four gas characteristics of the drugs with high frequency used in each syndrome type of this study indicates that the use of cold drugs is the most frequent. The statistical analysis of the five flavor characteristics of the drugs with higher frequency in each syndrome type of this study indicates that the bitter drugs are used the most frequently, and the sweet taste is the second. The frequency of saltwater drugs is the least. The statistical analysis of the drugs with higher frequency in each syndrome type of this study indicates that the drugs belong to the liver, heart and kidney meridians. The drugs of lung meridian and spleen meridian were more .4.The Meta analysis of the curative effect of combination of traditional Chinese and western medicine in treating Henoch-Schonlein purpura nephritis (Henoch-Schonlein purpura nephritis) with combined traditional Chinese and western medicine was carried out in 27 articles [51n 52n 55556J 72-94] which were included in the study. In the aspects of urine erythrocyte count level, 24 hour urinary protein quantification and raising serum albumin level, integrated traditional Chinese and western medicine treatment is superior to western medicine treatment alone and can reduce liver function abnormality. The occurrence of adverse reactions such as infection and gastrointestinal reaction. Conclusion 1. The distribution of syndromes, the choice of prescription and the understanding of etiology and pathogenesis of this disease in traditional Chinese medicine are basically consistent. 2. Yinqiao Powder, Rhino Corner and Rehmannia decoction, Sanren decoction are commonly used in the treatment of this disease. Shenqi Dihuang decoction, Zhenwu decoction, Zhibai Dihuang decoction, Taohong Siwu decoction, Guipi decoction, Yupingfeng San, Buyang Huanwu decoction. 3. Meta analysis indicates that the treatment of Henoch-Schonlein purpura nephritis by combination of traditional Chinese and Western medicine is superior to that of western medicine alone.
【學(xué)位授予單位】：湖北中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R692.34

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