本文關(guān)鍵詞：加味五苓散對(duì)腎病綜合征水腫患者腎小管功能影響的臨床研究　出處：《福建中醫(yī)藥大學(xué)》2017年碩士論文　論文類(lèi)型：學(xué)位論文

  更多相關(guān)文章： 加味五苓散 原發(fā)性腎病綜合征 水腫 腎小管損傷

【摘要】：研究目的:主要觀察加味五苓散對(duì)脾腎陽(yáng)虛型原發(fā)性腎病綜合征水腫患者的臨床療效、水電解質(zhì)及腎小管損傷的影響,進(jìn)一步探討其可能的作用機(jī)理。研究方法:將符合原發(fā)性腎病綜合征合并水腫的脾腎陽(yáng)虛型患者70例,隨機(jī)分為試驗(yàn)組和對(duì)照組,對(duì)照組以常規(guī)西藥治療,試驗(yàn)組在對(duì)照組治療基礎(chǔ)上加加味五苓散顆粒劑(豬苓9g、澤瀉15g、白術(shù)9g、茯苓9g、桂枝6g、黨參12g、黃芪12g、益母草9g、附子(黑順片)3g),全成分,日1劑,每劑與50ml開(kāi)水沖服,2次/天,療程為2周;治療期間,每天監(jiān)測(cè)患者體重、尿量及浮腫變化情況,同時(shí)檢測(cè)治療前后血清白蛋白、24h尿蛋白定量、電解質(zhì)(鉀、鈉)及腎小管損害標(biāo)志物(β2-MG、NAG、NGAL)。研究結(jié)果:1、兩組患者經(jīng)治療后水腫癥狀均有減輕,脾腎陽(yáng)虛的中醫(yī)癥狀減輕,但試驗(yàn)組療效明顯優(yōu)于對(duì)照組。2、治療后兩組血清白蛋白、24h尿蛋白定量均有顯著差異,其中在升高血清白蛋白、降低24h尿蛋白方面試驗(yàn)組效果優(yōu)于對(duì)照組。3、治療后兩組電解質(zhì)紊亂(低鉀、低鈉的發(fā)生率)具有顯著差異,其中試驗(yàn)組療效優(yōu)于對(duì)照組。4、治療后兩組在降低NAG、NGAL方面具有顯著差異,其中試驗(yàn)組的效果明顯優(yōu)于對(duì)照組;而治療后兩組在降低β2-MG方面兩組沒(méi)有顯著差異。研究結(jié)論:加味五苓散聯(lián)合西藥可有效降低西藥利尿治療過(guò)程中腎小管的損傷程度,還可減少電解質(zhì)紊亂的發(fā)生,總體上改善脾腎陽(yáng)虛型PNS水腫患者的臨床癥狀。加味五苓散的臨床應(yīng)用過(guò)程中未發(fā)現(xiàn)明顯副作用,具有臨床實(shí)用價(jià)值。
[Abstract]:Objective: to observe the effect of Jiawei Wuling Powder on the edema of primary nephrotic syndrome with deficiency of spleen and kidney yang and the effect of water electrolyte and renal tubule injury. Methods: 70 patients with primary nephrotic syndrome complicated with edema of spleen and kidney yang deficiency were randomly divided into experimental group and control group, and the control group was treated with routine western medicine. The experimental group was treated with modified Wuling Powder granules (9 g, 15 g, 9 g, 9 g, 6 g, 12 g, 12 g, 12 g, 9 g, 9 g). Radix aconite (Radix aconite 3 g / d, total component, 1 dose per day, 2 times a day with 50 ml boiled water), the course of treatment was 2 weeks; During the treatment, the changes of body weight, urine volume and swelling were monitored every day. At the same time, serum albumin 24 hours urine protein and electrolyte (potassium) were measured before and after treatment. Sodium) and renal tubular damage marker (尾 2-MGN NAGN NGALL). The results showed that the edema symptoms of the two groups were alleviated after treatment, and the TCM symptoms of deficiency of spleen and kidney yang were alleviated. However, the therapeutic effect of the test group was significantly better than that of the control group. After treatment, there were significant differences between the two groups in serum albumin 24 hours urine protein quantification, among which the serum albumin was increased. The effect of the test group was better than that of the control group in reducing 24h urine protein. After treatment, there was a significant difference between the two groups in electrolyte disorder (low potassium, low sodium incidence), and the effect of the test group was better than that of the control group. There was significant difference between the two groups in reducing NGAL after treatment, and the effect of the experimental group was better than that of the control group. However, there was no significant difference between the two groups in reducing 尾 2-MG after treatment. Conclusion: Jiawei Wuling Powder combined with western medicine can effectively reduce the degree of renal tubular injury in the course of diuretic therapy. It can also reduce the occurrence of electrolyte disturbance, improve the clinical symptoms of PNS edema patients with spleen and kidney yang deficiency, and no obvious side effects were found in the clinical application of Jiawei Wuling Powder, which is of clinical practical value.
【學(xué)位授予單位】：福建中醫(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)】：R277.5

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