本文關鍵詞： 中醫(yī)藥治療 臨床療效 化濁解毒 慢性腎衰竭 臨床研究　出處：《河北醫(yī)科大學》2017年碩士論文　論文類型：學位論文

【摘要】：目的:基于“濁毒理論”運用化濁解毒方治療慢性腎衰竭(CRF)患者,通過臨床觀察其療效及安全性,以期為臨床治療慢性腎衰竭患者提供一種療效確切的治療方法。方法:選擇河北省中醫(yī)院腎病科門診慢性腎衰竭患者180例(血清肌酐3個月內(nèi)持續(xù)穩(wěn)定在442umol/L以下),所有患者隨機分為化濁解毒治療組92例(治療組)和尿毒清治療組88例(對照組)。兩組均在西醫(yī)常規(guī)治療的基礎上。療程為3個月。通過檢測患者治療前后中醫(yī)癥狀積分、血肌酐(Scr)、尿素氮(BUN)、血尿酸(UA)、血漿白蛋白(Alb)、血紅蛋白(HGB)、內(nèi)生肌酐清除率(Ccr)、24小時尿蛋白定量(24h-UTP)、膽固醇(CHOL)、甘油三酯(TG)等來探討化濁解毒方在治療慢性腎衰竭中的臨床療效。結(jié)果:1治療組總有效率為86.59%,中醫(yī)證候總有效率為92.68%;對照組分別為68.75%和71.25%,兩組比較均有統(tǒng)計學意義(P0.01)。2兩組治療前中醫(yī)癥狀積分無明顯差異(P0.05)。兩組患者治療后比較,治療組明顯優(yōu)于對照組(P0.05)。3兩組患者腎功能指標治療前比較無統(tǒng)計學差異(P0.05)。兩組患者治療前后療效比較,BUN、Scr、UA均顯著性下降(P0.01),Ccr均顯著提高(P0.01)。兩組治療后比較,治療組明顯優(yōu)于對照組(P0.05)。4兩組患者治療前CHOL、TG比較無統(tǒng)計學差異(P0.05),具有可比性。兩組患者治療前后比較,CHOL、TG均顯著降低(P0.01)。兩組治療后比較,治療組優(yōu)于對照組(P0.05)。5治療組血紅蛋白、血白蛋白明顯提高,優(yōu)于對照組(P0.05)。6兩組患者治療前24小時尿蛋白定量比較無統(tǒng)計學差異(P0.05)。兩組患者治療前后比較,24h-UTP均顯著減少(P0.01),但治療組明顯優(yōu)于對照組(P0.05)。7治療過程中未發(fā)現(xiàn)嚴重不良反應。結(jié)論:1運用化濁解毒方治療慢性腎功能衰竭,能明顯改善患者的臨床癥狀及腎功能,糾正腎性貧血,提高血漿白蛋白及內(nèi)生肌酐清除率,降低血脂及24小時尿蛋白定量,從而延緩慢性腎衰竭病程進展。2兩組患者在治療過程中均無明顯不良反應的發(fā)生,其安全性值得肯定。3綜上,化濁解毒法在改善癥狀及實驗室指標方面有獨特的優(yōu)勢,且是安全有效的,值得進一步臨床開發(fā)應用和推廣。
[Abstract]:Objective: Based on the "Zhuodu theory" use huazhuojiedu Decoction in treating chronic renal failure (CRF) patients, to observe the clinical efficacy and safety, in order to provide an effective therapy for clinical treatment of patients with chronic renal failure. Methods: patients in the outpatient department of nephropathy of Hebei Provincial Hospital of TCM of chronic renal failure in 180 cases (serum creatinine within 3 months remained stable under 442umol/L), all patients were randomly divided into 92 cases of huazhuojiedu treatment group (treatment group) and Niaoduqing treatment group of 88 cases (control group). The two groups were on the basis of conventional treatment. The course of treatment was 3 months. The patients before and after treatment detection of TCM symptom score, serum creatinine (Scr), urea nitrogen (BUN), blood uric acid (UA), plasma albumin (Alb), hemoglobin (HGB), creatinine clearance rate (Ccr), 24 hour urinary protein (24h-UTP), cholesterol (CHOL), triglyceride (TG). Discussion of Huazhuojiedufang in Clinical efficacy of the treatment of chronic renal failure in 1. Results: the total efficiency of treatment group was 86.59%, the total effective rate of TCM syndromes was 92.68%; the control group were 68.75% and 71.25%, the two groups had statistical significance (P0.01) TCM symptom score had no significant difference between the two groups before treatment (.2 P0.05) two groups of patients. After treatment, the treatment group was significantly better than the control group (P0.05.3) two groups of patients with renal function indexes before treatment had no significant difference (P0.05). Two groups of patients before and after treatment, BUN, Scr, UA were significantly decreased (P0.01), Ccr were significantly higher (P0.01). The two groups after treatment compared with the treatment group than the control group (P0.05 CHOL) before the treatment of.4 patients in the two groups, TG had no significant difference (P0.05), comparable. Two groups of patients before and after treatment, CHOL, TG were significantly decreased (P0.01). The two group after treatment, the treatment group than the control group (P0.05.5 red blood treatment group) Protein, blood albumin increased significantly, better than the control group (P0.05.6) two groups of patients before treatment, 24 hours urine protein had no significant difference (P0.05). Two groups of patients before and after treatment, 24h-UTP decreased significantly (P0.01), but the treatment group was significantly better than the control group (P0.05) found serious adverse reaction.7 treatment in the process of 1. Conclusion: using huazhuojiedu Decoction in treatment of chronic renal failure, clinical symptoms and renal function were obviously improved, correction of renal anemia, increase plasma albumin and creatinine clearance rate, reduce blood fat and 24 hour urinary protein, thereby delaying disease progression of chronic renal failure.2 patients in the two groups no obvious adverse reaction during the treatment, the security of the positive.3 in conclusion, huazhuojiedu method has unique advantages in improving the symptoms and laboratory indexes, and is safe and effective, worthy of further clinical development Application and promotion.

【學位授予單位】：河北醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R277.5

【參考文獻】

相關期刊論文 前10條

1 張玲;熊維建;張?zhí)?;黃連堿對慢性腎功能衰竭大鼠的治療作用及其機制研究[J];中國現(xiàn)代應用藥學;2017年01期

2 王億平;王東;金華;呂勇;程fe;胡順金;茅燕萍;魏玲;劉家生;王立媛;章雪蓮;;清腎顆粒對慢性腎衰竭濕熱證患者免疫炎癥的干預作用[J];中國中西醫(yī)結(jié)合雜志;2016年12期

3 吳競;林雪琴;;益腎降濁沖劑對慢性腎衰竭血清內(nèi)皮素的影響[J];光明中醫(yī);2016年21期

4 姚敏;周恩超;;從虛與毒論治慢性腎衰竭[J];四川中醫(yī);2016年11期

5 楊秀煒;周微;王守永;;慢性腎衰竭從瘀論治[J];長春中醫(yī)藥大學學報;2016年05期

6 易繼飛;;健脾益腎泄?jié)岱街委熉阅I衰竭臨床研究[J];實用中醫(yī)藥雜志;2016年10期

7 胡江華;孫善紅;孫善健;;中藥離子導入治療慢性腎衰竭臨床觀察[J];實用中醫(yī)藥雜志;2016年10期

8 王銀萍;陳靜;王宏安;劉冰冰;孟丹丹;張守琳;;趙振昌教授從虛論治慢性腎衰經(jīng)驗擷菁[J];中國中醫(yī)藥現(xiàn)代遠程教育;2016年19期

9 麻志恒;彭文;倪兆慧;王怡;周家俊;汪年松;鐘利平;余柯娜;何立群;;健脾清化方治療慢性腎臟病(3期)脾虛濕熱型患者的臨床療效觀察[J];中華中醫(yī)藥雜志;2016年10期

10 黃f 萌;嚴曉華;陳麗;張雪梅;;張雪梅教授從脾論治慢性腎臟病的經(jīng)驗[J];浙江中醫(yī)藥大學學報;2016年09期

，

本文編號：1455198