本文關(guān)鍵詞： 腎性貧血 益腎清利 活絡(luò)泄?jié)岱?臨床研究　出處：《南京中醫(yī)藥大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：目的:評價"益腎清利、活絡(luò)泄?jié)?法治療慢性腎臟病3-5期腎性貧血的臨床療效,提高中醫(yī)對該病理論及診療方面的認(rèn)識。方法:采用臨床觀察法,納入的100例患者均是2015.03-2016.12就診于江蘇省中醫(yī)院腎內(nèi)科門診或住院治療的符合中、西醫(yī)診斷標(biāo)準(zhǔn)為腎性貧血(非透析)的患者,試驗組和對照組各50例。對照組50例除基礎(chǔ)治療外,加用多糖鐵復(fù)合物膠囊0.3g/d及葉酸片15mg/d口服。治療組50例在對照組治療的基礎(chǔ)上予"益腎清利、活絡(luò)泄?jié)?法辨證治療,中藥每日一劑,三餐后溫服;1個月為1個療程,觀察2個療程。觀察治療前后試驗組與對照組的中醫(yī)證候、血常規(guī)指標(biāo)、腎功能指標(biāo),比較臨床療效,并觀察和記錄不良反應(yīng)。結(jié)果:中醫(yī)證候積分療效對比:比較試驗組及對照組治療前后中醫(yī)證候總積分,試驗組總有效率76%,對照組總有效率42%,兩組使用經(jīng)秩和檢驗,試驗組中醫(yī)總體療效優(yōu)于對照組,差異有統(tǒng)計學(xué)意義(P0.05)。試驗組、對照組治療前后神疲乏力、腰腿酸軟、面色蒼白或萎黃、浮腫、納差、惡心嘔吐、肢體麻木等臨床癥狀均有所緩解,其中治療前后試驗組與對照組相比,神疲乏力、腰腿酸軟、浮腫、大便干結(jié)等癥狀改善明顯,面色萎黃或蒼白、納差、惡心嘔吐、肢體麻木等癥狀改善與對照組相比無明顯統(tǒng)計學(xué)意義。西醫(yī)疾病療效比較:試驗組、對照組治療前后血常規(guī)、腎功能等指標(biāo)均有好轉(zhuǎn),其中與對照組相比,試驗組血常規(guī)中的Hb、Hct,腎功能中的Scr、Ccr等指標(biāo)均有明顯改善,兩組治療后血常規(guī)、腎功能指標(biāo)對比有顯著差異。試驗組和對照組總有效率分別為50%和38%,經(jīng)秩和檢驗,P0.05,并不能說明試驗組與對照組之間有明顯差異。結(jié)論:益腎清利活絡(luò)泄?jié)岱ǜ纳颇I功能的同時,能夠改善腎性貧血,且療效顯著,該法以補腎為先,重視健脾養(yǎng)胃滋養(yǎng)后天,兼顧活血清利,使正氣得復(fù),氣血得調(diào)。尤其在中醫(yī)證候方面,改善患者神疲乏力、腰腿酸軟、浮腫、納差、大便干結(jié)等諸多癥狀,提高了患者的生存質(zhì)量。同時,對于提高患者血紅蛋白水平,穩(wěn)定腎功能方面,試驗組均高于對照組,表明益腎清利活絡(luò)泄?jié)岱ǜ纳颇I性貧血療效確切。
[Abstract]:Objective: To evaluate the Yishen kiyotoshi, active clinical curative effect of Xiezhuo "treatment of stage 3-5 chronic kidney disease renal anemia, to improve the understanding of the theory of traditional Chinese medicine diagnosis and treatment of the disease. Methods: the clinical observation, 100 cases of patients were 2015.03-2016.12 admitted to Jiangsu Province Traditional Chinese Medicine Hospital Nephrology outpatient or inpatient treatment in accordance with the diagnostic criteria of Western medicine, for renal anemia (non dialysis patients), the experimental group and the control group with 50 cases in each group. The control group of 50 cases in addition to the basic treatment, combined with Iron Polysaccharide Complex Capsules 0.3g/d and Folic Acid Tablets 15mg/d orally. The treatment group of 50 cases in the control group based on the treatment of treated by Yishen kiyotoshi, active relief" the method of syndrome differentiation and treatment, traditional Chinese medicine and twice a day, after meals day; 1 months for 1 courses, 2 courses of treatment. TCM syndromes, experimental group and control group before and after treatment, blood routine, renal function, and to observe the clinical efficacy. And the adverse reactions were recorded. Results: comparison of efficacy of TCM points: a comparison between the experimental group and the control group before and after treatment of TCM syndrome total score, total effective rate of the experimental group 76%, control group total effectiveness 42%, two groups using the rank sum test, the test group was better than that of traditional Chinese medicine the overall efficacy of the control group, the difference was statistically significant (P0.05). The experimental group and control group before and after treatment, lassitude, yaotuisuanruan, pale or sallow complexion, edema, anorexia, nausea and vomiting, numbness and other symptoms were relieved after treatment the experimental group compared with the control group, lassitude, yaotuisuanruan, edema, dry stool symptoms improved significantly. Pale or sallow complexion, anorexia, nausea and vomiting, numbness and other symptoms improved compared with the control group was not statistically significant. Compared with western medicine disease curative effect: the experimental group, the control group before and after treatment, blood routine, renal function indexes were improved, the In the experimental group compared with the control group, routine blood test, Hb, Hct, renal function in Scr, Ccr and other indicators were significantly improved after treatment in the two groups, blood routine, renal function indexes were significantly different between the experimental group and the control group. The total effective rate was 50% and 38%, the rank and inspection, P0.05, and not that there are obvious differences between the experimental group and the control group. Conclusion: Yishen kiyotoshi active Xiezhuo method to improve kidney function at the same time, can improve renal anemia, and the effect is significant, the kidney for the first, pay attention to spleen and stomach nourishing acquired, both Huoxue Qingli, the gas is too complex, and so adjustable. Especially in the TCM syndrome, improve patient lassitude, yaotuisuanruan, edema, anorexia, dry stool and other symptoms, improve the quality of life of the patients. At the same time, to improve the hemoglobin level in patients with stable renal function, the experimental group were higher than the control group, showed Yishen kiyotoshi The method of activating collaterals and relieving turbidity is effective in improving renal anemia.

【學(xué)位授予單位】：南京中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R277.5

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