發(fā)布時(shí)間：2018-02-26 02:31

  本文關(guān)鍵詞： CKD5期 益腎清利 和絡(luò)泄?jié)岱?延緩進(jìn)展 臨床研究　出處：《南京中醫(yī)藥大學(xué)》2016年碩士論文　論文類型：學(xué)位論文

【摘要】：目的：評(píng)價(jià)“益腎清利、和絡(luò)泄?jié)帷狈ㄑ泳徛阅I臟病(CKD5期)病情進(jìn)展的療效,提高中醫(yī)對(duì)該病理論及診療方面的認(rèn)識(shí)。方法：本研究入組符合條件的CKD5期患者共60例。在西醫(yī)一般治療的基礎(chǔ)上,予中醫(yī)“益腎清利、和絡(luò)泄?jié)帷狈訙p治療。收集治療前后臨床癥狀、腎功能、鈣磷代謝、脂質(zhì)代謝、營(yíng)養(yǎng)狀況、安全性等指標(biāo),以4個(gè)月為間隔,隨訪時(shí)間12個(gè)月。最后對(duì)數(shù)據(jù)進(jìn)行統(tǒng)計(jì)分析。結(jié)果：1.臨床癥狀：60例患者治療4月、8月、12月的臨床癥狀積分較0月呈不斷下降的趨勢(shì)。且8月的臨床癥狀積分與0月相比具有統(tǒng)計(jì)學(xué)差異(P0.05),12月的臨床癥狀積分與0月相比具有顯著統(tǒng)計(jì)學(xué)差異(P0.01)。中醫(yī)主癥中“面色晦暗,倦怠乏力,腰膝酸軟,身重困倦,食少納呆,口干”12月的積分與0月相比具有顯著統(tǒng)計(jì)學(xué)差異(P0.01)。2.證候療效：經(jīng)治療12月,60例患者中58例患者的臨床癥狀積分較前有所下降,證候療效的總有效率為81.7%。3.疾病療效：經(jīng)治療12個(gè)月,60例患者中顯效2例(占3.3%),有效31例(占51.7%),穩(wěn)定16例(占26.7%),無效11例(占18.3%)�？傆行Х�(wěn)定率為81.7%,總有效率為55%。4.腎功能：60例患者治療4月、8月、12月的血肌酐較0月均呈下降趨勢(shì)。且4月血肌酐與0月相比具有顯著統(tǒng)計(jì)學(xué)差異(P0.01),8月血肌酐水平與0月相比具有統(tǒng)計(jì)學(xué)差異(P0.05)。60例患者治療4月、8月、12月的腎小球?yàn)V過率較0月呈上升趨勢(shì)。且4月的腎小球?yàn)V過率與0月相比具有顯著統(tǒng)計(jì)學(xué)差異(P0.01),8月腎小球?yàn)V過率與0月相比具有統(tǒng)計(jì)學(xué)差異(P0.05)。5.鈣磷代謝：60例患者治療12月的血磷以及PTH較0月稍有下降,且兩者具有統(tǒng)計(jì)學(xué)差異(P0.05)。6.脂質(zhì)代謝：60例患者治療12月的TC、TG、LDL較0月稍有下降,且兩者差異具有統(tǒng)計(jì)學(xué)差異(P0.05)。7.營(yíng)養(yǎng)狀況：60例患者治療12月的血紅蛋白較0月呈上升趨勢(shì),且兩者差異具有統(tǒng)計(jì)學(xué)差異(P0.05)。8.安全性指標(biāo)：60例患者在整個(gè)治療過程中,出現(xiàn)3例血鉀升高的情況,經(jīng)過降鉀處理,再次給予中藥后,未再出現(xiàn)血鉀升高。60例患者治療過程中均未出現(xiàn)大便顏色的改變,僅2例患者出現(xiàn)便質(zhì)、便次的波動(dòng)。60例患者未見明顯其他的不良反應(yīng)。結(jié)論：“益腎清利、和絡(luò)泄?jié)帷狈▽?duì)改善患者臨床癥狀,特別是主癥方面的療效確切。而且在短期內(nèi)(4-8月)對(duì)改善慢性腎臟病(CKD5期)患者的腎功能具有一定療效。遠(yuǎn)期上可延緩慢性腎臟病(CKD5期)患者病情的進(jìn)展。并且具備一定的調(diào)節(jié)鈣磷代謝、調(diào)脂、糾正貧血的作用。
[Abstract]:Objective: to evaluate the efficacy of "Yishen Qingli, and collateral-draining turbid" method in delaying the progression of chronic kidney disease (CKD5). Methods: 60 patients with CKD5 were enrolled in this study. On the basis of the general treatment of western medicine, the Chinese medicine "Yishen Qingli", "Yishen Qingli", was given. Before and after treatment, clinical symptoms, renal function, calcium and phosphorus metabolism, lipid metabolism, nutritional status and safety were collected at intervals of 4 months. The follow-up time was 12 months. Finally, the data were statistically analyzed. Results: the clinical symptom scores of 60 patients with clinical symptoms: April, August, December showed a decreasing trend compared with 0 months. In December, there was a significant difference in the score of clinical symptoms compared with that in 0 month (P 0.01). Fatigue, weakness of waist and knee, heavy body weight, low intake, dry mouth "the score of December was significantly different from that of 0month (P 0.01) .Syndromes effect: the clinical symptom scores of 58 cases of 60 cases treated in December were lower than those of the previous ones, and the clinical symptom scores of 58 cases were lower than that of the previous ones, and the clinical symptom scores of 58 cases were lower than those of the previous ones. The total effective rate of syndrome curative effect was 81.7.3.The total effective rate was 81.7%. The total effective rate was 81.7%. The total effective rate was 81.7% and the total effective rate was 550.The effective rate was 3.30.The effective rate was 31 cases (51.7%), 16 cases were stable (26.7%), 11 cases were ineffective (18.3%). The total effective stability rate was 81.7%, and the total effective rate was 55.4kidney. In April, August and December, the serum creatinine levels in 60 patients with functional component showed a downward trend compared with that in 0 months. There was a significant difference in creatinine levels between December and 0 months (P 0.01), and there was a statistical difference in serum creatinine levels between #date鈪，

本文編號(hào)：1536185