發(fā)布時間：2018-03-27 06:13

  本文選題：降濁湯　切入點：慢性腎衰竭失代償期　出處：《黑龍江省中醫(yī)藥科學(xué)院》2017年碩士論文

【摘要】：目的:通過觀察降濁湯治療慢性腎衰竭失代償期脾虛濕濁、瘀血阻滯證的臨床療效,并為中醫(yī)藥治療慢性腎衰竭提供一定的依據(jù)。方法:選取2015年6月至2016年12月在黑龍江省中醫(yī)醫(yī)院腎六科門診和住院處被確診為慢性腎衰竭(脾虛濕濁、瘀血阻滯證)的患者,符合中西醫(yī)納入標準56例:治療組(服用降濁湯)28例、對照組(服用尿毒清顆粒)28例。兩組以不間斷用藥60天為一個療程進行臨床觀察,觀察治療前后臨床癥狀積分和實驗室指標:Scr、BUN、血鉀、血鈉、血鈣、血磷等數(shù)值的變化,并在本療程結(jié)束后統(tǒng)計數(shù)據(jù)結(jié)果。結(jié)果:1.治療組患者臨床癥狀治療總有效率為82.14%,對照組為60.71%,兩組相比P0.05,具有顯著性差異,治療組療效優(yōu)于對照組。2.兩組的中醫(yī)癥候積分治療前差別無顯著性P0.05,治療后均減少,并且治療組優(yōu)于對照組,具有顯著性差異P0.05。3.治療前,治療組與對照組Scr和BUN經(jīng)過統(tǒng)計學(xué)分析,差別無顯著性(P0.05),具有可比性。治療后與治療前相比差別具有顯著性P0.05,并且治療后治療組BUN、Scr呈現(xiàn)明顯下降,治療組明顯優(yōu)于對照組,差別具有顯著性P0.05。4.兩組治療前24小時尿蛋白定量、尿常規(guī)紅細胞計數(shù)比較,P0.05,差別無顯著性;兩組治療后24小時尿蛋白定量、尿常規(guī)紅細胞計數(shù)比較P0.05,差別具有顯著性。對照組治療前后24小時尿蛋白定量比較,P0.05,差別具有顯著性。5.治療前治療組與對照組血鉀、血鈉、血鈣、血磷水平經(jīng)過統(tǒng)計學(xué)分析,P0.05,差別無顯著性。治療后與治療前相比差別具有顯著性P0.05,治療后治療組血鉀、血磷水平明顯降低,血鈉、血鈣明顯升高,治療組優(yōu)于對照組,差別具有顯著性P0.05.結(jié)論:1.在中醫(yī)基礎(chǔ)理論的指導(dǎo)下辨證論治,以“健脾利濕、活血化瘀”為治療原則,運用降濁湯進行為期兩個月的治療并與服用尿毒清顆粒的對照組進行比較分析,在改善患者臨床癥狀方面具有積極地治療作用。2.經(jīng)過臨床觀察,降濁湯對于改善患者肌酐、尿素氮水平,降低24小時尿蛋白定量和尿常規(guī)紅細胞計數(shù)治療效果顯著,治療后治療組血鉀、血磷明顯降低,血鈉、血鈣明顯升高。3.試驗結(jié)束后,兩組患者均沒有出現(xiàn)明顯的不適癥狀和異常的實驗室指標,所選方藥對于機體的安全指標沒有顯著影響。
[Abstract]:Objective: to observe the clinical effect of Jiangzhuo decoction on spleen deficiency and dampness and blood stasis in the decompensation period of chronic renal failure. Methods: from June 2015 to December 2016, patients with chronic renal failure (spleen deficiency and dampness, blood stasis) were diagnosed as chronic renal failure (spleen deficiency and dampness, blood stasis) in the clinic and inpatient of six departments of traditional Chinese Medicine Hospital of Heilongjiang Province from June 2015 to December 2016. 56 cases were in accordance with the standard of traditional Chinese and western medicine: the treatment group (28 cases taking Jiangzhuo decoction) and the control group (28 cases taking Niaoduqing granule). The two groups were treated continuously for 60 days for a course of clinical observation. To observe the changes of clinical symptom scores and laboratory indexes, such as: Scr-BUN, potassium, sodium, calcium and phosphorus, before and after treatment. Results: 1. The total effective rate of clinical symptom treatment in the treatment group was 82.14 and that in the control group was 60.71. There was a significant difference between the two groups (P 0.05). The curative effect of the treatment group was better than that of the control group .2.There was no significant difference between the two groups before and after treatment (P0.05), and the treatment group was superior to the control group (P0.05.3). There was no significant difference in Scr and BUN between the treatment group and the control group (P 0.05), and there was a significant difference between the treatment group and the control group (P 0.05) after treatment, and after treatment, the bun SCR in the treatment group was significantly lower than that in the control group, and the treatment group was significantly better than the control group. The difference was significant (P0.05.4). The urine protein was measured 24 hours before treatment in the two groups, and there was no significant difference in urine routine erythrocyte count (P0.05) between the two groups, 24 hours after treatment, there was no significant difference in urine protein between the two groups. There was a significant difference in urine routine erythrocyte count between two groups (P 0.05). Before and after treatment, the urine protein in the control group was significantly higher than that in the control group (P 0.05), and the difference was significant. 5. Before treatment, there was a significant difference between the treatment group and the control group in blood potassium, sodium and calcium. There was no significant difference in serum phosphorus level after treatment compared with that before treatment (P 0.05). After treatment, the serum potassium and phosphorus levels in the treatment group were significantly decreased, the serum sodium and calcium levels were significantly increased, and the treatment group was superior to the control group. The difference was significant (P0.05.Conclusion: 1. Under the guidance of the basic theory of TCM, the principle of "invigorating spleen and promoting dampness, promoting blood circulation and removing blood stasis" should be taken as the treatment principle. Compared with the control group taking Niaoduqing granule, Jiangzhuo decoction has positive therapeutic effect in improving the clinical symptoms of patients. 2. After clinical observation, Jiangzhuo decoction can improve the creatinine of patients. Urea nitrogen level, 24 hour urine protein quantity and urine routine red blood cell count were significantly reduced. After treatment, serum potassium and phosphorus were significantly decreased, blood sodium and serum calcium were significantly increased .3.After the end of the trial, There were no obvious symptoms of discomfort and abnormal laboratory indexes in both groups, and the prescription had no significant effect on the safety index of the body.
【學(xué)位授予單位】：黑龍江省中醫(yī)藥科學(xué)院
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R277.5

【參考文獻】

相關(guān)期刊論文 前10條

1 李焦枝;;中藥口服加灌腸佐治慢性腎衰26例療效觀察[J];國醫(yī)論壇;2015年06期

2 陳玉米;;血清胱抑素C在慢性腎臟疾病患者中的臨床研究[J];轉(zhuǎn)化醫(yī)學(xué)電子雜志;2015年03期

3 莫燦強;陳慧敏;;尿毒清顆粒劑治療慢性腎衰竭的臨床療效[J];中國藥物經(jīng)濟學(xué);2015年02期

4 付春梅;皮持衡;傅建萍;張瑋瑋;楊文君;;論濕濁與慢性腎臟病[J];北京中醫(yī)藥大學(xué)學(xué)報;2014年10期

5 鄧韜;;中藥保留灌腸治療慢性腎衰的臨床觀察[J];內(nèi)蒙古中醫(yī)藥;2014年17期

6 孫麗萍;;康腎顆粒治療慢性腎功能不全的療效分析[J];中國醫(yī)學(xué)創(chuàng)新;2013年35期

7 章斌;金劍;金芝貴;吳飛華;;枳殼的藥理作用與臨床應(yīng)用進展[J];醫(yī)藥導(dǎo)報;2013年11期

8 徐培俠;;中藥口服與灌腸治療慢性腎衰的觀察與護理[J];工企醫(yī)刊;2013年03期

9 徐梅香;李紅霞;;腎衰寧片治療慢性腎衰竭69例[J];光明中醫(yī);2013年03期

10 梁黎黎;宋丹;陳健;史偉;;史偉教授從脾腎論治慢性腎功能衰竭經(jīng)驗[J];遼寧中醫(yī)藥大學(xué)學(xué)報;2012年03期

，

本文編號：1670340