本文選題：膜性腎病 + 中藥治療　； 參考：《北京中醫(yī)藥大學(xué)》2017年碩士論文

【摘要】：目的進(jìn)一步證實劉玉寧教授治療膜性腎病的中藥方案的有效性,探索更好的治療方案,為中醫(yī)治療成人膜性腎病提供參考。方法本研究屬于回顧性分析研究,共收集67例MN患者,分為中藥組32例、西藥組35例。兩組除給予對癥基礎(chǔ)治療外,中藥組予中藥湯劑,根據(jù)患者個人情況,辨證論治,隨證加減,西藥組均應(yīng)用免疫抑制治療方案,觀察期均為6個月,數(shù)據(jù)采集時間點為治療前、治療3個月、治療6個月后,對兩組24小時尿蛋白、血清白蛋白及中醫(yī)證候積分治療前后療效進(jìn)行對比,運用軟件SPSS 17.0統(tǒng)計分析。結(jié)果1.蛋白尿療效評價:中藥組24小時尿蛋白定量由治療前的4.43±2.64下降至2.58±2.15,臨床痊愈1例,顯效16例,有效14例,無效1例,總有效率96.9%;西藥組24小時尿蛋白定量由治療前的4.80±2.08下降至3.17±2.39,臨床痊愈2例,顯效15例,有效10例,無效8例,總有效率77.1%,兩組均可有效降低尿蛋白的水平,經(jīng)秩和檢驗,P0.05,認(rèn)為兩組在降低尿蛋白水平方面統(tǒng)計學(xué)上無差異。2.中醫(yī)證候?qū)W療效評價:中藥組中醫(yī)證候積分由治療前30.20± 10.76下降至19.00±9.23,臨床痊愈0例,顯效2例,有效19例,無效9例,總有效率70.0%;西藥組中醫(yī)證候積分由治療前26.17± 10.19下降至18.46±8.51,臨床痊愈0例,站效1例,有效13列,無效21例,總有效率40.0%,兩組均可有效改善癥狀,經(jīng)秩和檢驗,P0.05,中藥組在改善癥狀方面優(yōu)于西藥組。3.血清蛋白:中藥組和西藥組均可升高血清白蛋白,經(jīng)協(xié)方差分析,P0.05,認(rèn)為兩組在升高血清白蛋白方面差異不明顯。結(jié)論中藥組在降低尿蛋白水平方面療效顯著,與西藥組的療效無明顯差異;兩組在升高血清白蛋白方面療效相當(dāng);中藥組在改善中醫(yī)證候情況方面優(yōu)于西藥方案,兩者均有療效;劉玉寧教授治療膜性腎病的中醫(yī)治療方案療效顯著,具有較高臨床價值,值得進(jìn)一步探索研究。
[Abstract]:Objective to further confirm the effectiveness of Professor Liu Yuning in treating membranous nephropathy and explore a better treatment scheme to provide reference for the treatment of adult membranous nephropathy.Methods 67 patients with MN were divided into Chinese medicine group (n = 32) and western medicine group (n = 35).In addition to basic symptomatic treatment, the traditional Chinese medicine group was given traditional Chinese medicine decoction. According to the individual situation of the patients, the patients were treated with differentiation of symptoms and signs, plus or minus with the syndrome. The western medicine group were treated with immunosuppressive therapy program, the observation period was 6 months, and the time point of data collection was before treatment.After 3 months of treatment and 6 months of treatment, the effects of 24 hours urine protein, serum albumin and TCM syndromes integral before and after treatment were compared between the two groups. The statistical analysis was carried out by using software SPSS 17.0.Result 1.Evaluation of the therapeutic effect of proteinuria: in the Chinese medicine group, the urinary protein quantity decreased from 4.43 鹵2.64 before treatment to 2.58 鹵2.15. 1 case was cured, 16 cases were effective, 14 cases were effective, and 1 case was ineffective.The total effective rate was 96.90.In the western medicine group, the 24-hour urinary protein quantity decreased from 4.80 鹵2.08 before treatment to 3.17 鹵2.39. The clinical recovery was 2 cases, the effective rate was 15 cases, the effective rate was 10 cases, the total effective rate was 77.1%, and both groups could effectively reduce the level of urinary protein.The rank sum test showed that there was no statistical difference between the two groups in reducing urinary protein levels. 2. 2.Evaluation of TCM syndromes efficacy: the score of TCM syndromes decreased from 30.20 鹵10.76 before treatment to 19.00 鹵9.23 in TCM group. There were 0 cases of clinical recovery, 2 cases of remarkable effect, 19 cases of effective and 9 cases of failure.The score of TCM syndromes in the western medicine group decreased from 26.17 鹵10.19 before treatment to 18.46 鹵8.51, the clinical recovery was 0 cases, the station effect was 1 case, the effective rate was 13 cases, the total effective rate was 40.0%.By rank sum test, P0.05, the traditional Chinese medicine group is better than the western medicine group in improving symptoms. 3.Serum protein: both Chinese medicine group and western medicine group could increase serum albumin, and the analysis of covariance showed that there was no significant difference between the two groups in raising serum albumin.Both of them have curative effect. Professor Liu Yu-ning 's traditional Chinese medicine treatment for membranous nephropathy has remarkable curative effect and has high clinical value, which is worthy of further exploration and study.
【學(xué)位授予單位】：北京中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R249;R277.5

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