本文選題：特發(fā)性FSGS + 積雪草��； 參考：《廣西中醫(yī)藥大學(xué)》2017年碩士論文

【摘要】：目的:觀察復(fù)方大黃積雪草顆粒及大黃蟄蟲(chóng)丸治療特發(fā)性局灶節(jié)段性腎小球硬化的療效,以評(píng)價(jià)復(fù)方大黃積雪草顆粒及大黃蟄蟲(chóng)丸的臨床療效及安全性,為尋找廣西特色藥治療特發(fā)性FSGS提供經(jīng)驗(yàn)。方法:選取2015年1月至2016年6月廣西中醫(yī)藥大學(xué)附屬瑞康醫(yī)院、廣西中醫(yī)藥大學(xué)第一附屬醫(yī)院及解放軍三零三醫(yī)院門診及病房收治的分期屬于CKD2~3期,尿蛋白水平小于3.5g/d的特發(fā)性FSGS,中醫(yī)辨證屬脾腎虧虛、濕熱瘀血患者60例為研究對(duì)象,用隨機(jī)數(shù)字表法,隨機(jī)分為A、B、C組,各20例,A組給予厄貝沙坦片,每日1次,每次300mg,于每日清晨時(shí)服藥。B組在A組基礎(chǔ)上予大黃蟄蟲(chóng)丸,每次3g,每日3次。C組在A組基礎(chǔ)上給予復(fù)方大黃積雪草顆粒,每次口服15g,每日3次。三組采取同樣的基礎(chǔ)治療,共同觀察12周。所有患者于用藥前后分別檢測(cè)相關(guān)指標(biāo):ALB、BUN、Scr、TG、TC、LDL-C、HDL-C、PT、APTT、URBC、UCyst C、24UPR。從0周開(kāi)始每隔4周測(cè)1次共4次。同時(shí)觀察患者治療前后的臨床體征及癥狀改善狀況,比較各組治療后的效果。結(jié)果:1、治療后三組患者取得較好的療效,B、C兩組的總有效率分別是89.47%和90.00%,均明顯優(yōu)于A組63.16%(P0.05),差異有統(tǒng)計(jì)學(xué)意義,且B、C兩組療效相近(P0.05)。2、三組中醫(yī)癥候積分經(jīng)過(guò)治療后均有所下降(P0.05),但B、C兩組均較A組下降更為明顯(P0.01),且B、C兩組無(wú)明顯差異(P0.05)。三組治療后24UPR、TC、TG、LDL-C、Scr、BUN、URBC、UCyst C均有所下降,ALB、HDL-C均有所上升(P0.05),但B、C兩組均較A組改善更為明顯(P0.05),且B、C兩組療效相近(P0.05)。3、三組治療前后PT、APTT比較均無(wú)明顯差異(P0.05)。A組患者中有3例出現(xiàn)了上呼吸道感染,B組患者有5例出現(xiàn)了輕度腹瀉,C組患者無(wú)明顯不適。結(jié)論:復(fù)方大黃積雪草顆粒及大黃蟄蟲(chóng)丸對(duì)分期屬于CKD2~3期,尿蛋白水平小于3.5g/d的特發(fā)性FSGS且中醫(yī)辨證屬脾腎虧虛,濕熱瘀血的患者臨床療效較好,且兩種藥物的療效相當(dāng),但復(fù)方大黃積雪草顆粒不良反應(yīng)較少。
[Abstract]:Objective: to observe the curative effect of compound rhubarb asiatica granule and rhubarb Zhizheng pill in the treatment of idiopathic focal segmental glomerulosclerosis, and to evaluate the clinical efficacy and safety of compound rhubarb asiatica granule and rhubarb Zhizheng pill. To provide experience for finding characteristic drugs in Guangxi for treating idiopathic FSGS. Methods: from January 2015 to June 2016, the stage of outpatient treatment and ward treatment of Ruikang Hospital affiliated to Guangxi University of traditional Chinese Medicine, the first affiliated Hospital of Guangxi University of traditional Chinese Medicine and the PLA 303 Hospital were classified as CKD2~3. 60 patients with deficiency of spleen and kidney and blood stasis due to dampness and heat were divided randomly into group A (n = 20) and group A (n = 20) with irbesartan once a day. Group B was given rhubarb stinging pill on the basis of group A, 3 g each time, and group C was given compound rhubarb asiatica granule on the basis of group A three times a day, taking orally 15g every time, 3 times a day. The three groups received the same basic treatment and were observed for 12 weeks. All the patients were tested for the relative indexes of TCLDL-C PTT APTTBCU UCyst Con 24 UPR. before and after administration of the drug, the relevant indexes were: 1% ALBN BUNG, TGG, TCU, LDL-C, PTT, APTTT BCU, UCyst C, 24 UPR. From 0 weeks to 4 weeks, a total of 4 times every 4 weeks. At the same time, the clinical signs and symptoms were observed before and after treatment. Results the total effective rates of the three groups were 89.47% and 90.005, respectively, which were significantly better than those of group A (63.16P 0.05). The scores of TCM symptoms in the three groups were all decreased after treatment, but both of the two groups were significantly lower than group A (P 0.01), and there was no significant difference between the two groups (P 0.05). After treatment, the levels of HDL-C in all three groups were decreased, but the improvement of HDL-C in both groups was more obvious than that in group A (P 0.05), and the curative effect of group B C was similar to that of group B C (P 0.05). There was no significant difference in PTT APTT between the three groups before and after treatment. In group A, there was no significant difference in the levels of PTT and APTT between the two groups. There was no significant difference between the three groups before and after treatment. In group A, there was no significant difference between the two groups. There were 5 cases of mild diarrhea in group B with respiratory tract infection and no obvious discomfort in group C. Conclusion: compound Rhubarb Xuecao granule and Rhubarb Zhechong Pill belong to CKD2~3 stage, urine protein level is lower than 3.5g/d in idiopathic FSGS, TCM syndrome differentiation belongs to deficiency of spleen and kidney, damp-heat blood stasis is a better clinical effect, and the two drugs have the same curative effect. But the adverse reaction of compound rhubarb asiatica granule is less.
【學(xué)位授予單位】：廣西中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R277.5

【參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 張春伶;孫玉霞;李林;馬家怡;李屹;;基于血管內(nèi)皮生長(zhǎng)因子及其受體途徑的局灶節(jié)段性腎小球硬化大鼠的艾灸干預(yù)隨機(jī)對(duì)照實(shí)驗(yàn)[J];中華中醫(yī)藥雜志;2017年02期

2 董沖霄;劉盼;張璐;王春寒;賀艷光;謝津育;;小劑量激素聯(lián)合他克莫司膠囊治療局灶節(jié)段性腎小球硬化并發(fā)早期腎衰竭對(duì)血壓、血糖和血鉀的影響[J];臨床和實(shí)驗(yàn)醫(yī)學(xué)雜志;2016年24期

3 尚懿純;曹式麗;楊洪濤;李潔;竇一田;;腎蘇Ⅱ方對(duì)局灶節(jié)段性腎小球硬化大鼠Notch-PI3K/PKB通路串話及足細(xì)胞EMT的影響[J];中華中醫(yī)藥雜志;2016年12期

4 趙煥東;李潔;楊洪濤;;辛通暢絡(luò)法對(duì)FSGS大鼠尿蛋白及血漿白蛋白的影響[J];中醫(yī)學(xué)報(bào);2016年08期

5 王君;王賀勇;;大黃蟄蟲(chóng)丸配合西藥治療慢性腎功能衰竭療效觀察[J];山西中醫(yī);2016年05期

6 戴英俠;;小兒腎臟疾病與脂質(zhì)代謝紊亂臨床探討[J];中外醫(yī)療;2016年08期

7 黃勇;曹式麗;;局灶節(jié)段性腎小球硬化之微觀辨證[J];河南中醫(yī);2016年04期

8 董沖霄;劉盼;張璐;王春寒;賀艷光;謝津育;;小劑量激素聯(lián)合他克莫司對(duì)局灶節(jié)段性腎小球硬化并發(fā)早期腎衰竭患者尿β2-MG、NAG的影響[J];中國(guó)臨床研究;2016年01期

9 韓世盛;盧嫣;王怡;;中西醫(yī)結(jié)合治療局灶節(jié)段性腎小球硬化療效評(píng)價(jià)及藥物探析[J];時(shí)珍國(guó)醫(yī)國(guó)藥;2016年01期

10 姚梅宏;曾德華;謝飛來(lái);曲利娟;曾玲;李敏;劉慶宏;鄭智勇;;塌陷型與細(xì)胞型局灶節(jié)段性腎小球硬化癥的臨床病理分析[J];臨床與實(shí)驗(yàn)病理學(xué)雜志;2015年12期

相關(guān)會(huì)議論文 前3條

1 李夏玉;徐楠;李恒;韓飛;程軍;梁倩;陳江華;;環(huán)孢素A作為救援療法用于激素及他克莫司治療抵抗的成人局灶節(jié)段性腎小球硬化[A];2014浙江省腎臟病學(xué)術(shù)年會(huì)論文匯編[C];2014年

2 孫偉;陳繼紅;高坤;周棟;劉麗;賴仁勝;朱萱萱;;大黃蟄蟲(chóng)丸對(duì)阿霉素腎硬化大鼠系膜基質(zhì)抑制作用的實(shí)驗(yàn)研究[A];2008年全國(guó)中西醫(yī)結(jié)合腎臟病南京論壇論文匯編[C];2008年

3 王東生;陳方平;賀石林;解勤之;付斌;李昕;曹星玉;陳焱;;大黃蟄蟲(chóng)丸血漿藥理學(xué)與血清藥理學(xué)作用的比較研究[A];第六屆全國(guó)中西醫(yī)結(jié)合基礎(chǔ)理論研究學(xué)術(shù)研討會(huì)暨第二屆湖南省中西醫(yī)結(jié)合學(xué)會(huì)肝病專業(yè)學(xué)術(shù)年會(huì)論文集[C];2010年

相關(guān)碩士學(xué)位論文 前1條

1 傅保娣;芍藥苷對(duì)缺氧損傷人臍靜脈內(nèi)皮細(xì)胞的影響[D];山東大學(xué);2007年

，

本文編號(hào)：1860588