本文選題：慢性腎臟病 + 血管鈣化��； 參考：《黑龍江中醫(yī)藥大學(xué)》2017年碩士論文

【摘要】：目的:觀察祛瘀化濁湯改善慢性腎臟病4期濕濁瘀血證患者的殘腎功能、礦物質(zhì)代謝及血管鈣化的療效。方法:篩選2016年3月-2016年12月黑龍江中醫(yī)藥大學(xué)附屬第一醫(yī)院腎病科門診患者,選取符合慢性腎臟病4期合并血管鈣化,中醫(yī)辯證屬于陰陽(yáng)俱虛,兼濕濁瘀血證的患者60例。完善患者初始時(shí)刻各項(xiàng)理化指標(biāo),給予祛瘀化濁湯、西醫(yī)基礎(chǔ)治療及生活飲食控制。4周為一個(gè)療程,所有患者均給予6個(gè)療程的系統(tǒng)中西醫(yī)結(jié)合治療。觀察患者治療前后腎小球?yàn)V過率、中醫(yī)癥狀評(píng)分、鈣、磷,全段甲狀旁腺激素(iPTH),頸動(dòng)脈內(nèi)-中膜厚度(IMT)及阻力指數(shù)(RI),并做出療效評(píng)價(jià)。結(jié)果:祛瘀化濁湯對(duì)慢性腎臟病4期濕濁瘀血證患者治療效果較好,總體有效率達(dá)94.44%,治療后各種中醫(yī)癥狀有所改善(P0.05)。血肌酐、腎小球?yàn)V過濾、血鈣、iPTH經(jīng)過治療后均有明顯改善(P0.01),患者血磷水平在治療前后無明顯改善(P0.05)�；颊哜}磷乘積在治療后有所提高(P0.05),治療后IMT及RI均有不同程度的改善(P0.05)。結(jié)論:祛瘀化濁湯可以有效保護(hù)慢性腎臟病患者殘余腎功能,糾正礦物質(zhì)代謝紊亂以及PTH異常升高,延緩患者血管鈣化,顯著改善患者各種不適癥狀及全身狀態(tài),延緩病情進(jìn)展。
[Abstract]:Objective: to observe the effect of Quyu Huazhuo decoction on residual renal function, mineral metabolism and vascular calcification in patients with dampness and blood stasis syndrome in 4 stages of chronic kidney disease. Methods: from March 2016 to December 2016, 60 patients with chronic kidney disease combined with vascular calcification in the first affiliated Hospital of Heilongjiang University of traditional Chinese Medicine were selected. Improve the initial time of the patients physical and chemical indicators, given Quyu Huazhuo decoction, Western medicine basic treatment and diet control for 4 weeks as a course of treatment, all patients were given 6 courses of integrated Chinese and Western medicine treatment. The glomerular filtration rate, TCM symptom score, calcium, phosphorus, total parathyroid hormone IPTHD, IMT (IMT) and resistance index (RI) were observed before and after treatment, and the curative effect was evaluated. Results: Quyu Huazhuo decoction had a better effect on the patients with dampness and blood stasis syndrome of chronic kidney disease stage 4, the total effective rate was 94.444.After the treatment, all kinds of TCM symptoms were improved (P 0.05). Serum creatinine, glomerular filtration, serum calcium and iPTH were all significantly improved after treatment, and no significant improvement was found in serum phosphorus level before and after treatment. The product of calcium and phosphorus increased after treatment (P 0.05), IMT and RI improved in different degree after treatment. Conclusion: Quyu Huazhuo decoction can effectively protect the residual renal function of patients with chronic kidney disease, correct the disorder of mineral metabolism and the abnormal increase of PTH, delay the vascular calcification of the patients, and significantly improve the patients' symptoms of discomfort and the state of the whole body. Delay the progress of the disease.
【學(xué)位授予單位】：黑龍江中醫(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

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