【摘要】：目的:通過觀察腎衰方加桂枝為主多途徑治療CKD3期脾腎陽虛、濕濁血瘀證型患者的療效情況,探討該療法對實驗室指標及中醫(yī)臨床癥狀的影響,為進一步指導中醫(yī)臨床治療實踐提供依據(jù)。材料與方法:1.本次選取2015年1月-2016年12月在遼寧中醫(yī)藥大學附屬醫(yī)院腎內(nèi)科病房診斷為CKD3期脾腎陽虛、濕濁血瘀證型患者共96例,依納入標準、排除標準最終選52例納入研究。選取采用腎衰寧片為主治療的患者納入對照組,共計26例;采用腎衰方加桂枝為主治療的患者納入治療組,共計26例。2.兩組同時給予低鹽、低優(yōu)質(zhì)蛋白等對癥治療;降氮煎劑中藥保留灌腸周五次,結(jié)腸透析治療周兩次。治療組予中藥湯劑腎衰方加桂枝,每日一劑,100ml日三次口服;對照組予腎衰寧片口服,一次5片,一日3次。兩組治療療程二周。3.觀察治療前后兩組患者的臨床癥狀、體征及中醫(yī)證候積分。比較兩組患者治療前后的血清肌酐(Scr)、尿素氮(BUN)、內(nèi)生肌酐清除率(Ccr)的變化。結(jié)果:疾病療效:治療組總有效率為86.7%,對照組總有效率為76.7%,95%CI有重疊,無統(tǒng)計學差異。中醫(yī)證候療效:治療組總有效率92.31%,對照組總有效率57.70%,95%CI無重疊,有統(tǒng)計學差異。結(jié)論:基礎(chǔ)治療結(jié)合口服腎衰方加桂枝、降氮煎劑中藥保留灌腸和結(jié)腸透析治療的三聯(lián)療法可以作為CKD3期脾腎陽虛、濕濁血瘀證型患者的臨床選擇,且此治療方案能更有效改善患者的中醫(yī)證候和尿素氮水平。
[Abstract]:Objective: to observe the curative effect of Shenshuai prescription plus Guizhi in treating CKD3 patients with deficiency of spleen and kidney yang, dampness and blood stasis, and to explore the effect of this therapy on laboratory indexes and clinical symptoms of TCM. To further guide the clinical treatment of traditional Chinese medicine to provide the basis. Materials and methods: 1. From January 2015 to December 2016, 96 cases of CKD3 patients with deficiency of spleen and kidney yang and dampness and turbid blood stasis were diagnosed in Department of Nephrology of affiliated Hospital of Liaoning University of traditional Chinese Medicine. 52 cases were included in the study according to inclusive criteria and exclusion criteria. A total of 26 patients treated with Shenshuai decoction plus Guizhi were included in the control group, and 26 patients were included in the treatment group with Shenshuai decoction plus Guizhi. 2. The two groups were given low salt, low quality protein and other symptomatic treatments. The treatment group was treated with Shenshuai decoction plus Guizhi, one dose of 100ml per day, three times a day, while the control group was given Shenshuaining tablets, 5 tablets once a day, 3 times a day. The two groups were treated for two weeks. The clinical symptoms, signs and TCM syndromes were observed before and after treatment. Serum creatinine (SCR), urea nitrogen (bun) and endogenous creatinine clearance (CCR) were compared before and after treatment. Results: the total effective rate was 86.7 in the treatment group and 76.7in the control group. There was no statistical difference between the two groups. The curative effect of TCM syndrome: the total effective rate of the treatment group was 92.31, the total effective rate of the control group was 57.70 and 95% CI had no overlap, there was statistical difference. Conclusion: the basic treatment combined with oral Shenshuai prescription plus Guizhi, nitrogen-reducing decoction retention enema and colon dialysis can be used as the clinical choice of CKD3 patients with deficiency of spleen and kidney yang, dampness and blood stasis. This treatment can improve TCM syndrome and urea nitrogen level more effectively.
【學位授予單位】：遼寧中醫(yī)藥大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R277.5

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