濟(jì)陰宣陽法治療水腫病陰陽兩型病例系列研究
發(fā)布時(shí)間：2018-07-29 19:32
【摘要】：背景:經(jīng)過幾千年的發(fā)展,中醫(yī)在治療水腫病方面有豐富的經(jīng)驗(yàn),臨床治療水腫時(shí)注重整體觀,講究追本溯源,辨證論治,常從肺、脾、腎、三焦論治。然而,隨著社會(huì)環(huán)境的變化和現(xiàn)代醫(yī)學(xué)技術(shù)的進(jìn)步,水腫病的治療亦變得復(fù)雜起來,水腫久治不愈或反復(fù)發(fā)作者,不僅有陽虛不能制水的病因,更因?yàn)橹委熯^程中應(yīng)用利尿劑、激素、溫?zé)崴幍人幬锖膫幗?使其復(fù)加有陰虛原因。陰陽互根互用,陽損及陰,陰損及陽,針對(duì)陰陽兩虛型的水腫,運(yùn)用濟(jì)陰宣陽法治療符合病機(jī),可以為水腫病的中醫(yī)治療打開新的思路。目的:針對(duì)陰陽兩虛型水腫的患者,辨證應(yīng)用濟(jì)陰湯和宣陽湯加減作為干預(yù)措施,以驗(yàn)證濟(jì)陰宣陽法治療陰陽兩虛型水腫的有效性和安全性,探索中醫(yī)濟(jì)陰宣陽法治療水腫的新思路和新方法,為進(jìn)一步的臨床隨機(jī)對(duì)照試驗(yàn)提供一定的立題依據(jù)。方法:本研究采用前瞻性病例系列研究的方法,根據(jù)診斷標(biāo)準(zhǔn)、納入標(biāo)準(zhǔn)、排除標(biāo)準(zhǔn),連續(xù)招募水腫病陰陽兩虛型患者30例。本研究治療水腫病采用濟(jì)陰宣陽之法,通過中醫(yī)辨證,予濟(jì)陰湯和宣陽湯加減治療,每日1劑,分早晚2次溫服,并分別記錄治療前、治療2周后,治療4周后患者體重、水腫變化的記分情況和中醫(yī)癥狀采集量表記分情況。在下肢水腫的測(cè)量時(shí)采用分段測(cè)量腿圍的方法,使測(cè)量誤差性相對(duì)減小。最終將30例陰陽兩虛型水腫患者治療前、治療2周后、治療4周后體重、水腫變化的記分情況以及中醫(yī)癥狀采集量表記分情況進(jìn)行統(tǒng)計(jì)學(xué)分析,并對(duì)其安全性進(jìn)行評(píng)定,以驗(yàn)證濟(jì)陰宣陽法治療陰陽兩虛型水腫的有效性和安全性。結(jié)果:濟(jì)陰宣陽法在改善水腫病陰陽兩虛型患者中醫(yī)癥狀方面療效確切,治療后2周療效指數(shù)在0～70%(不包括0)的有20例,占納入病例的66.67%;治療4周后療效指數(shù)在0～70%(不包括0)的有26例,占納入病例的86.67%,大于70%的有3例,占納入患者的10%。各單項(xiàng)中醫(yī)癥狀積分除"健忘"癥狀外,其余單項(xiàng)中醫(yī)癥狀積分較治療前均有改善,其差異具有統(tǒng)計(jì)學(xué)意義(P0.05)。納入的30例水腫病陰陽兩虛型患者治療前與治療后2周、治療后4周體重、水腫恢復(fù)的時(shí)間及下肢分段周長(zhǎng)的測(cè)定較前減輕,其差異有統(tǒng)計(jì)學(xué)意義(P0.05),提示濟(jì)陰宣陽法對(duì)水腫的改善療效明顯,且未發(fā)現(xiàn)明顯藥物不良反應(yīng)。結(jié)論:濟(jì)陰宣陽法能夠改善水腫病陰陽兩虛型患者水腫嚴(yán)重程度,使水腫癥狀減輕,同時(shí)能夠改善患者陰陽兩虛的癥狀,提示濟(jì)陰宣陽之法對(duì)治療陰陽兩虛型水腫有明顯療效,可以為中醫(yī)臨床辨證治療水腫提供新的思路和方法。
[Abstract]:Background: after thousands of years of development, Chinese medicine has rich experience in the treatment of edema, clinical treatment of edema pay attention to the overall view, pay attention to tracing the source, differentiation treatment, often from the lung, spleen, kidney, tri-Jiao treatment. However, with the change of social environment and the progress of modern medical technology, the treatment of edema has become more complicated. Those who have not been cured for a long time or repeatedly have not only the cause of Yang deficiency but also the use of diuretics in the course of treatment. Hormones, warm-heat drugs and other drugs injure Yin-Jin, so that it adds Yin deficiency reasons. According to the edema of yin and yang deficiency type, the treatment of yin and yang deficiency is in line with the pathogenesis, which can open a new way for the traditional Chinese medicine treatment of edema disease. Objective: to investigate the efficacy and safety of Jiyin decoction and Xuanyang decoction in treating edema of yin and yang deficiency type by syndrome differentiation in order to verify the efficacy and safety of Jiyin Xuanyang method in treating edema of yin and yang deficiency type. To explore new ideas and methods of treating edema with traditional Chinese medicine method of Jiyin Xuanyang, and to provide some basis for further randomized controlled trials. Methods: according to diagnostic criteria, inclusion criteria and exclusion criteria, 30 cases of edema with deficiency of both yin and yang were recruited in this study. In this study, the treatment of edema by the method of Jiyin Xuanyang, through TCM syndrome differentiation, Jiyin decoction and Xuanyang decoction reduced treatment, 1 dose per day, divided into morning and evening, 2 times warm, and recorded before treatment, 2 weeks after treatment, 4 weeks after treatment of the patient's weight, The score of edema change and the score of TCM symptom acquisition scale. In the measurement of lower limb edema, the measurement error of leg circumference is relatively reduced by using the method of measuring leg circumference in sections. Finally, 30 cases of edema with deficiency of both yin and yang were statistically analyzed before treatment, 2 weeks after treatment, 4 weeks after treatment, the score of edema changes and the score of TCM symptom collection scale, and the safety of the patients was evaluated. To verify the efficacy and safety of Jiyin Xuanyang method in treating edema with deficiency of both yin and yang. Results: the curative effect of Jiyin Xuanyang method on improving the symptoms of traditional Chinese medicine in patients with deficiency of both yin and yang in edema was definite. The curative effect index of 20 cases was 0 ~ 70% (not including 0) in 2 weeks after treatment. After 4 weeks of treatment, the curative effect index was 0.70% (excluding 0) in 26 cases, accounting for 86.67% of the cases, and more than 70% in 3 cases, accounting for 10% of the patients. In addition to the "amnesia" symptoms, the other single TCM symptom scores were improved compared with before treatment, the difference was statistically significant (P0.05). The weight, recovery time of edema and segmental circumference of lower extremities in 30 patients with edema before and 2 weeks after treatment, 4 weeks after treatment and 4 weeks after treatment were reduced. The difference was statistically significant (P0.05), suggesting that Jiyin Xuanyang method was effective in improving edema, and no obvious adverse drug reactions were found. Conclusion: the method of invigorating yin and promoting yang can improve the severity of edema in patients with deficiency of both yin and yang, alleviate the symptoms of edema, and improve the symptoms of deficiency of both yin and yang, suggesting that the method of Jiyin and Xuanyang has obvious curative effect on edema of type of deficiency of yin and yang. It can provide new ideas and methods for TCM clinical treatment of edema.
【學(xué)位授予單位】：北京中醫(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)】：R256.51
[Abstract]:Background: after thousands of years of development, Chinese medicine has rich experience in the treatment of edema, clinical treatment of edema pay attention to the overall view, pay attention to tracing the source, differentiation treatment, often from the lung, spleen, kidney, tri-Jiao treatment. However, with the change of social environment and the progress of modern medical technology, the treatment of edema has become more complicated. Those who have not been cured for a long time or repeatedly have not only the cause of Yang deficiency but also the use of diuretics in the course of treatment. Hormones, warm-heat drugs and other drugs injure Yin-Jin, so that it adds Yin deficiency reasons. According to the edema of yin and yang deficiency type, the treatment of yin and yang deficiency is in line with the pathogenesis, which can open a new way for the traditional Chinese medicine treatment of edema disease. Objective: to investigate the efficacy and safety of Jiyin decoction and Xuanyang decoction in treating edema of yin and yang deficiency type by syndrome differentiation in order to verify the efficacy and safety of Jiyin Xuanyang method in treating edema of yin and yang deficiency type. To explore new ideas and methods of treating edema with traditional Chinese medicine method of Jiyin Xuanyang, and to provide some basis for further randomized controlled trials. Methods: according to diagnostic criteria, inclusion criteria and exclusion criteria, 30 cases of edema with deficiency of both yin and yang were recruited in this study. In this study, the treatment of edema by the method of Jiyin Xuanyang, through TCM syndrome differentiation, Jiyin decoction and Xuanyang decoction reduced treatment, 1 dose per day, divided into morning and evening, 2 times warm, and recorded before treatment, 2 weeks after treatment, 4 weeks after treatment of the patient's weight, The score of edema change and the score of TCM symptom acquisition scale. In the measurement of lower limb edema, the measurement error of leg circumference is relatively reduced by using the method of measuring leg circumference in sections. Finally, 30 cases of edema with deficiency of both yin and yang were statistically analyzed before treatment, 2 weeks after treatment, 4 weeks after treatment, the score of edema changes and the score of TCM symptom collection scale, and the safety of the patients was evaluated. To verify the efficacy and safety of Jiyin Xuanyang method in treating edema with deficiency of both yin and yang. Results: the curative effect of Jiyin Xuanyang method on improving the symptoms of traditional Chinese medicine in patients with deficiency of both yin and yang in edema was definite. The curative effect index of 20 cases was 0 ~ 70% (not including 0) in 2 weeks after treatment. After 4 weeks of treatment, the curative effect index was 0.70% (excluding 0) in 26 cases, accounting for 86.67% of the cases, and more than 70% in 3 cases, accounting for 10% of the patients. In addition to the "amnesia" symptoms, the other single TCM symptom scores were improved compared with before treatment, the difference was statistically significant (P0.05). The weight, recovery time of edema and segmental circumference of lower extremities in 30 patients with edema before and 2 weeks after treatment, 4 weeks after treatment and 4 weeks after treatment were reduced. The difference was statistically significant (P0.05), suggesting that Jiyin Xuanyang method was effective in improving edema, and no obvious adverse drug reactions were found. Conclusion: the method of invigorating yin and promoting yang can improve the severity of edema in patients with deficiency of both yin and yang, alleviate the symptoms of edema, and improve the symptoms of deficiency of both yin and yang, suggesting that the method of Jiyin and Xuanyang has obvious curative effect on edema of type of deficiency of yin and yang. It can provide new ideas and methods for TCM clinical treatment of edema.
【學(xué)位授予單位】：北京中醫(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)】：R256.51
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相關(guān)期刊論文 前10條
1 王箏;熊云昭;王萱;吳麗敏;陳立祥;王淼;梁麗娟;許慶友;;趙玉庸從肺論治腎性水腫經(jīng)驗(yàn)[J];中華中醫(yī)藥雜志;2017年03期
2 陳佳靜;葉小舟;張Z，
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