【摘要】：目的:觀察益腎補脾方對慢性腎臟病CKD3期脾腎氣虛證患者鈣磷代謝異常的影響。方法:本研究通過選取60例2014年10月至2016年10月在廣西中醫(yī)藥大學第一附屬醫(yī)院腎內(nèi)科門診就診或住院的符合納入標準和排除標準的慢性腎臟病3期的脾腎氣虛型患者,隨機分為對照組和治療組,對照組給予基礎(chǔ)治療加碳酸鈣D3,治療組在對照組的基礎(chǔ)上加用益腎補脾方,療程6個月。觀察患者的血鈣、血磷、全型甲狀旁腺激素、腎功能、24小時尿蛋白定量、中醫(yī)癥候量化評分等指標,并進行安全性評價,為中醫(yī)治療慢性腎臟病CKD3期脾腎氣虛鈣磷紊提供臨床依據(jù)。結(jié)果:經(jīng)過6個月的臨床研究,經(jīng)統(tǒng)計兩組數(shù)據(jù)所得結(jié)果:(1)血清鈣:治療后,治療組血清鈣平均值為2.13±0.19,對照組平均值為1.92±0.13,兩組結(jié)果經(jīng)過比較,P0.05,差異有統(tǒng)計學意義,治療組療效優(yōu)于對照組。(2)血清磷:治療后,治療組血清磷平均值為1.34±0.02,對照組平均值為1.45±0.03,兩組結(jié)果經(jīng)過比較,P0.05,差異有統(tǒng)計學意義,治療組療效優(yōu)于對照組。(3)全型甲狀旁腺激素(iPTH):治療后,治療組iPTH平均值為72.16±6.27,對照組平均值為76.12±6.43,兩組結(jié)果經(jīng)過比較,P0.05,差異有統(tǒng)計學意義,治療組療效優(yōu)于對照組。(4)血肌酐:治療后,治療組血肌酐平均值為123.02±17.95,對照組平均值為132.28±29.22,兩組結(jié)果經(jīng)過比較,P0.05,差異有統(tǒng)計學意義,治療組療效優(yōu)于對照組。(5)血清尿素氮:治療后,治療組血清尿素氮平均值為9.06±2.07,對照組平均值為10.52±2.32,兩組結(jié)果經(jīng)過比較,P0.05,差異有統(tǒng)計學意義,治療組療效優(yōu)于對照組。(6)24小時尿蛋白定量:治療后,治療組24小時尿蛋白定量平均值為5.75±0.95,對照組平均值為6.31±1.09,兩組結(jié)果經(jīng)過比較,P0.05,差異有統(tǒng)計學意義,治療組療效優(yōu)于對照組。(7)中醫(yī)癥候積分:治療后,治療組中醫(yī)癥候積分平均值為6.60±2.61,對照組平均值為9.00±5.05,兩組結(jié)果經(jīng)過比較,P0.05,差異有統(tǒng)計學意義,治療組療效優(yōu)于對照組。結(jié)論:(1)益腎補脾方可有效改善慢性腎臟病CKD3期脾腎氣虛患者鈣磷代謝異常的指標。(2)益腎補脾方在有效改善CKD3期脾腎氣虛證患者鈣磷代謝的同時還可延緩腎功能的進展。
[Abstract]:Objective: to observe the effect of Yishen Bupi recipe on abnormal calcium and phosphorus metabolism in CKD3 patients with deficiency of spleen and kidney qi. Methods: from October 2014 to October 2016, 60 patients with spleen and kidney qi deficiency in stage 3 of chronic kidney disease were selected from the Department of Nephrology, first affiliated Hospital of Guangxi University of traditional Chinese Medicine. The control group was randomly divided into control group and treatment group. The control group was given basic treatment plus calcium carbonate D3. The treatment group was treated with Yishen Bupi recipe on the basis of control group for 6 months. Serum calcium, phosphorus, total parathyroid hormone, 24 hour urinary protein of renal function, quantitative score of TCM symptoms and so on were observed, and the safety was evaluated. To provide clinical basis for the treatment of chronic kidney disease in CKD3 stage spleen and kidney Qi deficiency calcium phosphorus methodicity. Results: after 6 months of clinical study, the results were as follows: (1) Serum calcium: after treatment, the average value of serum calcium in the treatment group was 2.13 鹵0.19, and the average value in the control group was 1.92 鹵0.13. The results of the two groups were compared with each other (P 0.05). (2) Serum phosphorus: after treatment, the average value of serum phosphorus in the treatment group was 1.34 鹵0.02, and the average value in the control group was 1.45 鹵0.03. (3) after the treatment of (iPTH):, the average iPTH of the treatment group was 72.16 鹵6.27, and the average value of the control group was 76.12 鹵6.43.The results of the two groups were compared with that of the control group (P 0.05). (4) after treatment, the mean value of serum creatinine was 123.02 鹵17.95 in the treatment group and 132.28 鹵29.22 in the control group. The difference between the two groups was statistically significant. (5) the serum urea nitrogen in the treatment group was better than that in the control group. The average value of serum urea nitrogen was 9.06 鹵2.07 in the treatment group and 10.52 鹵2.32 in the control group. There was a significant difference between the two groups. (6) the effect of the treatment group was better than that of the control group. (6) 24 hours urine protein quantification: after treatment, there was no significant difference between the two groups. The quantitative average value of urinary protein in the treatment group was 5.75 鹵0.95, and the average value in the control group was 6.31 鹵1.09.The results of the two groups were compared with that of the control group (P 0.05), the difference was statistically significant. (7) the TCM symptom score of the treatment group was better than that of the control group. (7) after treatment, there was no significant difference between the two groups. The average score of TCM symptom in the treatment group was 6.60 鹵2.61, and the average value in the control group was 9.00 鹵5.05. The difference between the two groups was statistically significant, and the curative effect of the treatment group was better than that of the control group. Conclusion: (1) Yishen Bupi decoction can effectively improve the indexes of abnormal calcium and phosphorus metabolism in CKD3 patients with deficiency of spleen and kidney qi, and (2) Yishen Bupi recipe can effectively improve calcium and phosphorus metabolism in patients with spleen and kidney qi deficiency syndrome in CKD3 stage and delay the progress of renal function at the same time.
【學位授予單位】：廣西中醫(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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