【摘要】：目的本研究通過觀察程錦國益氣活血化疲湯對(duì)慢性腎炎氣虛血瘀型的中醫(yī)癥狀積分及尿紅細(xì)胞計(jì)數(shù)、24小時(shí)尿蛋白定量、血漿白蛋白、腎功能、體液免疫指標(biāo)等實(shí)驗(yàn)室指標(biāo)水平的影響,客觀評(píng)價(jià)益氣活血化瘀湯對(duì)慢性腎炎氣虛血瘀型的治療作用,并探討其作用機(jī)制。探討程錦國教授益氣活血化瘀湯治療慢性腎炎氣虛血瘀型的療效。方法從2014年10月到2015年12月在溫州市中醫(yī)院腎內(nèi)科門診及住院的患者中篩選,隨機(jī)分為對(duì)照組(30例)和治療組(30例),對(duì)照組用單純西醫(yī)治療(科索亞片),治療組給予在科索亞片的基礎(chǔ)上加用益氣活血化瘀湯,兩組均治療6個(gè)月。觀察兩組患者中醫(yī)癥狀積分及尿紅細(xì)胞計(jì)數(shù)、24小時(shí)尿蛋白定量、血漿白蛋白、腎功能、體液免疫指標(biāo)等實(shí)驗(yàn)室指標(biāo)水平的變化,并對(duì)比兩組療效。結(jié)果1.疾病療效評(píng)價(jià):治療組總有效率86.67%,對(duì)照組總有效率66.67%,兩組有顯著性差異(P0.05)。益氣活血化瘀湯的疾病療效優(yōu)于對(duì)照組。2.證候療效評(píng)價(jià):治療組總有效率83.33%,對(duì)照組總有效率50.00%,兩組有非常顯著性差異(P0.01)。益氣活血化瘀湯的證候療效明顯優(yōu)于對(duì)照組。3.中醫(yī)癥狀總積分評(píng)價(jià):治療后兩組中醫(yī)癥狀總積分有非常顯著性差異(P0.01),益氣活血化瘀湯對(duì)中醫(yī)癥狀的改善明顯優(yōu)于對(duì)照組。4.單項(xiàng)癥狀積分評(píng):治療后兩組在疲倦乏力、自汗、面色黧黑或晦暗、腰痛、肢體麻木癥狀改善方面,有非常顯著性差異(P0.01),在氣短、懶言改善方面,有顯著性差異(P0.05),益氣活血化瘀湯對(duì)于各項(xiàng)癥狀的改善明顯優(yōu)于對(duì)照組。5.血尿療效評(píng)價(jià):治療后兩組尿紅細(xì)胞計(jì)數(shù)有非常顯著性差異(P0.01),益氣活血化疲湯改善血尿明顯優(yōu)于對(duì)照組。6.蛋白尿療效評(píng)價(jià):治療后兩組24小時(shí)尿蛋白定量有顯著性差異(P0.05),益氣活血化瘀湯改善蛋白尿優(yōu)于對(duì)照組。7.腎功能及血白蛋白評(píng)價(jià):治療后兩組血漿白蛋白、肌酐及尿素氮有顯著性差異(P0.05),益氣活血化瘀湯降低肌酐、尿素氮、提高血白蛋白優(yōu)于對(duì)照組。8.免疫指標(biāo)評(píng)價(jià):治療后免疫球蛋白IgG、IgA、補(bǔ)體C3兩組有顯著性差異(P0.05),益氣活血化瘀湯對(duì)血清IgG、IgA、C3改善優(yōu)于對(duì)照組。結(jié)論治療組能有效改善慢性腎炎氣虛血疲型患者的臨床癥狀,尤其在疲倦乏力、自汗、面色黧黑或晦暗、腰痛、肢體麻木的癥狀改善方面,明顯優(yōu)于對(duì)照組,亦能有效減少血尿和蛋白尿,改善白蛋白,穩(wěn)定腎功能,調(diào)節(jié)免疫,提高患者的生存質(zhì)量,表明益氣活血化瘀湯是治療慢性腎炎氣虛血瘀型的有效方劑,為臨床治療慢性腎炎氣虛血疲型提供了新的、安全的治療方法。
[Abstract]:Objective to observe the effect of Cheng Jinguo Yiqi Huoxue Huazhi decoction on TCM symptom score and urine erythrocyte count of chronic nephritis with Qi deficiency and blood stasis syndrome and 24 hours urine protein quantification, plasma albumin and renal function. The effect of humoral immunity index and other laboratory indexes on the therapeutic effect of Yiqi Huoxue Huayu decoction on qi deficiency and blood stasis type of chronic nephritis was evaluated objectively and its mechanism was discussed. To explore the therapeutic effect of Cheng Jinguo Professor Yiqi Huoxue Huayu decoction in treating chronic nephritis with qi deficiency and blood stasis. Methods from October 2014 to December 2015, the patients were selected from outpatients and inpatients of Department of Renal Medicine, Wenzhou traditional Chinese Medicine Hospital. They were randomly divided into control group (30 cases) and treatment group (30 cases). The control group was treated with western medicine alone (Kosova tablet), the treatment group was treated with Yiqi Huoxue Huayu decoction on the basis of Kosova tablet, both groups were treated for 6 months. To observe the changes of TCM symptom score and urine red blood cell count 24 hours urine protein quantity, plasma albumin, renal function, humoral immunity index and so on, and to compare the curative effect between the two groups. Result 1. The total effective rate of the treatment group was 86.67 and that of the control group was 66.67.The difference between the two groups was significant (P0.05). The curative effect of Yiqi Huoxue Huayu decoction was better than that of control group. The total effective rate of the treatment group was 83.33 and that of the control group was 50.00.The difference between the two groups was very significant (P0.01). The syndrome effect of Yiqi Huoxue Huayu decoction was better than that of control group. The total integral evaluation of TCM symptoms: after treatment there was a very significant difference between the two groups (P0.01), Yiqi Huoxue Huayu decoction to improve TCM symptoms was significantly better than the control group. 4. Single symptom score: after treatment, there were significant differences between the two groups in terms of fatigue and fatigue, self-sweating, dark complexion, low back pain, limb numbness (P0.01), improvement of shortness of breath and lazy speech. There was significant difference (P0.05), Yiqi Huoxue Huayu decoction for the improvement of symptoms was significantly better than the control group. 5. Evaluation of the curative effect of hematuria: after treatment, the two groups had very significant difference in urine red blood cell count (P0.01), Yiqi Huoxue Huapi decoction improved hematuria obviously better than the control group. 6. Evaluation of the therapeutic effect of proteinuria: there was significant difference between the two groups after treatment (P0.05), the improvement of proteinuria by Yiqi Huoxue Huayu decoction was better than that of the control group. 7. Renal function and serum albumin evaluation: after treatment, there were significant differences in plasma albumin, creatinine and urea nitrogen between the two groups (P0.05). Yiqi Huoxue Huayu decoction decreased creatinine, urea nitrogen, and increased serum albumin. Evaluation of immune index: after treatment immunoglobulin IgG,IgA, complement C3 had significant difference (P0.05), Yiqi Huoxue Huayu decoction improved serum IgG,IgA,C3 better than control group. Conclusion the treatment group can effectively improve the clinical symptoms of chronic nephritis patients with qi deficiency and blood exhaustion, especially in the aspects of fatigue and fatigue, self-sweating, dark or dark complexion, low back pain and limb numbness, which are obviously superior to those in the control group. It can also effectively reduce hematuria and proteinuria, improve albumin, stabilize renal function, regulate immunity and improve the quality of life of patients. It shows that Yiqi Huoxue Huayu decoction is an effective prescription for treating chronic nephritis with qi deficiency and blood stasis. It provides a new and safe method for the treatment of chronic nephritis qi deficiency and blood exhaustion.
【學(xué)位授予單位】：浙江中醫(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)】：R249;R277.5

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