【摘要】：目的:觀察疏風(fēng)清熱方對(duì)過敏性紫癜性腎炎風(fēng)熱搏結(jié)證患者的臨床療效及其安全性,并初步探討其在治療過敏性紫癜性腎炎風(fēng)熱搏結(jié)證的作用機(jī)制。方法:將符合納入標(biāo)準(zhǔn)的60例過敏性紫癜性腎炎風(fēng)熱搏結(jié)證患者,使用抽簽法隨機(jī)分為試驗(yàn)組和對(duì)照組,每組各30例。兩組患者均給予基礎(chǔ)治療,試驗(yàn)組加用疏風(fēng)清熱方,對(duì)照組加用腎炎康復(fù)片,療程為8周。觀察并分析兩組患者在治療前與治療后中醫(yī)癥狀計(jì)量評(píng)分、24小時(shí)尿蛋白定量、尿紅細(xì)胞計(jì)數(shù)、CD4+、CD8+、CD4+/CD8+、肝功能、腎功能及血壓的變化情況。采用SPSS17.0統(tǒng)計(jì)軟件對(duì)數(shù)據(jù)進(jìn)行處理,觀察疏風(fēng)清熱方對(duì)過敏性紫癜性腎炎風(fēng)熱搏結(jié)證患者的臨床療效,并初步探討其作用機(jī)制。結(jié)果:(1)臨床綜合療效:試驗(yàn)組痊愈5例,顯效12例,有效9例,無(wú)效4例,總有效率為86.67%,對(duì)照組痊愈2例,顯效6例,有效11例,無(wú)效11例,總有效率為63.33%,試驗(yàn)組總有效率高于對(duì)照組,有明顯差異(P0.05)。(2)中醫(yī)癥候療效:治療8周后較治療前,兩組患者的中醫(yī)癥狀計(jì)量評(píng)分均顯著下降(P0.01),且試驗(yàn)組比對(duì)照組下降更顯著(P0.01)。(3)實(shí)驗(yàn)室指標(biāo):治療4周后較治療前,兩組患者的24小時(shí)尿蛋白定量、尿紅細(xì)胞計(jì)數(shù)指標(biāo)均顯著下降(P0.01),但試驗(yàn)組與對(duì)照組相比均無(wú)明顯差別(P0.05);治療8周后較治療前,24小時(shí)尿蛋白定量、尿紅細(xì)胞計(jì)數(shù)、CD4+、CD4+/CD8+指標(biāo)均顯著下降(P0.01),且試驗(yàn)組與對(duì)照組相比均下降更明顯(P0.05);治療8周后較治療前,兩組患者的CD8+指標(biāo)均顯著上升(P0.01),且試驗(yàn)組與對(duì)照組相比均上升更明顯(P0.05)。(4)安全性指標(biāo):兩組患者治療前及治療8周后肝功能及腎功能指標(biāo)均無(wú)顯著變化(P0.05),血壓稍有下降趨勢(shì),但無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論:疏風(fēng)清熱方能顯著改善過敏性紫癜性腎炎風(fēng)熱搏結(jié)證患者的臨床癥狀,通過糾正機(jī)體的免疫功能紊亂,降低患者的24小時(shí)尿蛋白定量及尿紅細(xì)胞計(jì)數(shù),是治療過敏性紫癜性腎炎風(fēng)熱搏結(jié)證患者的有效方劑。
[Abstract]:Objective: to observe the clinical efficacy and safety of Shufeng Qingre recipe in the treatment of allergic purpura nephritis with wind-heat beats, and to explore the mechanism of its effect on the treatment of allergic purpura nephritis. Methods: sixty patients with wind-heat syndrome of Henoch-Schonlein purpura nephritis were randomly divided into experimental group and control group with 30 cases in each group. Two groups of patients were given basic treatment, the trial group plus Shufeng Qingre prescription, the control group plus nephritis rehabilitation tablets, the course of treatment was 8 weeks. To observe and analyze the changes of TCM symptom score, urine protein quantity, urine red blood cell count, CD4, CD8, CD4 / CD8, liver function, renal function and blood pressure in both groups before and after treatment. The data were processed by SPSS17.0 software to observe the clinical effect of Shufeng Qingrefang on patients with allergic purpura nephritis and wind-heat syndrome, and to explore its mechanism. Results: (1) Clinical comprehensive efficacy: in the trial group, 5 cases were cured, 12 cases were markedly effective, 9 cases were effective, 4 cases were ineffective, the total effective rate was 86.67 cases. In the control group, 2 cases were cured, 6 cases were markedly effective, 11 cases were ineffective. The total effective rate was 63.33. The total effective rate of the experimental group was higher than that of the control group (P0.05). (2). The scores of TCM symptom in both groups were significantly decreased (P0. 01), and the laboratory index (P0. 01). (3) in the experimental group was significantly lower than that in the control group (P0. 01). (3). Urine red blood cell count index decreased significantly (P0.01), but there was no significant difference between the test group and the control group (P0.05). After 8 weeks of treatment, 24 hours urine protein, urine red blood cell count, CD4, CD4 / CD8 were significantly decreased (P0.01), and compared with the control group, the decrease was more significant (P0.05). After 8 weeks of treatment, the CD8 indexes of both groups were significantly higher than those before treatment (P0.01). Compared with the control group, the safety indexes of the two groups were significantly increased (P0.05). (4): there were no significant changes in liver function and renal function in both groups before treatment and 8 weeks after treatment (P0.05), and the blood pressure decreased slightly. But there was no statistical significance (P0.05). Conclusion: Shufeng Qingre prescription can significantly improve the clinical symptoms of patients with allergic purpura nephritis with wind-heat knotting syndrome. By correcting the disorder of immune function of the body, it can reduce the 24-hour urine protein quantity and urine red blood cell count in patients with Henoch-Schonlein purpura nephritis. Is the treatment of Henoch-Schonlein purpura nephritis wind-heat syndrome patients with an effective prescription.
【學(xué)位授予單位】：山東中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2016
【分類號(hào)】：R277.5

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