發(fā)布時(shí)間：2018-12-24 10:17

【摘要】：目的：通過(guò)對(duì)尿酸性腎病患者的臨床治療與觀察,分析比較消風(fēng)蠲痹湯與苯溴馬隆兩組患者的實(shí)驗(yàn)室檢查、中醫(yī)癥候積分、臨床療效等,明確消風(fēng)蠲痹湯的臨床療效。為該方在臨床上的推廣提供切實(shí)的臨床依據(jù)。方法：收集2015年3月至2015年12月廣東省中西醫(yī)結(jié)合醫(yī)院腎病風(fēng)濕科住院及門(mén)診治療的患者,臨床診斷為尿酸性腎病,中醫(yī)辨證為脾腎虧虛,濕熱痹阻型,符合納入標(biāo)準(zhǔn)及排除標(biāo)準(zhǔn)的受試者60例。隨機(jī)分為中藥組(消風(fēng)蠲痹湯組)和對(duì)照組(苯溴馬隆組),每組各30例。中藥組：西醫(yī)常規(guī)治療,加用消風(fēng)蠲痹湯,水煎劑口服,日一劑,早晚餐后半小時(shí)后服用,連續(xù)治療4周；對(duì)照組：西醫(yī)常規(guī)治療,加苯溴馬隆口服,起始劑量50mg/天,可加量至100mg/天,連續(xù)治療4周。在治療前后分別記錄入組人員的中醫(yī)證候量表評(píng)分,收集治療前后的血清肌酐(SCr)、尿素氮(BUN)、血尿酸(BUA)、胱抑素C (Cys-c),β2微球蛋白(β 2-MG)等。對(duì)所有資料作詳細(xì)記錄并對(duì)其進(jìn)行統(tǒng)計(jì)分析。結(jié)果：1.治療前兩組患者中醫(yī)證候積分水平具有可比性,差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05);治療后兩組中醫(yī)證候臨床療效比較,對(duì)照組共26例,總有效24例(91.31%),其中顯效5例(19.23%),有效19例(73.08%),無(wú)效2例(7.69%)：中藥組共25例,總有效23例(92%),其中顯效16例(64%),有效7例(28%),無(wú)效2例(8%)。兩組患者經(jīng)治療后中醫(yī)證候均有改善,其中中藥組優(yōu)于對(duì)照組,差異具有統(tǒng)計(jì)學(xué)意義(P0.05)。2.兩組治療前SCr、BUN、BUA、Cys-c,β2-MG水平具有可比性,差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05);治療后兩組SCr、BUN、BUA、Cys-c,β2-MG均較治療前下降,差異有統(tǒng)計(jì)學(xué)意義(P0.05),且中藥組的SCr、BUN、Cys-c、β2-MG下降水平明顯,優(yōu)于對(duì)照組,組間差異具有統(tǒng)計(jì)學(xué)意義(P0.05)：兩組BUA下降水平差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論：中藥消風(fēng)蠲痹湯在配合常規(guī)西醫(yī)治療的基礎(chǔ)上,對(duì)于尿酸性腎病的臨床癥狀及腎功能實(shí)驗(yàn)室指標(biāo)均有改善,療效顯著,且優(yōu)于苯溴馬隆組的療效；在治療過(guò)程中兩組均未見(jiàn)明顯不良反應(yīng)。消風(fēng)蠲痹湯在改善患者臨床癥狀、降尿酸、保護(hù)腎功能等方面療效顯著。
[Abstract]:Objective: through the clinical treatment and observation of patients with uric acid nephropathy, the clinical efficacy of Xiaofeng Juanbi decoction and benzbromine Malone was analyzed and compared. To provide a practical clinical basis for the clinical promotion of the prescription. Methods: from March 2015 to December 2015, the patients with nephropathy and rheumatism in Department of Nephrology and Rheumatology of Guangdong Provincial Integrated Chinese and Western Medicine Hospital were collected. The patients were diagnosed as uric acid nephropathy, and the syndrome differentiation of TCM was deficiency of spleen and kidney, obstruction of dampness and heat. 60 subjects met the inclusion criteria and exclusion criteria. They were randomly divided into traditional Chinese medicine group (Xiaofeng Juanbi decoction group) and control group (benzbromarone group) with 30 cases in each group. Traditional Chinese medicine group: Western medicine routine treatment, plus Xiaofeng Juanbi decoction, water decoction oral, one dose a day, morning and evening meal half an hour after taking, continuous treatment for 4 weeks; The control group was treated with routine western medicine, taking benbromalone orally for 4 weeks. The initial dose was 50mg/ day, and the dosage could be added to 100mg/ day for 4 weeks. The scores of TCM syndrome scale were recorded before and after treatment. Serum creatinine, (SCr), urea nitrogen, (BUN), (BUA), cystatin C (Cys-c) and 尾 2 microglobulin (尾 2-MG) were collected before and after treatment. Make detailed records of all materials and make statistical analysis of them. Results: 1. Before treatment, the TCM syndromes integral level of the two groups was comparable, the difference was not statistically significant (P0.05); After treatment, there were 26 cases in control group, 24 cases (91.31%) were effective, 5 cases (19.23%) were effective, 19 cases (73.08%) were effective, 2 cases (7.69%) were ineffective. The total effective rate was 92% (23 / 23), including 16 cases (64%), 7 cases (28%) and 2 cases (8%). Two groups of patients after treatment of TCM syndrome improved, the Chinese medicine group is better than the control group, the difference is statistically significant (P0.05). The levels of SCr,BUN,BUA,Cys-c, 尾 2-MG were comparable between the two groups before treatment (P0.05). After treatment, the SCr,BUN,BUA,Cys-c, 尾 2-MG of the two groups were significantly lower than that of the control group (P0.05), and the SCr,BUN,Cys-c, 尾 2-MG level of the TCM group was significantly lower than that of the control group. The difference between the two groups was statistically significant (P0.05): there was no significant difference in the decrease of BUA between the two groups (P0.05). Conclusion: the traditional Chinese medicine Xiaofeng Juanbi decoction can improve the clinical symptoms and renal function laboratory indexes of uric acid nephropathy on the basis of routine western medicine treatment, and the curative effect is significant, and is superior to the effect of benbromalone group. No significant adverse reactions were observed in both groups during the course of treatment. Xiaofeng Juanbi decoction is effective in improving clinical symptoms, reducing uric acid and protecting renal function.
【學(xué)位授予單位】：廣州中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2016
【分類(lèi)號(hào)】：R277.5

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