腎衰方治療不同原發(fā)病致CKD3～4期脾腎兩虛濕濁血瘀證臨床研究
發(fā)布時(shí)間：2019-04-26 20:23
【摘要】：目的:本文旨在觀察腎衰方治療不同原發(fā)病(高血壓、糖尿病、慢性腎炎三種原發(fā)病)致慢性腎臟病(CKD)3~4期脾腎兩虛濕濁血瘀證患者的臨床療效,探討腎衰方對治療不同原發(fā)病致慢性腎臟病的中醫(yī)臨床癥狀及實(shí)驗(yàn)室指標(biāo)的影響,進(jìn)一步指導(dǎo)中醫(yī)臨床實(shí)踐。材料與方法:收集在2015年3月~2016年9月期間,遼寧中醫(yī)藥大學(xué)附屬醫(yī)院腎內(nèi)科病房,入院治療的慢性腎臟病(CKD)3~4期患者,依據(jù)本實(shí)驗(yàn)研究所制定的診斷、納入及排除標(biāo)準(zhǔn),共選取115例患者。依據(jù)原發(fā)病分為三組,均予基礎(chǔ)內(nèi)科治療及腎衰方中藥湯劑口服,療程為2周。治療結(jié)束后觀察各組患者治療前后的臨床癥狀積分、腎臟功能相關(guān)指標(biāo),包括血清肌酐(Scr)、血清尿素氮(BUN)、內(nèi)生肌酐清除率(Ccr)的變化情況,計(jì)算總有效率,比較三組臨床療效的差異,并橫向比較腎衰方對不同原發(fā)病的療效和影響。結(jié)果:1.三組患者臨床療效比較疾病療效比較,治療后三組患者的臨床癥狀、體征均有所改善(P0.05),慢性腎炎組總有效率為81.82%,而高血壓組總有效率為56.76%,糖尿病組總有效率為55.88%,以慢性腎炎組改善更為明顯(P0.0167)。中醫(yī)證候療效比較,治療后三組患者的臨床癥狀均有所好轉(zhuǎn)(P0.05),慢性腎炎組總有效率79.55%,高血壓組總有效率54.05%,糖尿病組總有效率50.00%,以慢性腎炎組改善更為明顯(P0.0167)。2.三組患者中醫(yī)癥狀積分比較三組與治療前相比較中醫(yī)癥狀積分均有所降低(P0.05),差異具有統(tǒng)計(jì)學(xué)意義,提示三組治療均有效。治療前后三組間差異比較,高血壓組與糖尿病組組間比較,P㧐0.05,差異無統(tǒng)計(jì)學(xué)意義,慢性腎炎組與其他兩組組間比較,P0.05,差異具有統(tǒng)計(jì)學(xué)意義。3.三組患者腎臟功能相關(guān)指標(biāo)水平比較三組治療后均可降低Scr、BUN,增加Ccr,P0.05,提示差異具有統(tǒng)計(jì)學(xué)意義;而Scr、BUN降低幅度,Ccr上升幅度方面,慢性腎炎組明顯高于高血壓組與糖尿病組(P0.05)。結(jié)論:腎衰方對不同原發(fā)病(高血壓、糖尿病、慢性腎炎三種原發(fā)病)致慢性腎臟病(CKD)3~4期脾腎兩虛濕濁血瘀證的患者,可以有效緩解其臨床癥狀、體征,改善腎臟功能,降低血清肌酐、血清尿素氮,提高內(nèi)生肌酐清除率,尤其對慢性腎炎致慢性腎臟病更具意義。該方對臨床具有指導(dǎo)意義,進(jìn)而拓展其臨床運(yùn)用范圍。
[Abstract]:Objective: to observe the clinical efficacy of Shenshuai recipe in treating chronic renal disease caused by different primary diseases (hypertension, diabetes and chronic glomerulonephritis) in (CKD) 3 / 4 stage of spleen-kidney deficiency and dampness-turbidity and blood stasis syndrome. To explore the effect of Shenshuai recipe on the clinical symptoms and laboratory indexes of chronic kidney disease caused by different primary diseases, and to further guide the clinical practice of traditional Chinese medicine. Materials and methods: from March 2015 to September 2016, the Department of Nephropathy, affiliated Hospital of Liaoning University of traditional Chinese Medicine, and hospitalized patients with chronic kidney disease (CKD) 3 / 4) were collected, according to the diagnosis, inclusion and exclusion criteria established by this laboratory research institute. 115 patients were selected. According to the primary disease, they were divided into three groups and were given basic medical treatment and Shenshuai decoction orally for 2 weeks. After treatment, the clinical symptom score, renal function related indexes, including the changes of serum creatinine (Scr), serum urea nitrogen (BUN), endogenous creatinine clearance rate (Ccr), and the total effective rate were observed before and after treatment, and the total effective rate was calculated. To compare the clinical curative effect of three groups, and to compare the curative effect and influence of Shenshuai recipe on different primary diseases. Results: 1. After treatment, the clinical symptoms and signs of the three groups were improved (P0.05). The total effective rate of chronic nephritis group was 88.82%, and the total effective rate of hypertension group was 56.76%. The total effective rate in the diabetic group was 55.88%, and the improvement was more obvious in the chronic nephritis group (P 0.0167). After treatment, the clinical symptoms of the three groups were improved (P0.05), the total effective rate of chronic nephrotic group was 79.55%, the total effective rate of hypertension group was 54.05%, and the total effective rate of diabetes group was 50.00%, the total effective rate of chronic nephritis group was 79.55%, the total effective rate of hypertension group was 54.05%. The improvement was more obvious in chronic glomerulonephritis group (P0.0167). TCM symptom score of three groups was lower than that of pre-treatment (P0.05), the difference was statistically significant, suggesting that the three groups were effective. Before and after treatment, there was no significant difference between hypertension group and diabetes group (P < 0.05), but there was no significant difference between chronic nephritis group and other two groups (P 0.05, P < 0.05). 3. There was a significant difference between hypertension group and diabetes group (P < 0.05). The levels of renal function related indexes in the three groups were significantly lower than those in the three groups after treatment. The increase of Scr,BUN, and Ccr,P0.05, in the three groups were significantly lower than those in the control group. On the other hand, the decrease of Scr,BUN and the increase of Ccr in chronic nephritis group were significantly higher than those in hypertension group and diabetic group (P0.05). Conclusion: Shenshuai recipe can effectively relieve clinical symptoms, signs and improve renal function in patients with chronic renal disease caused by different primary diseases (hypertension, diabetes mellitus, chronic glomerulonephritis) in (CKD) 3 / 4 stage of spleen-kidney deficiency and dampness-turbidity and blood stasis syndrome. Reducing serum creatinine, serum urea nitrogen and increasing endogenous creatinine clearance rate are especially significant for chronic renal disease induced by chronic nephrosis. This prescription has guiding significance to clinical practice, and then expand its clinical application range.
【學(xué)位授予單位】：遼寧中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R277.5
本文編號：2466358
[Abstract]:Objective: to observe the clinical efficacy of Shenshuai recipe in treating chronic renal disease caused by different primary diseases (hypertension, diabetes and chronic glomerulonephritis) in (CKD) 3 / 4 stage of spleen-kidney deficiency and dampness-turbidity and blood stasis syndrome. To explore the effect of Shenshuai recipe on the clinical symptoms and laboratory indexes of chronic kidney disease caused by different primary diseases, and to further guide the clinical practice of traditional Chinese medicine. Materials and methods: from March 2015 to September 2016, the Department of Nephropathy, affiliated Hospital of Liaoning University of traditional Chinese Medicine, and hospitalized patients with chronic kidney disease (CKD) 3 / 4) were collected, according to the diagnosis, inclusion and exclusion criteria established by this laboratory research institute. 115 patients were selected. According to the primary disease, they were divided into three groups and were given basic medical treatment and Shenshuai decoction orally for 2 weeks. After treatment, the clinical symptom score, renal function related indexes, including the changes of serum creatinine (Scr), serum urea nitrogen (BUN), endogenous creatinine clearance rate (Ccr), and the total effective rate were observed before and after treatment, and the total effective rate was calculated. To compare the clinical curative effect of three groups, and to compare the curative effect and influence of Shenshuai recipe on different primary diseases. Results: 1. After treatment, the clinical symptoms and signs of the three groups were improved (P0.05). The total effective rate of chronic nephritis group was 88.82%, and the total effective rate of hypertension group was 56.76%. The total effective rate in the diabetic group was 55.88%, and the improvement was more obvious in the chronic nephritis group (P 0.0167). After treatment, the clinical symptoms of the three groups were improved (P0.05), the total effective rate of chronic nephrotic group was 79.55%, the total effective rate of hypertension group was 54.05%, and the total effective rate of diabetes group was 50.00%, the total effective rate of chronic nephritis group was 79.55%, the total effective rate of hypertension group was 54.05%. The improvement was more obvious in chronic glomerulonephritis group (P0.0167). TCM symptom score of three groups was lower than that of pre-treatment (P0.05), the difference was statistically significant, suggesting that the three groups were effective. Before and after treatment, there was no significant difference between hypertension group and diabetes group (P < 0.05), but there was no significant difference between chronic nephritis group and other two groups (P 0.05, P < 0.05). 3. There was a significant difference between hypertension group and diabetes group (P < 0.05). The levels of renal function related indexes in the three groups were significantly lower than those in the three groups after treatment. The increase of Scr,BUN, and Ccr,P0.05, in the three groups were significantly lower than those in the control group. On the other hand, the decrease of Scr,BUN and the increase of Ccr in chronic nephritis group were significantly higher than those in hypertension group and diabetic group (P0.05). Conclusion: Shenshuai recipe can effectively relieve clinical symptoms, signs and improve renal function in patients with chronic renal disease caused by different primary diseases (hypertension, diabetes mellitus, chronic glomerulonephritis) in (CKD) 3 / 4 stage of spleen-kidney deficiency and dampness-turbidity and blood stasis syndrome. Reducing serum creatinine, serum urea nitrogen and increasing endogenous creatinine clearance rate are especially significant for chronic renal disease induced by chronic nephrosis. This prescription has guiding significance to clinical practice, and then expand its clinical application range.
【學(xué)位授予單位】：遼寧中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R277.5
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