【摘要】：目的：觀察“益腎清利活血法”延緩慢性腎臟病(CKD4期)患者腎功能減退的臨床療效及安全性。方法：回顧性分析2015年03月至2016年03月江蘇省中醫(yī)院腎內(nèi)科接受診治的符合納入標(biāo)準(zhǔn)的患者64例,從eGFR、Scr、BUN等實(shí)驗(yàn)室指標(biāo)評(píng)估的腎功能及癥狀積分這兩方而反映“益腎清利活血法”臨床療效,從ALT、AST、TC、TG、K等指標(biāo)評(píng)估木法的安全性�？偗煶�12個(gè)月。結(jié)果：(1)臨床癥狀：每治療3個(gè)月,64例患者癥狀總積分均較前減小,12個(gè)月后癥狀總積分與治療前相比,差異具有統(tǒng)計(jì)學(xué)意義(P0.05),總有效率為89.06%,其中顯效8例,有效32例,穩(wěn)定17例。(2)腎功能指標(biāo)：64例患者治療3、6、9、12個(gè)月后Scr、BUN、UA均下降,eGFR上升,且每個(gè)療程與初始比較差別均具有統(tǒng)計(jì)學(xué)意義(P0.05), Scr、eGFR隨時(shí)間(月)變化曲線圖顯示數(shù)值日趨平穩(wěn),說(shuō)明隨著療程延長(zhǎng)腎功能漸穩(wěn)定；患者整體1/Scr隨時(shí)問(wèn)(月)直線回歸斜率b值為正值,說(shuō)明遠(yuǎn)期療效呈改善趨勢(shì)。(3)安全性指標(biāo)：64例患者治療前后還采集了其他實(shí)驗(yàn)室指標(biāo),均有一定改善,UTP、Hb、ALB、Ca、TC治療前后比較有統(tǒng)計(jì)學(xué)差異(P0.05); C02CP、PTH、K、P、TG、ALT、AST治療前后比較無(wú)統(tǒng)計(jì)學(xué)差異(P0.05)。結(jié)論：“益腎清利活血法”對(duì)CKD4期具有治療作用,使患者臨床癥狀及腎功能得到有效的改善,隨著時(shí)問(wèn)的延長(zhǎng),本法具有維持病情穩(wěn)定、推延病程進(jìn)展作用,因此患者生活質(zhì)量得到顯著提高。
[Abstract]:Objective: to observe the clinical efficacy and safety of Yishen Qingli Huoxue method in delaying renal dysfunction in patients with chronic kidney disease (CKD4 stage). Methods: from March 2015 to March 2016, 64 patients who met the inclusion criteria in the Department of Nephrology, Jiangsu Provincial Hospital of traditional Chinese Medicine were analyzed retrospectively. from eGFR,Scr, to March 2016, 64 patients were diagnosed and treated in Jiangsu Provincial Hospital of traditional Chinese Medicine. The renal function and symptom score evaluated by BUN and other laboratory indexes reflected the clinical efficacy of "Yishen Qingli Huoxue method", and the safety of wooden method was evaluated from ALT,AST,TC,TG,K and other indexes. The total course of treatment was 12 months. Results: (1) Clinical symptoms: the total score of symptoms in 64 patients decreased after 3 months of treatment, and the total score of symptoms after 12 months was significantly different from that before treatment (P 0.05), and the total effective rate was 89.06%. Among them, 8 cases were markedly effective, 32 cases were effective and 17 cases were stable. (2) Renal function index: 64 patients were treated with 3, 6, 9, 12 months after treatment, Scr,BUN,UA decreased and eGFR increased, and there was significant difference between each course of treatment and the initial comparison (P 0.05). The curve of Scr,eGFR with time (month) showed that the value was becoming more and more stable, which indicated that the renal function became stable with the prolongation of the course of treatment. The whole patient 1/Scr asked (month) the linear regression slope b value was positive at any time, which indicated that the long-term curative effect showed an improvement trend. (3) Safety index: other laboratory indexes were collected before and after treatment in 64 patients, all of which were improved to a certain extent. UTP,Hb, There was significant difference between before and after ALB,Ca,TC treatment (P 0.05). There was no significant difference in C02 CP, PTH, K, P, TG, alt, AST before and after treatment (P 0.05). Conclusion: "Yishen Qingli Huoxue method" has therapeutic effect on CKD4 stage, which can effectively improve the clinical symptoms and renal function of the patients. with the prolongation of time, this method can maintain the stability of the disease and delay the progress of the course of disease. As a result, the quality of life of patients has been significantly improved.
【學(xué)位授予單位】：南京中醫(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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