补气祛风法治疗膜性肾病的理论探讨及临床疗效观察

发布时间：2018-01-09 12:02

本文关键词：补气祛风法治疗膜性肾病的理论探讨及临床疗效观察　出处：《南京中医药大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:探讨补气祛风法在膜性肾病治疗中的理论基础,并观察补气祛风法联合常规疗法对膜性肾病的临床疗效,为临床综合治疗本病提供新的恩路和方案。方法:理论研究方面主要通过文献检索和阅读,回顾膜性肾病的治疗方法,总结周师治疗膜性肾病的临床经验,提出补气祛风法治疗膜性肾病的方案。临床研究方面,共收集膜性肾病患者30例,随机分为治疗组与对照组各15例,对照组给予基础治疗联合激素治疗,治疗组在对照组的基础上配合补气祛风法中药方剂口服,疗程为6个月,观察治疗前后两组患者尿蛋白定量、血肌酐、尿素氮、症候积分的变化并进行临床疗效分析。结果:(1)补气祛风法治疗膜性肾病符合膜性肾病气虚风扰的病理特点,能够针对膜性肾病的患者标本兼治,从而达到改善临床症状和指标的作用。(2)治疗前:治疗组中医症候积分为(22.66±9.93),对照组中医症候积分为(23.71±8.86),p0.05,具有可比性;治疗后:治疗组中医症候积分为(8.00±6.26),对照组中医症候积分为(16.45士8.80),p0.05,差异有统计学意义。治疗组各症状的积分中,肢体水肿、咽喉不适、食欲、睡眠方面改善最为明显。(3)治疗前:治疗组尿蛋白定量均值为(6.82±2.06)g/d,对照组尿蛋白定量均值为(5.91±2.10)g/d,p0.05;治疗后:治疗组尿蛋白定量均值为(2.47±0.93)g/d,与同组治疗前数值比较p0.05,差异有统计学意义;对照组尿蛋白定量均值为(3.58±2.23)g/d,p0.05,与同组治疗前数值比较p0.05,差异有统计学意义;两组治疗后尿蛋白定量比较p0.05,差异有统计学意义。(4)两组患者治疗前后血肌酐、尿素氮指标对比无显著差异。(5)两组患者总疗效的比较。两组均有良好疗效,治疗组有效率为86.7%,对照组有效率60.0%。p0.05,差异有统计学意义。结论:补气祛风法治疗膜性肾病符合其中医肾气虚而风邪内扰的病理特点。在临床应用中,能够显著改善膜性肾病患者的临床症状,尤其在肢体水肿、咽喉不适、食欲、睡眠方面改善最为明显,对于蛋白尿的降低也起到积极的作用,联合常规治疗,能够提高临床疗效,延缓肾病进展,临床应推广应用并进一步的研究探索。
[Abstract]:Objective: to explore the theoretical basis of tonifying qi and expelling wind in the treatment of membranous nephropathy, and to observe the clinical effect of tonifying qi and expelling wind combined with routine therapy on membranous nephropathy. Methods: through literature retrieval and reading, review the treatment of membranous nephropathy, summarize Zhou Shi's clinical experience in treating membranous nephropathy. In clinical study, 30 patients with membranous nephropathy were randomly divided into treatment group (n = 15) and control group (n = 15). Treatment group on the basis of the control group combined with tonifying qi and dispelling wind traditional Chinese medicine prescription oral, the course of treatment is 6 months, observed before and after treatment of two groups of patients urine protein quantitative, blood creatinine, urea nitrogen. Results the treatment of membranous nephropathy with tonifying qi and expelling wind accords with the pathological characteristics of qi deficiency and wind disturbance of membranous nephropathy, and can be used to treat both symptoms and symptoms of membranous nephropathy. So as to improve the clinical symptoms and indicators before treatment: the treatment group TCM symptom score is 22.66 卤9.93, the control group TCM syndrome score is 23.71 卤8.86). P0.05, comparable; After treatment, the TCM symptom score of the treatment group was 8.00 卤6.26g, while that of the control group was 16.45 卤8.80 / p0.05. The difference was statistically significant. In the treatment group, there were edema of limbs, discomfort of pharynx and larynx, appetite. Before treatment, the quantitative average of urinary protein in the treatment group was 6.82 卤2.06 g / d, and that in the control group was 5.91 卤2.10 g / d. P0.05; After treatment, the quantitative mean of urinary protein in the treatment group was 2.47 卤0.93g / d, which was significantly higher than that before treatment (p0.05). The quantitative mean of urinary protein in the control group was 3.58 卤2.23 g / d P 0.05, which was significantly different from that of the control group before treatment. Urine protein quantitative comparison between the two groups after treatment p0.05, the difference was statistically significant. 4) before and after treatment of the two groups of patients serum creatinine. There was no significant difference in urea nitrogen index between the two groups. There was good curative effect in both groups. The effective rate was 86.7 in the treatment group and 60.0.p0.05 in the control group. Conclusion: the treatment of membranous nephropathy by tonifying qi and expelling wind accords with the pathological characteristics of deficiency of kidney qi and internal disturbance of wind. In clinical application, it can significantly improve the clinical symptoms of patients with membranous nephropathy. Especially in limb edema, throat discomfort, appetite, sleep improvement is the most obvious, for the reduction of proteinuria also plays a positive role, combined with conventional treatment, can improve the clinical efficacy, delay the progression of nephropathy. Clinical application should be popularized and further research should be carried out.
【学位授予单位】：南京中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R277.5

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