泄浊灌肠方治疗湿浊瘀阻型慢性肾功能衰竭的临床观察

发布时间：2018-03-10 15:37

本文选题：慢性肾功能衰竭　切入点：泄浊灌肠方　出处：《广州中医药大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:通过观察泄浊灌肠方治疗慢性肾衰(非透析,湿浊瘀阻型)患者的临床疗效,客观评价其临床疗效和安全性,为临床决策提供有价值的循证医学证据。方法:收集2016.01-2017.01海南省中医院肾病科住院诊断为慢性肾衰(非透析,湿浊瘀阻型)的患者,按患者意愿进行分组,根据排除标准,最后纳入86例患者,对照组44例,治疗组42例。对照组在基础治疗上加尿毒清颗粒冲服,治疗组在基础治疗上加用泄浊灌肠方灌肠。通过观察两组患者治疗前和治疗2周后血肌酐、肾小球滤过率、尿素氮、尿酸及主要临床症状的变化来评估泄浊灌肠方的疗效。结果:治疗后治疗组患者Scr、BUN、UA水平均较治疗前明显降低,eGFR水平升高,差异均有统计学意义(P01);而对照组患者治疗后仅有BUN、UA水平较治疗前明显降低(P0.01)。治疗后两组患者Scr、eGFR 水平相比差异无统计学意义;治疗后两组患者BUN、UA水平比较差异有统计学意义(P0.01、P0.05)。两组患者治疗后乏力、纳差、腹胀、水肿症状单项评分及总分均较治疗前明显降低(P0.01);而治疗后两组患者这四组症状的单项评分及总分组间相比差异无统计学意义(P0.05)。治疗后对照组和治疗组总体有效率分别为63.6%、85.7%,差异有统计学意义(P05)。本研究中泄浊灌肠方较为安全,无明显不良反应;尿毒清颗粒不良反应主要表现为消化道症状,占11.4%。结论:泄浊灌肠方对慢性肾衰患者的血肌酐、尿酸、尿素氮的清除作用较尿毒清颗粒更明显,治疗的总体有效率也优于尿毒清颗粒,且无明显不良反应,是治疗慢性肾衰竭患者安全有效的灌肠汤剂。
[Abstract]:Objective: to evaluate the clinical efficacy and safety of Xiezhuo enema prescription in the treatment of chronic renal failure (non-dialysis, dampness and stasis). To provide valuable evidence-based medical evidence for clinical decision-making. Methods: patients with chronic renal failure (non-dialysis, dampness and stasis) were collected from Department of Renal, Hainan traditional Chinese Medicine Hospital from January 2016.01-2017.2017.Methods: patients were divided into groups according to the wishes of the patients and according to the exclusion criteria. Finally, 86 patients were included, 44 in control group and 42 in treatment group. The patients in the treatment group were treated with Xiezhuo enema prescription. The serum creatinine, glomerular filtration rate and urea nitrogen were observed before and after 2 weeks of treatment in the treatment group. The changes of uric acid and main clinical symptoms were used to evaluate the curative effect of Xiezhuoenchang recipe. Results: after treatment, the level of Scr-BUN-UA in the treatment group was significantly lower than that before treatment, and the level of eGFR was increased. The difference was statistically significant (P < 0.01), but the level of Buena in the control group was significantly lower than that before treatment, but there was no significant difference between the two groups in the level of Scrn eGFR after treatment. After treatment, there was a significant difference between the two groups in the level of Buena UA, P0.01and P0.05.After treatment, the patients in the two groups suffered from fatigue, anorexia, abdominal distension, anorexia, abdominal distension, anorexia and abdominal distension. The single score and total score of edema symptoms were significantly lower than those before treatment, but there was no significant difference in the single score and total score of symptoms between the two groups after treatment. The total effective rate of the control group and the treatment group after treatment was higher than that of the control group. The difference was statistically significant (P 05). In this study, Xiezhuo enema was safe, There were no obvious adverse reactions, the adverse reactions of Niaoduqing granules were mainly digestive tract symptoms, accounting for 11.4.Conclusion: the clearance of serum creatinine, uric acid and urea nitrogen in patients with chronic renal failure was more obvious than that in Niaoduqing granules. The overall effective rate of the treatment is also better than that of Niaoduqing granule, and there is no obvious adverse reaction. It is a safe and effective enema decoction for patients with chronic renal failure.
【学位授予单位】：广州中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R277.5

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