中医辨证治疗儿童肾病综合征（反复）临床研究
发布时间：2018-08-22 21:20
【摘要】：目的:对中医辨证治疗肾病综合征反复的患儿进行临床观察,统计患儿反复的因素、特点、辨证分型、常用中药,总结分析遣方用药规律,以期减少肾病的反复。方法:搜集山东中医药大学附属医院儿科门诊就诊及住院治疗的肾病综合征患儿病历资料。统计36例患儿118次反复就诊的资料,将维持激素用量结合中医辨证治疗尿蛋白能够转阴者设为激素维持组,将提高激素用量结合中医辨证治疗尿蛋白方能转阴者设为激素提高组。统计患儿反复的病因、特点、证型分布,常用中药频次及其分类,分析总结中医辨证治疗起效的方药规律。采用spss17.0统计软件及中医传承辅助系统对患儿病历资料进行数据统计分析,所有统计检验均采用双侧检验,P0.05认为差异有统计学意义。结果:1.导致肾病反复的因素82%由感染引起,其中上呼吸道感染占32%,下呼吸道感染占17%,泌尿系感染占10%,胃肠道感染占11%,虫咬性皮炎占12%,劳累及其他因素亦分别占8%,10%。2.证型分布为湿热蕴结夹瘀、风水相博夹瘀、气虚湿停夹瘀、阳虚湿停夹瘀。激素维持组多湿热蕴结夹瘀,激素提高组多气虚湿停夹瘀。3.肾病综合征患儿反复后,均给予中医辨证治疗和对症处理,激素维持组占32%,激素提高组占68%。4.中医辨证治疗的常用药物,祛湿药占50%,理气药20%,活血化瘀药14%,温阳药2%,其他14%,两组常用药物分类及归经组间无明显差别。5.诱导期肾病患儿无反复,激素维持组患儿反复以维持缓解期居多,占68%,激素提高组患儿反复以拖尾期居多,占75%。结论:1.感染是肾病患儿反复最重要的因素;2.湿邪为肾病综合征反复重要的病理因素,祛湿治疗是重要的治法,结合八纲辨证祛邪扶正为宜;3.激素维持组转阴比例以维持缓解期的湿热蕴结夹瘀证多见,激素提高组未转阴比例以拖尾期的气虚湿停夹瘀证型多见。激素方案调整与否和中医辨证证型及激素应用的不同阶段有关。
[Abstract]:Objective: to make clinical observation on the children with recurrent nephrotic syndrome treated by TCM syndrome differentiation, to count the factors, characteristics, syndrome differentiation, common Chinese medicine, summarize and analyze the law of prescribing drugs in order to reduce the recurrence of nephropathy. Methods: the medical records of children with nephrotic syndrome in pediatrics outpatient clinic of Shandong University of traditional Chinese Medicine were collected. According to the data of 118 repeated visits of 36 cases of children, the maintenance hormone dosage combined with TCM syndrome differentiation treatment of urine protein can turn negative into hormone maintenance group. Increase hormone dosage combined with TCM syndrome differentiation treatment of urine protein can turn negative group as hormone improvement group. The causes, characteristics, distribution of syndromes, frequency and classification of traditional Chinese medicine were analyzed and summarized. Spss17.0 statistical software and traditional Chinese medicine inheritance assistant system were used to analyze the data of children's medical records. All statistical tests were carried out by bilateral test (P0.05) and the difference was statistically significant. The result is 1: 1. 82% of the factors causing recurrent nephropathy were caused by infection, including 32 upper respiratory tract infection, 17 lower respiratory tract infection, 10 urinary tract infection, 11 gastrointestinal tract infection, 12 insect bite dermatitis, 8 tiredness and other factors. The distribution of syndrome type is damp-heat accumulation knot and stasis, geomantic phase, Qi deficiency, dampness and stasis, Yang deficiency and dampness to stop blood stasis. The hormone maintenance group had more dampness and heat accumulation and blood stasis, while the hormone improvement group had more qi deficiency and dampness and stopped clamping blood stasis. 3. Children with nephrotic syndrome were treated with TCM syndrome differentiation and symptomatic treatment. The hormone maintenance group accounted for 32 and the hormone improvement group 68. 4. Traditional Chinese medicine syndrome differentiation treatment commonly used drugs, dispelling dampness medicine account for 50, Qi medicine 20, blood circulation and stasis drugs 14, warming Yang medicine 2, the other 14, the two groups of commonly used drugs classification and return to the meridian group no significant difference. 5. There was no recurrence in induced nephropathy. In the hormone maintenance group, maintenance remission was the most frequently, accounting for 68%. In the hormone improvement group, the delayed stage was the most frequently, accounting for 75%. Conclusion 1. Infection is the most important factor in children with nephropathy. Dampness is an important pathological factor of nephrotic syndrome repeatedly, the treatment of dispelling dampness is an important treatment method. The negative rate of hormone maintenance group was the dampness and heat accumulation and blood stasis syndrome in the remission period, while the non-negative proportion of the hormone increasing group was the Qi deficiency dampness and dampness stagnation syndrome in the tail stage. The adjustment of hormone scheme is related to different stages of TCM syndrome differentiation and hormone application.
【学位授予单位】：山东中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R272
[Abstract]:Objective: to make clinical observation on the children with recurrent nephrotic syndrome treated by TCM syndrome differentiation, to count the factors, characteristics, syndrome differentiation, common Chinese medicine, summarize and analyze the law of prescribing drugs in order to reduce the recurrence of nephropathy. Methods: the medical records of children with nephrotic syndrome in pediatrics outpatient clinic of Shandong University of traditional Chinese Medicine were collected. According to the data of 118 repeated visits of 36 cases of children, the maintenance hormone dosage combined with TCM syndrome differentiation treatment of urine protein can turn negative into hormone maintenance group. Increase hormone dosage combined with TCM syndrome differentiation treatment of urine protein can turn negative group as hormone improvement group. The causes, characteristics, distribution of syndromes, frequency and classification of traditional Chinese medicine were analyzed and summarized. Spss17.0 statistical software and traditional Chinese medicine inheritance assistant system were used to analyze the data of children's medical records. All statistical tests were carried out by bilateral test (P0.05) and the difference was statistically significant. The result is 1: 1. 82% of the factors causing recurrent nephropathy were caused by infection, including 32 upper respiratory tract infection, 17 lower respiratory tract infection, 10 urinary tract infection, 11 gastrointestinal tract infection, 12 insect bite dermatitis, 8 tiredness and other factors. The distribution of syndrome type is damp-heat accumulation knot and stasis, geomantic phase, Qi deficiency, dampness and stasis, Yang deficiency and dampness to stop blood stasis. The hormone maintenance group had more dampness and heat accumulation and blood stasis, while the hormone improvement group had more qi deficiency and dampness and stopped clamping blood stasis. 3. Children with nephrotic syndrome were treated with TCM syndrome differentiation and symptomatic treatment. The hormone maintenance group accounted for 32 and the hormone improvement group 68. 4. Traditional Chinese medicine syndrome differentiation treatment commonly used drugs, dispelling dampness medicine account for 50, Qi medicine 20, blood circulation and stasis drugs 14, warming Yang medicine 2, the other 14, the two groups of commonly used drugs classification and return to the meridian group no significant difference. 5. There was no recurrence in induced nephropathy. In the hormone maintenance group, maintenance remission was the most frequently, accounting for 68%. In the hormone improvement group, the delayed stage was the most frequently, accounting for 75%. Conclusion 1. Infection is the most important factor in children with nephropathy. Dampness is an important pathological factor of nephrotic syndrome repeatedly, the treatment of dispelling dampness is an important treatment method. The negative rate of hormone maintenance group was the dampness and heat accumulation and blood stasis syndrome in the remission period, while the non-negative proportion of the hormone increasing group was the Qi deficiency dampness and dampness stagnation syndrome in the tail stage. The adjustment of hormone scheme is related to different stages of TCM syndrome differentiation and hormone application.
【学位授予单位】：山东中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R272
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