化浊解毒方治疗慢性肾功能衰竭的临床研究

发布时间：2018-01-22 16:45

本文关键词： 中医药治疗临床疗效化浊解毒慢性肾衰竭临床研究　出处：《河北医科大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:基于“浊毒理论”运用化浊解毒方治疗慢性肾衰竭(CRF)患者,通过临床观察其疗效及安全性,以期为临床治疗慢性肾衰竭患者提供一种疗效确切的治疗方法。方法:选择河北省中医院肾病科门诊慢性肾衰竭患者180例(血清肌酐3个月内持续稳定在442umol/L以下),所有患者随机分为化浊解毒治疗组92例(治疗组)和尿毒清治疗组88例(对照组)。两组均在西医常规治疗的基础上。疗程为3个月。通过检测患者治疗前后中医症状积分、血肌酐(Scr)、尿素氮(BUN)、血尿酸(UA)、血浆白蛋白(Alb)、血红蛋白(HGB)、内生肌酐清除率(Ccr)、24小时尿蛋白定量(24h-UTP)、胆固醇(CHOL)、甘油三酯(TG)等来探讨化浊解毒方在治疗慢性肾衰竭中的临床疗效。结果:1治疗组总有效率为86.59%,中医证候总有效率为92.68%;对照组分别为68.75%和71.25%,两组比较均有统计学意义(P0.01)。2两组治疗前中医症状积分无明显差异(P0.05)。两组患者治疗后比较,治疗组明显优于对照组(P0.05)。3两组患者肾功能指标治疗前比较无统计学差异(P0.05)。两组患者治疗前后疗效比较,BUN、Scr、UA均显著性下降(P0.01),Ccr均显著提高(P0.01)。两组治疗后比较,治疗组明显优于对照组(P0.05)。4两组患者治疗前CHOL、TG比较无统计学差异(P0.05),具有可比性。两组患者治疗前后比较,CHOL、TG均显著降低(P0.01)。两组治疗后比较,治疗组优于对照组(P0.05)。5治疗组血红蛋白、血白蛋白明显提高,优于对照组(P0.05)。6两组患者治疗前24小时尿蛋白定量比较无统计学差异(P0.05)。两组患者治疗前后比较,24h-UTP均显著减少(P0.01),但治疗组明显优于对照组(P0.05)。7治疗过程中未发现严重不良反应。结论:1运用化浊解毒方治疗慢性肾功能衰竭,能明显改善患者的临床症状及肾功能,纠正肾性贫血,提高血浆白蛋白及内生肌酐清除率,降低血脂及24小时尿蛋白定量,从而延缓慢性肾衰竭病程进展。2两组患者在治疗过程中均无明显不良反应的发生,其安全性值得肯定。3综上,化浊解毒法在改善症状及实验室指标方面有独特的优势,且是安全有效的,值得进一步临床开发应用和推广。
[Abstract]:Objective: Based on the "Zhuodu theory" use huazhuojiedu Decoction in treating chronic renal failure (CRF) patients, to observe the clinical efficacy and safety, in order to provide an effective therapy for clinical treatment of patients with chronic renal failure. Methods: patients in the outpatient department of nephropathy of Hebei Provincial Hospital of TCM of chronic renal failure in 180 cases (serum creatinine within 3 months remained stable under 442umol/L), all patients were randomly divided into 92 cases of huazhuojiedu treatment group (treatment group) and Niaoduqing treatment group of 88 cases (control group). The two groups were on the basis of conventional treatment. The course of treatment was 3 months. The patients before and after treatment detection of TCM symptom score, serum creatinine (Scr), urea nitrogen (BUN), blood uric acid (UA), plasma albumin (Alb), hemoglobin (HGB), creatinine clearance rate (Ccr), 24 hour urinary protein (24h-UTP), cholesterol (CHOL), triglyceride (TG). Discussion of Huazhuojiedufang in Clinical efficacy of the treatment of chronic renal failure in 1. Results: the total efficiency of treatment group was 86.59%, the total effective rate of TCM syndromes was 92.68%; the control group were 68.75% and 71.25%, the two groups had statistical significance (P0.01) TCM symptom score had no significant difference between the two groups before treatment (.2 P0.05) two groups of patients. After treatment, the treatment group was significantly better than the control group (P0.05.3) two groups of patients with renal function indexes before treatment had no significant difference (P0.05). Two groups of patients before and after treatment, BUN, Scr, UA were significantly decreased (P0.01), Ccr were significantly higher (P0.01). The two groups after treatment compared with the treatment group than the control group (P0.05 CHOL) before the treatment of.4 patients in the two groups, TG had no significant difference (P0.05), comparable. Two groups of patients before and after treatment, CHOL, TG were significantly decreased (P0.01). The two group after treatment, the treatment group than the control group (P0.05.5 red blood treatment group) Protein, blood albumin increased significantly, better than the control group (P0.05.6) two groups of patients before treatment, 24 hours urine protein had no significant difference (P0.05). Two groups of patients before and after treatment, 24h-UTP decreased significantly (P0.01), but the treatment group was significantly better than the control group (P0.05) found serious adverse reaction.7 treatment in the process of 1. Conclusion: using huazhuojiedu Decoction in treatment of chronic renal failure, clinical symptoms and renal function were obviously improved, correction of renal anemia, increase plasma albumin and creatinine clearance rate, reduce blood fat and 24 hour urinary protein, thereby delaying disease progression of chronic renal failure.2 patients in the two groups no obvious adverse reaction during the treatment, the security of the positive.3 in conclusion, huazhuojiedu method has unique advantages in improving the symptoms and laboratory indexes, and is safe and effective, worthy of further clinical development Application and promotion.

【学位授予单位】：河北医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R277.5

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