宣通三焦、活血通络方治疗特发性膜性肾病临床疗效及安全性分析

发布时间：2018-02-10 22:03

本文关键词： 特发性膜性肾病宣通三焦、活血通络中西医结合临床研究临床疗效　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:本课题通过对特发性膜性肾病的临床研究,以观察宣通三焦、活血通络方治疗特发性膜性肾病的疗效及安全性,为临床推广应用提供数据支持及科学依据,并论证和探讨特发膜性肾病所存在的脾肾阳虚、水湿血瘀、三焦气化不利的基本病机,从而为中医辨证论治提供新思路。方法:将符合入选标准的62例特发性膜性肾病患者,采用随机数字表法分为试验组32例和对照组30例。对照组予激素联合环磷酰胺治疗,同时予以常规对症治疗,嘱患者休息、低盐低脂优质蛋白饮食以及利尿、降脂、降压、抗凝等对症治疗。试验组在对照组治疗基础上,加服宣通三焦、活血通络方,并随证加减。观察对比两组治疗前、治疗3个月、治疗6个月的各项疗效指标。结果:共有59例患者完成6个月观察,其中试验组30例,对照组29例。两组患者治疗前24小时尿蛋白定量比较无统计学差异(P(29)0.05),具有可比性,治疗3个月与治疗前比较,两组患者24小时尿蛋白均显著减少(P(27)0.01),且试验组疗效优于对照组(P(27)0.05),治疗6个月与治疗前比较,两组患者24小时尿蛋白均显著减少(P(27)0.01),且试验组疗效优于对照组(P(27)0.01);两组患者治疗前总蛋白、白蛋白比较无统计学差异(P(29)0.05),具有可比性,治疗3个月与治疗前比较,两组患者总蛋白、白蛋白均显著升高(P(27)0.01),两组比较无明显差异(P(29)0.05),治疗6个月与治疗前比较,两组患者总蛋白、白蛋白均明显升高(P(27)0.01),且试验组疗效优于对照组(P(27)0.01);两组患者治疗前总胆固醇、甘油三酯、低密度脂蛋白胆固醇比较无统计学差异(P(29)0.05),具有可比性,治疗3个月与治疗前比较,试验组总胆固醇显著降低(P(27)0.01),甘油三酯、低密度脂蛋白胆固醇无显著变化(P(29)0.05),对照组总胆固醇、甘油三酯、低密度脂蛋白胆固醇无显著变化(P(29)0.05),且两组比较无明显差异(P(29)0.05),治疗6个月与治疗前比较,两组患者总胆固醇、甘油三酯、低密度脂蛋白胆固醇均显著降低(P(27)0.01),且试验组疗效优于对照组(P(27)0.05,P(27)0.01);两组患者治疗前、治疗3个月、治疗6个月血肌酐、尿素氮、尿酸均无明显差异(P(29)0.05);治疗后两组患者生命体征及血、尿、便常规加潜血、肝功能、ECG及胆、脾、胰B超均未发现明显异常、治疗过程中无不良反应发生;试验组中医症候疗效及西医综合疗效优于对照组(P0.05,P(27)0.01)。结论:宣通三焦、活血通络方治疗特发性膜性肾病有较好的疗效,具有降低尿蛋白、升高血浆蛋白、调节血脂的作用,且有一定的保护肾功能作用,安全可靠,中医症候疗效及西医综合疗效突出,且随疗程延长疗效逐渐明显。
[Abstract]:Objective: to observe the efficacy and safety of Xuantong Sanjiao and Huoxue Tongluo decoction in the treatment of idiopathic membranous nephropathy through the clinical study of idiopathic membranous nephropathy, and to provide data support and scientific basis for clinical application. The basic pathogenesis of idiopathic membranous nephropathy such as deficiency of spleen and kidney yang, water dampness and blood stasis, and unfavorable gasification of three Jiao were demonstrated and discussed. Methods: 62 patients with idiopathic membranous nephropathy who met the inclusion criteria were selected. The control group was treated with hormone combined with cyclophosphamide, the control group was treated with routine therapy, the patients were told to rest, low-salt and low-fat high quality protein diet, diuretic, lipid-lowering, hypotensive, diuretic, lipid-lowering and hypotensive diet. The experimental group was treated with Xuantong Sanjiao, Huoxue Tongluo recipe, and the syndrome was added and subtracted. Before the treatment, the two groups were treated for 3 months. Results: a total of 59 patients were observed for 6 months, 30 in the experimental group and 29 in the control group. There was no significant difference in urinary protein between the two groups at 24 hours before treatment. After 3 months of treatment, the urine protein of 24 hours in both groups was significantly decreased compared with that before treatment, and the curative effect of the trial group was better than that of the control group, and compared with that of the control group at 6 months. The 24 hour urine protein of the two groups was significantly reduced, and the curative effect of the experimental group was better than that of the control group. There was no significant difference in the total protein and albumin between the two groups before treatment, and there was no statistical difference between the two groups. The total protein of the two groups was comparable after 3 months of treatment compared with that before treatment, and the total protein of the two groups was higher than that of the control group. There was no significant difference between the two groups. The total protein and albumin of the two groups were significantly higher than those of the control group after 6 months of treatment, and the curative effect of the test group was better than that of the control group. The total cholesterol and triglyceride of the two groups before treatment were higher than those of the control group, and there was no significant difference between the two groups in total cholesterol and triglyceride before treatment, and the effect of the test group was better than that of the control group, and the effect of the two groups was better than that of the control group. There was no significant difference in low density lipoprotein cholesterol (LDL-C). There was no significant difference in low density lipoprotein cholesterol (LDL-C). Compared with before treatment for 3 months, the total cholesterol of the trial group was significantly lower than that of the control group, and the total cholesterol of the trial group was significantly lower than that of the control group. There was no significant change in the level of triglyceride and low density lipoprotein cholesterol. There was no significant change in triglyceride, low density lipoprotein cholesterol, and there was no significant difference between the two groups. After 6 months of treatment, total cholesterol, triglyceride and triglyceride were compared between the two groups. Low density lipoprotein cholesterol (LDL-C) was significantly decreased in both groups, and the curative effect of the trial group was better than that of the control group. There was no significant difference in serum creatinine, urea nitrogen and uric acid between the two groups before and after treatment for 3 months and 6 months, and there was no significant difference in vital signs and blood between the two groups after treatment. Urine, routine addition of occult blood, liver function, ECG, bile, spleen, pancreas B ultrasound did not find any obvious abnormalities, no adverse reactions occurred in the course of treatment, the effect of traditional Chinese medicine and western medicine in the experimental group was better than that in the control group (P0.05P0. 05, P0. 05, P0. 27 and 0. 01). Conclusion: Xuantong Sanjiao, Xuan Tong San Jiao, is better than the control group. Huoxue Tongluo recipe has a good effect in treating idiopathic membranous nephropathy. It can reduce urine protein, increase plasma protein, regulate blood lipid, protect renal function, and is safe and reliable. The curative effect of TCM symptom and western medicine is outstanding, and the curative effect is obvious with the course of treatment.
【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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