益肾清利、和络泄浊法延缓慢性肾脏病（CKD5期）病情进展的临床疗效观察

发布时间：2018-02-26 02:31

  本文关键词： CKD5期 益肾清利 和络泄浊法 延缓进展 临床研究　出处：《南京中医药大学》2016年硕士论文　论文类型：学位论文

【摘要】：目的：评价“益肾清利、和络泄浊”法延缓慢性肾脏病(CKD5期)病情进展的疗效,提高中医对该病理论及诊疗方面的认识。方法：本研究入组符合条件的CKD5期患者共60例。在西医一般治疗的基础上,予中医“益肾清利、和络泄浊”法加减治疗。收集治疗前后临床症状、肾功能、钙磷代谢、脂质代谢、营养状况、安全性等指标,以4个月为间隔,随访时间12个月。最后对数据进行统计分析。结果：1.临床症状：60例患者治疗4月、8月、12月的临床症状积分较0月呈不断下降的趋势。且8月的临床症状积分与0月相比具有统计学差异(P0.05),12月的临床症状积分与0月相比具有显著统计学差异(P0.01)。中医主症中“面色晦暗,倦怠乏力,腰膝酸软,身重困倦,食少纳呆,口干”12月的积分与0月相比具有显著统计学差异(P0.01)。2.证候疗效：经治疗12月,60例患者中58例患者的临床症状积分较前有所下降,证候疗效的总有效率为81.7%。3.疾病疗效：经治疗12个月,60例患者中显效2例(占3.3%),有效31例(占51.7%),稳定16例(占26.7%),无效11例(占18.3%)。总有效稳定率为81.7%,总有效率为55%。4.肾功能：60例患者治疗4月、8月、12月的血肌酐较0月均呈下降趋势。且4月血肌酐与0月相比具有显著统计学差异(P0.01),8月血肌酐水平与0月相比具有统计学差异(P0.05)。60例患者治疗4月、8月、12月的肾小球滤过率较0月呈上升趋势。且4月的肾小球滤过率与0月相比具有显著统计学差异(P0.01),8月肾小球滤过率与0月相比具有统计学差异(P0.05)。5.钙磷代谢：60例患者治疗12月的血磷以及PTH较0月稍有下降,且两者具有统计学差异(P0.05)。6.脂质代谢：60例患者治疗12月的TC、TG、LDL较0月稍有下降,且两者差异具有统计学差异(P0.05)。7.营养状况：60例患者治疗12月的血红蛋白较0月呈上升趋势,且两者差异具有统计学差异(P0.05)。8.安全性指标：60例患者在整个治疗过程中,出现3例血钾升高的情况,经过降钾处理,再次给予中药后,未再出现血钾升高。60例患者治疗过程中均未出现大便颜色的改变,仅2例患者出现便质、便次的波动。60例患者未见明显其他的不良反应。结论：“益肾清利、和络泄浊”法对改善患者临床症状,特别是主症方面的疗效确切。而且在短期内(4-8月)对改善慢性肾脏病(CKD5期)患者的肾功能具有一定疗效。远期上可延缓慢性肾脏病(CKD5期)患者病情的进展。并且具备一定的调节钙磷代谢、调脂、纠正贫血的作用。
[Abstract]:Objective: to evaluate the efficacy of "Yishen Qingli, and collateral-draining turbid" method in delaying the progression of chronic kidney disease (CKD5). Methods: 60 patients with CKD5 were enrolled in this study. On the basis of the general treatment of western medicine, the Chinese medicine "Yishen Qingli", "Yishen Qingli", was given. Before and after treatment, clinical symptoms, renal function, calcium and phosphorus metabolism, lipid metabolism, nutritional status and safety were collected at intervals of 4 months. The follow-up time was 12 months. Finally, the data were statistically analyzed. Results: the clinical symptom scores of 60 patients with clinical symptoms: April, August, December showed a decreasing trend compared with 0 months. In December, there was a significant difference in the score of clinical symptoms compared with that in 0 month (P 0.01). Fatigue, weakness of waist and knee, heavy body weight, low intake, dry mouth "the score of December was significantly different from that of 0month (P 0.01) .Syndromes effect: the clinical symptom scores of 58 cases of 60 cases treated in December were lower than those of the previous ones, and the clinical symptom scores of 58 cases were lower than that of the previous ones, and the clinical symptom scores of 58 cases were lower than those of the previous ones. The total effective rate of syndrome curative effect was 81.7.3.The total effective rate was 81.7%. The total effective rate was 81.7%. The total effective rate was 81.7% and the total effective rate was 550.The effective rate was 3.30.The effective rate was 31 cases (51.7%), 16 cases were stable (26.7%), 11 cases were ineffective (18.3%). The total effective stability rate was 81.7%, and the total effective rate was 55.4kidney. In April, August and December, the serum creatinine levels in 60 patients with functional component showed a downward trend compared with that in 0 months. There was a significant difference in creatinine levels between December and 0 months (P 0.01), and there was a statistical difference in serum creatinine levels between #date鈪，

本文编号：1536185