加味黑地黄丸改善慢性肾脏病患者（CKD3-4期）营养不良状态的临床研究

发布时间：2018-03-14 04:41

本文选题：加味黑地黄丸　切入点：慢性肾脏病(CKD3-4期)　出处：《山东中医药大学》2016年硕士论文　论文类型：学位论文

【摘要】：目的:观察加味黑地黄丸对慢性肾脏病患者(CKD3-4期)肾性营养不良状态的临床干预效果,探讨中西医结合治疗本病的优势和可行性,以期更好的发挥中医药在肾性营养不良治疗方面的治疗优势和潜力。方法:收集山东中医药大学附属医院66例慢性肾脏病(CKD3-4期)肾性营养不良患者,并将其随机分为试验组和对照组两组,试验组应用西医基础治疗,并加用加味黑地黄丸,对照组仅应用西医基础治疗的方法,2个月作为一治疗疗程,疗程结束后并观察两组治疗前后临床症状的变化、主观营养评估(SGA)积分、体重指数(BMI)和上臂肌围(AMC),以及肾功能、白蛋白(ALB)、前白蛋白(PA)、转铁蛋白(TRF)、血脂的变化结果并进行统计学分析及讨论。结果:试验组总有效率为86.67%,对照组有效率64.52%,两组间统计差异明显(P0.05),证明其总有效率高于对照组;中医证侯疗效上试验组(80.00%)亦优于对照组(54.84%),具备统计差异(P0.05),在中医症状总积分方面试验组优于对照组(P0.05),单项症状比较方面试验组改善纳呆少食、倦怠乏力、肢体困重、腰膝酸软、腰腹冷痛方面优于对照组(P0.05);而在恶心呕吐、气短懒言、脘腹胀满、失眠症状的比较无统计差异;试验组SGA评分下降优于对照组(P0.05);两组在治疗后的体重指数均升高且组间比较有差异(P0.05),而上臂肌围的组内及组间比较无差异;试验组患者肾小球滤过率(GFR)升高,血肌酐(Scr)、尿素氮(BUN)水平下降,且Scr、GFR组间疗效比较具统计学差异(P0.05),而BUN治疗后的组间比较不具差异(P0.05);试验组治疗后生化指标血清白蛋白(ALB)、前白蛋白(PA)、转铁蛋白(TRF)水平升高,且疗效均优于对照组(P0.05),两组胆固醇(CHOL)水平变化无统计意义(P0.05)。结论:加味黑地黄丸在一定程度上保护CKD3-4期患者肾功能,改善其营养不良状态,并使患者的生存质量提高。
[Abstract]:Objective: to observe the clinical intervention effect of Jiawei Heidihuang pills on chronic kidney disease (CKD 3-4) renal dystrophy, and to explore the advantages and feasibility of integrated traditional Chinese and western medicine in the treatment of this disease. Methods: 66 patients with chronic kidney disease (CKD3-4) were collected from the affiliated Hospital of Shandong University of traditional Chinese Medicine to give full play to the advantages and potential of traditional Chinese medicine in the treatment of renal malnutrition. They were randomly divided into two groups: the experimental group and the control group. The experimental group was treated with basic western medicine, and the treatment group was treated with modified Heidi Dihuang pill. The control group was treated with western medicine for 2 months as a course of treatment. After the course of treatment, the changes of clinical symptoms, subjective nutrition assessment (SGA) scores, body mass index (BMI) and arm muscle circumference (AMC), and renal function were observed before and after treatment in both groups. Results: the total effective rate of the test group was 86.677.The effective rate of the control group was 64.52. The statistical difference between the two groups was significant (P 0.05), which proved that the total effective rate of the two groups was higher than that of the control group. On the curative effect of TCM syndromes, the experimental group was also superior to the control group (54.84) and had statistical difference (P 0.05). The experimental group was superior to the control group in the total score of TCM symptoms (P 0.05). The single symptom comparison of the experimental group improved the intake of food less, fatigue and fatigue, heavy limbs, and weak waist and knee. Lumbar and abdominal cold pain was better than that of control group (P 0.05), but there was no statistical difference in nausea and vomiting, short breath and lazy speech, abdominal distention and insomnia. The SGA score in the experimental group was lower than that in the control group (P 0.05), the body mass index of the two groups was increased after treatment and there was significant difference between the two groups, but there was no difference in the muscle circumference of the upper arm between the two groups. The glomerular filtration rate (GFR) of the patients in the trial group was higher than that in the control group. The levels of serum creatinine creatinine (SCR) and bun bun (BUNA) decreased, and there was a significant difference in the curative effect of Scr-GFR group (P 0.05), but there was no significant difference between the two groups after BUN treatment (P 0.05), and the levels of serum albumin (Alb), prealbumin (PAA), transferrin (TRF) increased after treatment in the experimental group. The therapeutic effect was better than that of the control group (P 0.05). There was no statistical significance in the changes of cholesterol in the two groups. Conclusion: the modified Heidi Dihuang pill can protect renal function, improve the malnutrition and improve the quality of life of the patients with CKD3-4 to a certain extent.
【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】：2016
【分类号】：R277.5

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