艾灸对慢性肾脏病1~3期患者临床症状和肾血流的观察研究

发布时间：2018-03-17 07:46

本文选题：艾灸　切入点：慢性肾脏病1～3期　出处：《浙江中医药大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的观察穴位艾灸对慢性肾脏病1～3期患者临床症状及肾血流动力学的影响效果。方法将符合纳排标准的慢性肾脏病1～3期患者按照就诊先后顺序进行编号,奇数为对照组,偶数为实验组,每组各31例。对照组给予基础治疗,实验组在基础治疗上加用肾俞、足三里穴穴位艾灸,每天一次,每次每穴15分钟,7天一个疗程,共2个疗程。观察两组患者干预前后的实验室指标及中医临床症状积分的变化情况并评价其疗效。同时选取实验组16名患者,采用彩色多普勒超声诊断仪观察艾灸对这些患者的肾动脉血流动力学的即刻效应。结果1.干预后,两组患者的中医症状总积分较干预前均下降,自身前后比较差异具有统计学意义(P0.05);两组组间比较,差异也具有统计学意义(P0.05)。在各单项症状得分上,干预后实验组在腰酸膝软、水肿症状改善上优于对照组,差异有统计学意义(P0.05)。2.干预后,中医证侯疗效实验组总有效率74.2%,对照组总有效率61.3%。两组总有效率比较,差异具有统计学意义(P0.01)。3.干预后,24小时尿蛋白定量实验组较干预前下降,自身前后比较差异具有统计学意义(P0.05)。24小时尿蛋白定量下降值组间比较差异也有统计学意义(P0.05)。4.实验组16名患者在艾灸后即刻及艾灸后15分钟时肾脏阻力指数较艾灸前下降,差异均具有统计学意义(P0.05);舒张末期血流速度在艾灸后15分钟时较艾灸前增快,差异具有统计学意义(P0.05)。5.接受艾灸干预的所有患者未发生有关艾灸的不良反应。结论1.艾灸在一定程度上能改善慢性肾脏病1～3期患者部分临床症状,尤其对腰酸膝软、水肿症状改善效果明显,能有效改善中医证候疗效。2.艾灸可降低慢性肾脏病1～3期患者24小时尿蛋白定量。3.艾灸可降低慢性肾脏病1～3期患者的肾血流阻力,加快舒张末期血流速度,且能维持一定的时间。4.艾灸疗法无副作用,值得临床推广应用。
[Abstract]:Objective to observe the effect of acupoint moxibustion on clinical symptoms and renal hemodynamics in patients with chronic kidney disease (stage 1). The control group was given basic treatment, and the experimental group was treated with Shenshu and Zusanli acupoints moxibustion once a day for 15 minutes and 7 days for a course of treatment. Two courses of treatment were used to observe the changes of laboratory indexes and clinical symptom scores of TCM before and after intervention, and to evaluate the efficacy of the two groups. 16 patients in the experimental group were selected at the same time. The instant effect of moxibustion on renal artery hemodynamics of these patients was observed by using color Doppler ultrasound diagnostic instrument. Results 1. After intervention, the total score of TCM symptoms in the two groups decreased as compared with that before intervention. The difference before and after intervention was statistically significant (P 0.05), and the difference between the two groups was statistically significant (P 0.05). In each single symptom score, the experimental group was superior to the control group in improving the symptoms of lumbar acid knee and edema after intervention. After intervention, the total effective rate of the experimental group was 74.2 and that of the control group was 61.3.The total effective rate of the two groups was significantly higher than that of the control group. There was significant difference between the two groups. The renal resistance index of 16 patients in the experimental group was decreased immediately after moxibustion and 15 minutes after moxibustion compared with that before moxibustion. The blood flow velocity at the end of diastolic phase increased faster at 15 minutes after moxibustion than before moxibustion. The difference was statistically significant (P 0.05). There were no adverse reactions related to moxibustion in all the patients who received moxibustion intervention. Conclusion 1. Moxibustion can improve some clinical symptoms of patients with chronic kidney disease at stage 1 and 3, especially on the soft of lumbar and knee. The symptoms of edema were improved obviously, and the curative effect of TCM syndrome was improved effectively. 2. Moxibustion can reduce 24 hour urine protein quantity of chronic kidney disease patients in stage 1 and 3. Moxibustion can reduce renal blood flow resistance of patients with chronic kidney disease at stage 1 and 3. Accelerate the end diastolic blood flow velocity, and can maintain a certain time. 4. Moxibustion therapy has no side effects, it is worthy of clinical application.
【学位授予单位】：浙江中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R248.9

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