从脾胃升降理论治疗慢性肾脏病的疗效观察

发布时间：2018-03-28 07:35

本文选题：慢性肾脏病　切入点：脾胃气机升降理论　出处：《广州中医药大学》2016年硕士论文

【摘要】：目的：从中医脾胃气机升降理论出发,临床观察健脾益肾、升清降浊法对慢性肾脏病(CKD)3-5期患者的各项实验室指标和症候积分的影响,客观评价健脾益肾、升清降浊法对慢性肾脏病3-5期患者的疗效,为中医药治疗慢性肾脏病提供新的思路和方法。方法：本研究采用随机对照的研究方法,根据西医慢性肾脏病3-5期诊断标准及中医脾肾气虚夹湿浊证的诊断标准,选取50例符合脾肾气虚夹湿浊的慢性肾脏病3-5期患者作为研究对象,随机分为治疗组25例,对照组25例。两组均给予改善肾脏循环、降压、降糖、降脂、纠正贫血、纠正电解质紊乱及酸碱失衡、纠正贫血、纠正钙磷代谢紊乱等对症支持治疗。治疗组在对症支持治疗的基础上,以健脾益肾、升清降浊中药汤剂内服进行治疗。8周后收集治疗组和对照组前后中医症候积分及尿素氮(blood urea nitrogen, BUN)、血肌酐(Serum creatinine, Scr)、肾小球滤过率(GFR)、血红蛋白(Hemoglobin, HGB)、白蛋白((Serum Albumin, ALB)等实验室指标的变化,并运用SPSS 22.0对数据进行统计分析,评价健脾益肾、升清降浊法对慢性肾脏病3-5期患者的临床疗效。结果：治疗组和对照组两组患者临床总疗效对比,治疗组总有效率优于对照组总有效率(P0.05)。两组患者在治疗前后临床症候积分均有改善,治疗组优于对照组,具有统计学意义(P0.05)。两组治疗前后BUN、Scr、GFR、HGB、ALB均有改善,具有统计学意义(P0.05),治疗后组间比较BUN、Scr、GFR、HGB差异具有统计学意义(P0.05), ALB无统计学意义(P0.05)。结论：以“脾胃气机升降理论”为基础,运用健脾益肾、升清降浊法可以改善慢性肾脏病3-5期患者症候积分,有效改善患者临床症状,降低尿素氮、血肌酐,提高肾小球率过滤和血红蛋白水平,改善患者肾功能和贫血,延缓慢性肾脏病的进展。
[Abstract]:Objective: to observe the effects of the methods of invigorating spleen and tonifying kidney, raising spleen and removing turbidity on the laboratory indexes and syndromes of patients with chronic kidney disease (CKD) in phase 3-5, and to evaluate objectively the effect of strengthening spleen and tonifying the kidney, based on the theory of rising and lowering spleen and stomach qi in traditional Chinese medicine. The therapeutic effect of Shengqing Jiangzhuo method on patients with chronic kidney disease at 3-5 stages provides a new way of thinking and method for the treatment of chronic kidney disease with traditional Chinese medicine. According to the criteria of 3 to 5 stages of chronic kidney disease in western medicine and the diagnostic criteria of spleen and kidney qi deficiency and dampness turbidity in traditional Chinese medicine, 50 cases of chronic kidney disease in 3 to 5 stages of spleen and kidney qi deficiency and dampness were selected as research objects, and were randomly divided into treatment group (25 cases). 25 cases in the control group were treated with improved renal circulation, hypotension, hypoglycemia, lipid reduction, correction of anemia, correction of electrolyte disturbance and acid-base imbalance, correction of anemia, Correction of disorders of calcium and phosphorus metabolism and other symptomatic support treatment. The treatment group in the treatment group on the basis of symptomatic support treatment to strengthen the spleen and kidney, After oral administration of Shengqingjiangzhuo traditional Chinese medicine decoction for 8 weeks, the changes of TCM syndromes integral, blood urea nitrogenin, bunn, serum creatinine serum creatinine, Scrine, glomerular filtration rate, hemoglobulin, HGBM, albumin Serum Albumin, and so on were collected before and after treatment in the treatment group and the control group. SPSS 22.0 was used to analyze the data, to evaluate the clinical effect of strengthening spleen and tonifying kidney, raising clear and reducing turbidity in patients with chronic kidney disease in three to five stages. Results: the total clinical curative effect of treatment group and control group was compared with that of control group. The total effective rate of the treatment group was better than that of the control group (P 0.05). The clinical symptom scores of the two groups were improved before and after treatment, and the treatment group was superior to the control group (P 0.05). After treatment, the difference of BUNScr-Scr-GFRG-HGB was statistically significant (P 0.05), but ALB had no statistical significance (P 0.05). Conclusion: based on the theory of "spleen and stomach Qi rising and lowering", we can use the theory of strengthening spleen and nourishing the kidney to strengthen the spleen and nourish the kidney. The method of raising clear and reducing turbidity can improve symptom score of patients with chronic kidney disease in 3-5 stages, effectively improve clinical symptoms, reduce urea nitrogen, serum creatinine, increase glomerular filtration and hemoglobin level, improve renal function and anemia of patients. Delay the progress of chronic kidney disease.
【学位授予单位】：广州中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R277.5

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