宋立群教授治疗肾性蛋白尿用药规律的研究

发布时间：2018-04-01 18:05

本文选题：肾性蛋白尿　切入点：用药规律　出处：《黑龙江中医药大学》2016年硕士论文

【摘要】：目的：通过分析宋立群教授治疗肾性蛋白尿所使用的药物,总结出宋立群教授治疗肾性蛋白尿的基本治疗方法及临床用药规律,为今后中医药治疗肾性蛋白尿提供更有力的理论依据与临床指导,同时有助于专家经验的完善与发展。方法：根据纳入及排除标准收集2011年01月至2015年06月就诊于黑龙江中医药大学附属第一医院肾病科门诊及病房的500名肾性蛋白尿患者的首诊处方,所有患者均由宋立群教授诊治。将500个处方中使用的药物运用SPSS18.0统计软件进行频数分析、聚类分析,运用SAS统计软件进行因子分析,并归纳总结其规律结果：1.频数分析结果收入的500则临床处方中共使用164味药,总频数为8902次。其中有39味药物的使用频数在50次以上,累计使用频率达83.52%。前26味药物的使用频数在100次以上,累计使用频率达72.37%,是治疗肾性蛋白尿的主要药物。药物四气统计由高到低排列为平性、温性、寒性、凉性药；五味统计由高到低排列为甘味、苦味涩味、酸味、辛味、淡味、咸味；归经统计前五位依次排列为肝、肾、脾、胃、肺。药类统计以补虚药和收涩药使用频次最高,为治疗肾性蛋白尿最主要的两类药物。2.聚类分析结果本研究对累计使用频率在91.61%以上的62味药物进行聚类分析,共得到常用药对组合9对,常用药物组合6组。3.因子分析结果本研究对累计使用频率在91.61%以上的62味药物进行因子分析,得出公因子17个。结论：1.白术、芡实、黄芪、金樱子、女贞子、茯苓、覆盆子、沙苑子、菟丝子、白果、桑螵蛸、生地黄、大蓟、小蓟、熟地黄、杜仲、穿山龙、龙葵、石莲子、侧柏叶、地榆、苏木、墨旱莲,是治疗肾性蛋白尿的主要药物；2.平、温、微温；甘、苦、涩；肾经、脾经、肝经是治疗肾性蛋白尿用药的主要性味、归经；3.补虚药、收涩药是治疗肾性蛋白尿的主要药物类别；4.利水渗湿药、祛风湿药、活血化瘀药、清热药是治疗肾性蛋白尿邪实之证的主要药物类别；5.肾精失固、脾失健运、肝阴不足、肺失输布与湿、热、毒瘀等病理产物夹杂致病是肾性蛋白尿主要的病机、病性；6.重视调畅气机,本虚与标实同治是肾性蛋白尿的基本治疗原则。
[Abstract]:Objective: to analyze the drugs used by Professor Song Li-qun in the treatment of renal proteinuria, and to summarize the basic treatment methods and clinical drug use of Professor Song Li-qun for the treatment of renal proteinuria.It provides more effective theoretical basis and clinical guidance for the treatment of renal proteinuria with traditional Chinese medicine in the future, and is helpful to the improvement and development of expert experience at the same time.Methods: according to the criteria of inclusion and exclusion, the first diagnosis prescriptions of 500 renal proteinuria patients were collected from January 2011 to June 2015 in the Department of Renal Clinic and Ward of the first affiliated Hospital of Heilongjiang University of traditional Chinese Medicine.All patients were treated by Professor Song Liqun.The drugs used in 500 prescriptions were analyzed by SPSS18.0 statistical software, cluster analysis, factor analysis by SAS statistical software, and summarized the regular result: 1. 1.The total frequency of the 500 clinical prescriptions was 8902.39 of them were used more than 50 times, and the accumulative frequency was 83.52.The first 26 drugs were used more than 100 times and the accumulative frequency was 72.37. It was the main drug for the treatment of renal proteinuria.From high to low, the statistics of the four qi of drugs are arranged as flat, warm, cold and cool drugs; the statistics of five flavors are arranged from high to low to sweet, bitter, acrid, sour, symplectic, light and salty; the top five are liver, kidney, spleen and stomach.Lung.The most frequently used drugs are tonifying drugs and astringent drugs, which are the two most important drugs in the treatment of renal proteinuria.The results of cluster analysis showed that there were 9 pairs of common drug pairs and 6 groups of commonly used drugs.The results of factor analysis showed that there were 17 common factors in 62 drugs whose cumulative frequency was over 91.61%.Conclusion 1.Atractylodes macrocephala, Euryale Euryale, Astragalus membranaceus, Cherry Cherry, Ligustrum lucidum, Poria cocos, Raspberry, Astragalus complanatus, Cuscuta chinensis, White Fruit, Mater Mater, Raw Rehmannia, Thistle, small thistle, cooked Rehmannia, Eucommia, Trigonthus chinensis, Dragon Sunflower, Lotus seed, side Cypress Leaf, Ulmus pumila, Sappa sappa,Artemisia mongolica, is the main treatment of renal proteinuria 2.Flat, warm, mild temperature; Gan, bitter, astringent; Kidney, spleen, liver Meridian is the main sexual flavor of the treatment of renal proteinuria.Tonifying medicine, astringent medicine is the main type of treatment of renal proteinuria.The medicine of promoting water and infiltrating dampness, dispelling rheumatism, activating blood circulation and removing blood stasis and clearing away heat are the main kinds of drugs to treat the syndrome of kidney proteinuria.The pathogenesis of renal proteinuria is mainly caused by kidney essence loss, spleen failure, liver yin deficiency, lung loss and dampness, heat, toxin stasis and other pathological products.It is the basic principle of kidney proteinuria to pay attention to regulating qi regulating machine and treating deficiency with standard solid.
【学位授予单位】：黑龙江中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R249;R277.5

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