刘玉宁教授应用中药治疗膜性肾病的临床疗效观察

发布时间：2018-04-12 18:55

本文选题：膜性肾病 + 中药治疗　；参考：《北京中医药大学》2017年硕士论文

【摘要】：目的进一步证实刘玉宁教授治疗膜性肾病的中药方案的有效性,探索更好的治疗方案,为中医治疗成人膜性肾病提供参考。方法本研究属于回顾性分析研究,共收集67例MN患者,分为中药组32例、西药组35例。两组除给予对症基础治疗外,中药组予中药汤剂,根据患者个人情况,辨证论治,随证加减,西药组均应用免疫抑制治疗方案,观察期均为6个月,数据采集时间点为治疗前、治疗3个月、治疗6个月后,对两组24小时尿蛋白、血清白蛋白及中医证候积分治疗前后疗效进行对比,运用软件SPSS 17.0统计分析。结果1.蛋白尿疗效评价:中药组24小时尿蛋白定量由治疗前的4.43±2.64下降至2.58±2.15,临床痊愈1例,显效16例,有效14例,无效1例,总有效率96.9%;西药组24小时尿蛋白定量由治疗前的4.80±2.08下降至3.17±2.39,临床痊愈2例,显效15例,有效10例,无效8例,总有效率77.1%,两组均可有效降低尿蛋白的水平,经秩和检验,P0.05,认为两组在降低尿蛋白水平方面统计学上无差异。2.中医证候学疗效评价:中药组中医证候积分由治疗前30.20± 10.76下降至19.00±9.23,临床痊愈0例,显效2例,有效19例,无效9例,总有效率70.0%;西药组中医证候积分由治疗前26.17± 10.19下降至18.46±8.51,临床痊愈0例,站效1例,有效13列,无效21例,总有效率40.0%,两组均可有效改善症状,经秩和检验,P0.05,中药组在改善症状方面优于西药组。3.血清蛋白:中药组和西药组均可升高血清白蛋白,经协方差分析,P0.05,认为两组在升高血清白蛋白方面差异不明显。结论中药组在降低尿蛋白水平方面疗效显著,与西药组的疗效无明显差异;两组在升高血清白蛋白方面疗效相当;中药组在改善中医证候情况方面优于西药方案,两者均有疗效;刘玉宁教授治疗膜性肾病的中医治疗方案疗效显著,具有较高临床价值,值得进一步探索研究。
[Abstract]:Objective to further confirm the effectiveness of Professor Liu Yuning in treating membranous nephropathy and explore a better treatment scheme to provide reference for the treatment of adult membranous nephropathy.Methods 67 patients with MN were divided into Chinese medicine group (n = 32) and western medicine group (n = 35).In addition to basic symptomatic treatment, the traditional Chinese medicine group was given traditional Chinese medicine decoction. According to the individual situation of the patients, the patients were treated with differentiation of symptoms and signs, plus or minus with the syndrome. The western medicine group were treated with immunosuppressive therapy program, the observation period was 6 months, and the time point of data collection was before treatment.After 3 months of treatment and 6 months of treatment, the effects of 24 hours urine protein, serum albumin and TCM syndromes integral before and after treatment were compared between the two groups. The statistical analysis was carried out by using software SPSS 17.0.Result 1.Evaluation of the therapeutic effect of proteinuria: in the Chinese medicine group, the urinary protein quantity decreased from 4.43 卤2.64 before treatment to 2.58 卤2.15. 1 case was cured, 16 cases were effective, 14 cases were effective, and 1 case was ineffective.The total effective rate was 96.90.In the western medicine group, the 24-hour urinary protein quantity decreased from 4.80 卤2.08 before treatment to 3.17 卤2.39. The clinical recovery was 2 cases, the effective rate was 15 cases, the effective rate was 10 cases, the total effective rate was 77.1%, and both groups could effectively reduce the level of urinary protein.The rank sum test showed that there was no statistical difference between the two groups in reducing urinary protein levels. 2. 2.Evaluation of TCM syndromes efficacy: the score of TCM syndromes decreased from 30.20 卤10.76 before treatment to 19.00 卤9.23 in TCM group. There were 0 cases of clinical recovery, 2 cases of remarkable effect, 19 cases of effective and 9 cases of failure.The score of TCM syndromes in the western medicine group decreased from 26.17 卤10.19 before treatment to 18.46 卤8.51, the clinical recovery was 0 cases, the station effect was 1 case, the effective rate was 13 cases, the total effective rate was 40.0%.By rank sum test, P0.05, the traditional Chinese medicine group is better than the western medicine group in improving symptoms. 3.Serum protein: both Chinese medicine group and western medicine group could increase serum albumin, and the analysis of covariance showed that there was no significant difference between the two groups in raising serum albumin.Both of them have curative effect. Professor Liu Yu-ning 's traditional Chinese medicine treatment for membranous nephropathy has remarkable curative effect and has high clinical value, which is worthy of further exploration and study.
【学位授予单位】：北京中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R249;R277.5

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