参芪五苓饮治疗儿童脾虚湿盛型紫癜性肾炎蛋白尿的临床观察

发布时间：2018-04-26 17:57

本文选题：参芪五苓饮 + 儿童紫癜性肾炎　；参考：《云南中医学院》2017年硕士论文

【摘要】：目的:通过临床研究,观察参芪五苓饮治疗儿童脾虚湿盛型紫癜性肾炎蛋白尿的临床疗效。方法:将60例符合脾虚湿盛型的紫癜性肾炎患儿随机、平行、对照,分为治疗组和对照组,各30例。治疗组给予口服参芪五苓饮,对照组给予口服肾炎康复片,两组各治疗2疗程(8周)。疗程结束后,观察治疗前后尿蛋白(PRO)、尿红细胞(RBC)、尿微量蛋白(m ALB)、24小时尿蛋白(UPRO)及中医症候的变化。结果:1.临床的总疗效比较:治疗8周后两组患儿的总有效率比较,治疗组患儿的总有效率为86.67%,对照组患儿的总有效率为66.67%,治疗组总有效率明显优于对照组,可认为差异有显著统计学意义(P0.01)。2.中医证候的总疗效比较:治疗8周后两组患儿的中医证候总有效率比较,治疗组患儿中医证候总有效率为93.3%,对照组患儿中医证候总有效率为70.0%,治疗组中医证候总有效率明显优于对照组,可认为差异有显著统计学意义(P0.01)。3.中医单项症状的疗效比较:治疗8周后两组患儿中医症状都较治疗前有所改善(P0.05);治疗后治疗组患儿皮疹、饮食改善的情况优于对照组,可认为差异有显著统计学意义(P0.01),治疗组患儿体倦乏力、面黄少华、二便的改善情况优于对照组,可认为差异有统计学意义(P0.05);两组患儿治疗8周后汗出无差异,无统计学意义(P㧐0.05)。4.PRO、m ALB、UPRO指标的比较:治疗4周后两组患儿PRO、m ALB、UPRO指标组间比较差异无统计学意义(P㧐0.05),治疗8周后两组患儿PRO、m ALB、UPRO指标组间比较差异有统计学意义(P0.05)。两组患儿治疗前、治疗第4周、治疗第8周组内比较差异有显著统计学意义(P0.01)。5.RBC指标的比较:治疗4周后两组患儿RBC指标组间比较差异有统计学意义(P0.05),治疗8周后两组患儿RBC指标组间比较差异有统计学意义(P0.05)。两组患儿治疗前、治疗第4周、治疗第8周组内比较差异有显著统计学意义(P0.01)。结论:1.参芪五苓饮可明显改善脾虚湿盛型紫癜性肾炎患儿的症状。2.参芪五苓饮可明显改善脾虚湿盛型紫癜性肾炎患儿的尿蛋白、尿微量蛋白、24小时尿蛋白。3.治疗期间未发现明显毒副作用及严重不良反应,说明参芪五苓饮是治疗脾虚湿盛型紫癜性肾炎患儿安全的治疗方法。
[Abstract]:Objective: to observe the clinical effect of Shenqi Wuling decoction on proteinuria of purpura purpura nephritis with spleen deficiency and dampness. Methods: 60 cases of Henoch-Schonlein purpura nephritis were randomly divided into treatment group (n = 30) and control group (n = 30). The treatment group was treated with Shenqi Wuling decoction and the control group with the nephritis rehabilitation tablet. The two groups were treated for 8 weeks. After the course of treatment, the changes of urinary protein proton, urine red blood cell, urinary microalbuminuria and 24 hour urinary protein UPROP were observed before and after the treatment, as well as the symptoms of TCM. The result is 1: 1. Comparison of the total clinical efficacy: after 8 weeks of treatment, the total effective rate of the two groups was 86.67, the total effective rate of the control group was 66.67, the total effective rate of the treatment group was significantly better than that of the control group. It can be concluded that the difference is statistically significant (P 0.01). Comparison of the total curative effect of TCM syndrome: after 8 weeks of treatment, the total effective rate of TCM syndromes in the two groups was compared. The total effective rate of TCM syndrome in treatment group was 93.3g and that in control group was 70.0.The total effective rate of TCM syndrome in treatment group was obviously better than that in control group, and the difference was statistically significant. Comparison of curative effect of single symptom of TCM: after 8 weeks of treatment, the symptoms of TCM in both groups were improved compared with those before treatment, and the situation of skin rash and diet improvement in the treatment group was better than that in the control group after treatment. It can be concluded that the difference is statistically significant (P 0.01). The improvement of fatigue, Huang Shaohua and second stool in the treatment group is better than that in the control group, and there is no difference in sweating after 8 weeks of treatment between the two groups. There was no significant difference between the two groups after 4 weeks of treatment. There was no significant difference between the two groups. After 8 weeks of treatment, there was a significant difference between the two groups in the index of Prom ALBU UPRO (P0.05), and there was a significant difference between the two groups after 8 weeks of treatment (P 0.05). The children in both groups were treated for 4 weeks before treatment. There was significant difference in the RBC index between the two groups after 4 weeks of treatment (P 0.05), and there was significant difference between the two groups after 8 weeks of treatment (P 0.05). After 8 weeks of treatment, there was significant difference between the two groups in the RBC index. There were significant differences between the two groups before, 4 weeks and 8 weeks after treatment (P 0.01). Conclusion 1. Shenqi Wuling decoction can obviously improve the symptoms of spleen deficiency and dampness type purpura nephritis. Shenqi Wuling decoction can obviously improve urine protein in children with spleen deficiency and dampness type purpura nephritis. No obvious side effects and serious adverse reactions were found during the treatment, indicating that Shenqi Wuling Yin is a safe treatment for children with spleen deficiency and dampness purpura purpura nephritis.
【学位授予单位】：云南中医学院
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R272

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