升清降浊法治疗慢性肾衰竭脾肾亏虚、湿浊潴留证的临床研究

发布时间：2018-05-04 18:49

本文选题：脾肾亏虚、湿浊潴留 + 慢性肾衰竭　；参考：《山东中医药大学》2016年硕士论文

【摘要】：目的:观察升清降浊法治疗慢性肾衰竭脾肾亏虚、湿浊潴留证的临床疗效,并探讨其作用机理,为临床治疗慢性肾衰竭提供一定的理论依据。方法:将符合纳入标准的60例患者,随机分为试验组与对照组各30例。两组均予西医常规治疗,试验组予升清降浊汤中药煎剂,对照组予尿毒清颗粒。两组均以8周为1疗程。观察患者治疗前后血肌酐(Scr)、尿素氮(BUN)、内生肌酐清除率(Ccr)、24h尿蛋白定量(UPQ)、血红蛋白(Hb)、血红细胞计数(RBC)、血清白蛋白(Alb)及中医症状和证候积分的变化。结果:(1)临床综合疗效:治疗后对照组总有效率60%,试验组总有效率76.67%,两组比较有显著差异(P0.05),表明试验组临床综合疗效优于对照组。(2)中医证候疗效:对照组总有效率66.67%;试验组总有效率86.67%,试验组明显高于对照组(P0.05)。(3)肾功能:两组治疗后血Scr和BUN均降低,Ccr升高,与治疗前比较均具有显著性差异(P0.05),说明试验组和对照组均能改善肾功能;治疗后血Scr、BUN、Ccr组间比较有统计学意义(P0.05),说明试验组在改善肾功能方面优于对照组。(4)血常规、Alb、24hUPQ:试验组治疗后Hb、RBC、Alb均明显升高,24hUPQ降低,与治疗前相比均具有显著性差异(P0.05),对照组治疗后Hb、RBC、Alb升高,24hUPQ降低,与治疗前相比具有统计学意义(P0.05);治疗后Hb、RBC、24hUPQ、Alb组间比较具有显著性差异(P0.05),说明试验组升高Hb、RBC、Alb,降低24hUPQ优于对照组。结论:运用升清降浊法治疗慢性肾衰竭脾肾亏虚、湿浊潴留证具有较好的疗效,对于改善肾功能、肾性贫血及低蛋白血症,延缓慢性肾衰竭病程的进展,具有一定的临床意义,值得进一步研究和推广。
[Abstract]:Objective: to observe the clinical effect of Shengqingjiangzhuo method in treating chronic renal failure with deficiency of spleen and kidney and retention of dampness and turbidity, and to explore its mechanism, and to provide some theoretical basis for clinical treatment of chronic renal failure. Methods: 60 patients who met the inclusion criteria were randomly divided into two groups: the experimental group (n = 30) and the control group (n = 30). Both groups were treated with routine western medicine. The experimental group was treated with Shengqing Jiangzhuo decoction and the control group with Niaoduqing granule. Both groups were treated with 8 weeks as a course of treatment. Before and after treatment, the changes of creatinine, bun, creatinine clearance rate (CCR), 24-hour urinary protein quantification (UPQN), hemoglobin (HB), red blood cell count (RBCU), serum albumin (Alb), TCM symptoms and syndromes were observed. Results 1) Clinical comprehensive curative effect: after treatment, the total effective rate of the control group was 60 and the total effective rate of the test group was 76.67. There was a significant difference between the two groups, which indicated that the clinical comprehensive curative effect of the experimental group was better than that of the control group. 2) the total effective rate of the control group was better than that of the control group. The total effective rate of the test group was 86.67, which was significantly higher than that of the control group (P 0.05, P < 0.05).) Renal function: after treatment, both Scr and BUN in the two groups decreased the increase of CCR, and the total effective rate in the experimental group was 86.67, which was significantly higher than that in the control group. Compared with before treatment, there was significant difference (P 0.05), which indicated that both the experimental group and the control group could improve the renal function. After treatment, there was a significant difference in blood Scr-BUNCcr group (P 0.05), which indicated that the experimental group was superior to the control group in improving renal function (P < 0.05). There were significant differences between the two groups before and after treatment (P 0.05). The levels of 24hUPQ in the control group were significantly higher than those before the treatment (P 0.05), and that in the control group was significantly higher than that in the control group (P 0.05), which indicated that the increase of 24hUPQ in the test group was better than that in the control group (P < 0.05). Conclusion: the treatment of chronic renal failure with deficiency of spleen and kidney, retention of dampness and turbidity is effective, and it is of clinical significance to improve renal function, renal anemia and hypoproteinemia, and to delay the progression of chronic renal failure. It is worthy of further study and popularization.
【学位授予单位】：山东中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R277.5

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