复方大黄积雪草颗粒及大黄蛰虫丸对特发性FSGS的临床优选研究

发布时间：2018-05-08 07:56

本文选题：特发性FSGS + 积雪草　；参考：《广西中医药大学》2017年硕士论文

【摘要】：目的:观察复方大黄积雪草颗粒及大黄蛰虫丸治疗特发性局灶节段性肾小球硬化的疗效,以评价复方大黄积雪草颗粒及大黄蛰虫丸的临床疗效及安全性,为寻找广西特色药治疗特发性FSGS提供经验。方法:选取2015年1月至2016年6月广西中医药大学附属瑞康医院、广西中医药大学第一附属医院及解放军三零三医院门诊及病房收治的分期属于CKD2~3期,尿蛋白水平小于3.5g/d的特发性FSGS,中医辨证属脾肾亏虚、湿热瘀血患者60例为研究对象,用随机数字表法,随机分为A、B、C组,各20例,A组给予厄贝沙坦片,每日1次,每次300mg,于每日清晨时服药。B组在A组基础上予大黄蛰虫丸,每次3g,每日3次。C组在A组基础上给予复方大黄积雪草颗粒,每次口服15g,每日3次。三组采取同样的基础治疗,共同观察12周。所有患者于用药前后分别检测相关指标:ALB、BUN、Scr、TG、TC、LDL-C、HDL-C、PT、APTT、URBC、UCyst C、24UPR。从0周开始每隔4周测1次共4次。同时观察患者治疗前后的临床体征及症状改善状况,比较各组治疗后的效果。结果:1、治疗后三组患者取得较好的疗效,B、C两组的总有效率分别是89.47%和90.00%,均明显优于A组63.16%(P0.05),差异有统计学意义,且B、C两组疗效相近(P0.05)。2、三组中医症候积分经过治疗后均有所下降(P0.05),但B、C两组均较A组下降更为明显(P0.01),且B、C两组无明显差异(P0.05)。三组治疗后24UPR、TC、TG、LDL-C、Scr、BUN、URBC、UCyst C均有所下降,ALB、HDL-C均有所上升(P0.05),但B、C两组均较A组改善更为明显(P0.05),且B、C两组疗效相近(P0.05)。3、三组治疗前后PT、APTT比较均无明显差异(P0.05)。A组患者中有3例出现了上呼吸道感染,B组患者有5例出现了轻度腹泻,C组患者无明显不适。结论:复方大黄积雪草颗粒及大黄蛰虫丸对分期属于CKD2~3期,尿蛋白水平小于3.5g/d的特发性FSGS且中医辨证属脾肾亏虚,湿热瘀血的患者临床疗效较好,且两种药物的疗效相当,但复方大黄积雪草颗粒不良反应较少。
[Abstract]:Objective: to observe the curative effect of compound rhubarb asiatica granule and rhubarb Zhizheng pill in the treatment of idiopathic focal segmental glomerulosclerosis, and to evaluate the clinical efficacy and safety of compound rhubarb asiatica granule and rhubarb Zhizheng pill. To provide experience for finding characteristic drugs in Guangxi for treating idiopathic FSGS. Methods: from January 2015 to June 2016, the stage of outpatient treatment and ward treatment of Ruikang Hospital affiliated to Guangxi University of traditional Chinese Medicine, the first affiliated Hospital of Guangxi University of traditional Chinese Medicine and the PLA 303 Hospital were classified as CKD2~3. 60 patients with deficiency of spleen and kidney and blood stasis due to dampness and heat were divided randomly into group A (n = 20) and group A (n = 20) with irbesartan once a day. Group B was given rhubarb stinging pill on the basis of group A, 3 g each time, and group C was given compound rhubarb asiatica granule on the basis of group A three times a day, taking orally 15g every time, 3 times a day. The three groups received the same basic treatment and were observed for 12 weeks. All the patients were tested for the relative indexes of TCLDL-C PTT APTTBCU UCyst Con 24 UPR. before and after administration of the drug, the relevant indexes were: 1% ALBN BUNG, TGG, TCU, LDL-C, PTT, APTTT BCU, UCyst C, 24 UPR. From 0 weeks to 4 weeks, a total of 4 times every 4 weeks. At the same time, the clinical signs and symptoms were observed before and after treatment. Results the total effective rates of the three groups were 89.47% and 90.005, respectively, which were significantly better than those of group A (63.16P 0.05). The scores of TCM symptoms in the three groups were all decreased after treatment, but both of the two groups were significantly lower than group A (P 0.01), and there was no significant difference between the two groups (P 0.05). After treatment, the levels of HDL-C in all three groups were decreased, but the improvement of HDL-C in both groups was more obvious than that in group A (P 0.05), and the curative effect of group B C was similar to that of group B C (P 0.05). There was no significant difference in PTT APTT between the three groups before and after treatment. In group A, there was no significant difference in the levels of PTT and APTT between the two groups. There was no significant difference between the three groups before and after treatment. In group A, there was no significant difference between the two groups. There were 5 cases of mild diarrhea in group B with respiratory tract infection and no obvious discomfort in group C. Conclusion: compound Rhubarb Xuecao granule and Rhubarb Zhechong Pill belong to CKD2~3 stage, urine protein level is lower than 3.5g/d in idiopathic FSGS, TCM syndrome differentiation belongs to deficiency of spleen and kidney, damp-heat blood stasis is a better clinical effect, and the two drugs have the same curative effect. But the adverse reaction of compound rhubarb asiatica granule is less.
【学位授予单位】：广西中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R277.5

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