慢性肾功能不全急性加重的证型分布规律研究

发布时间：2018-05-10 22:00

本文选题：慢性肾功能不全急性加重 + 中医证型　；参考：《南京中医药大学》2017年硕士论文

【摘要】：1研究目的慢性肾功能不全急性加重非常常见,本文探讨慢性肾功能不全急性加重证型的分布规律,为进一步规范中医辨证论治、提高临床疗效提供可靠依据。2研究内容和方法通过回顾性分析无锡市中医医院肾病科住院病人的临床资料分析慢性肾功能不全急性加重的病例,研究慢性肾功能不全患者急性加重的原因;根据患者临床表现,通过中医望闻问切四诊分析,对急性加重患者中医证型进行总结,并且分析证型的分布规律。3研究结果1)本研究共调查86例患者,其中男性46例,女性40例,年龄28-89岁。2)原发病中最常见的是慢性肾小球肾炎,其次是糖尿病肾病、高血压性肾病、多囊肾、梗阻性肾病、慢性肾间质性肾炎、狼疮性肾病等。3)急性加重因素最常见于各种感染(48.84%),其次为血压急剧升高(16.28%)、急性心功能不全(16.28%)以及肾毒性药物(13.95%),原发疾病活动(2.33%)、消化道出血(2.33%)较少见。4)中医证型分布规律:所有证型均为虚实夹杂证型。正虚证(脾肾气虚证30例,肝肾阴虚23例,脾肾气阴两虚证19例,脾肾阳虚证8例,阴阳两虚证6例)。邪实证(湿热证29例,血瘀证23例,湿浊证17例,水气证15例,风动证2例)。4结论慢性肾功能不全急性加重好发于中老年人。慢性肾功能不全急性加重的原因包括各种感染、血压急剧升高、急性心功能衰竭、肾毒性药物等,其中感染最常见。中医证型特点为正虚邪实,正虚以脾肾气虚、肝肾阴虚多见,邪实以湿热证、血瘀证多见。
[Abstract]:Objective to investigate the distribution of acute exacerbation of chronic renal insufficiency in order to further standardize the treatment of TCM syndrome differentiation. To improve the clinical efficacy and provide reliable basis for 2 research contents and methods through retrospective analysis of the clinical data of the hospitalized patients in the Renal Department of Wuxi traditional Chinese Medicine Hospital, the cases of acute exacerbation of chronic renal insufficiency were analyzed. To study the causes of acute aggravation in patients with chronic renal insufficiency, to summarize the TCM syndrome types of patients with acute aggravation according to the clinical manifestations of the patients, In this study, 86 patients (46 males and 40 females aged 28-89 years) were investigated. The most common primary disease was chronic glomerulonephritis, followed by diabetic nephropathy. Hypertensive nephropathy, polycystic kidney disease, obstructive nephropathy, chronic renal interstitial nephritis, Lupus nephropathy and other acute exacerbation factors are most common in all kinds of infections 48.84A, followed by a sharp rise in blood pressure 16.28, acute cardiac insufficiency 16.28) and nephrotoxic drugs 13.9595, the primary disease activity 2.33g, gastrointestinal bleeding 2.33) less common. 4) TCM syndrome classification. Rule of cloth: all syndromes are deficiency-solid mixed card type. There were 30 cases of deficiency of spleen and kidney qi, 23 cases of yin deficiency of liver and kidney, 19 cases of deficiency of qi and yin of spleen and kidney, 8 cases of deficiency of yang of spleen and kidney, 6 cases of deficiency of yin and yang. There were 29 cases of dampness and heat syndrome, 23 cases of blood stasis syndrome, 17 cases of dampness and turbid syndrome, 15 cases of water and qi syndrome and 2 cases of wind movement syndrome. Conclusion the acute exacerbation of chronic renal insufficiency is more common in middle and old people. The causes of acute exacerbation of chronic renal insufficiency include various infections, rapid elevation of blood pressure, acute heart failure and nephrotoxic drugs, among which infection is the most common. TCM syndromes are characterized by deficiency of qi and deficiency of spleen and kidney, Yin deficiency of liver and kidney, damp-heat syndrome and blood stasis syndrome.
【学位授予单位】：南京中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R277.5

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