活血利水法对原发性肾性水肿血瘀证的临床疗效观察

发布时间：2018-05-13 01:10

本文选题：原发性肾性水肿 + 血瘀证　；参考：《青岛大学》2017年硕士论文

【摘要】：目的:研究活血利水法对原发性肾性水肿血瘀证的临床疗效观察,探讨其作用机制。方法:随机选取菏泽市中医医院在2016年3月份—2016年8月份接受治疗的70例原发性肾性水肿血瘀证型的患者(急性肾小球肾炎、肾病综合征、慢性肾功能衰竭)进行了临床研究。将患者随机分为两组,治疗组35例,对照组35例。在对患者进行治疗时,治疗组和对照组所有的患者均进行常规西医治疗,治疗方式主要是应用糖皮质激素、降压、降脂、免疫抑制剂以及对症支持治疗等,治疗组患者在西医治疗的基础上进行中医辩证应用丹芪活血利水汤治疗,患者的治疗周期为8个周。在治疗过程中要对患者的中医症候变化情况、24小时内尿蛋白定量、尿红细胞、肾小球滤过率、血肌酐、尿素氮、凝血酶原时间、ANP等进行实时监测,并进行记录。服药期间两组均予以同样的饮食指导。结果:1.总体疗效比较:治疗组有效率为93.33%,对照组患者71.42%(P0.05),总体疗效显著优于对照组,差异具有统计学意义。2.两组治疗前后24小时尿蛋白定量比较:两组治疗前后都有明显的降低,在降低蛋白尿水平上有统计学差异(P0.05或0.01),治疗组优于对照组。3.两组治疗前后血浆白蛋白比较:血浆白蛋白都有所升高,差值有统计学差异(P0.05或0.01),治疗组疗效明显优于对照组。4.两组治疗前后心钠素(ANP)比较:两组水平都有明显升高前后的比较统计(P0.01),具有明显差异。治疗组对升高患者ANP的作用明显优于对照组。5.两组治疗前后尿红细胞计数比较:患者尿红细胞记数水平都有明显降低,组间比较,经用药前后统计检验,具有明显差异(P0.01)。治疗组降低患者尿红细胞水平疗效明显优于对照组。6.两组治疗前后血肌酐、尿素氮比较:治疗前后都有所降低,同组间比较,经用药前后的比较统计检验(P0.05),具有显著差异。治疗组和对照组组间对比无统计学差异。结论:活血利水药物能有效改善原发性肾性水肿血瘀证患者症状,显著降低尿蛋白排泄量,减少尿红细胞,降低患者血肌酐、尿素氮水平,改善患者的肾功能。
[Abstract]:Objective: to study the clinical effect of activating blood circulation and promoting water therapy on primary renal edema and blood stasis syndrome and to explore its mechanism. Methods: 70 patients with primary renal edema and blood stasis syndrome (acute glomerulonephritis, nephrotic syndrome) were randomly selected from Heze traditional Chinese Medicine Hospital from March 2016 to August 2016. Chronic renal failure (CRF) is a clinical study. The patients were randomly divided into two groups: treatment group (n = 35) and control group (n = 35). When the patients were treated, all the patients in the treatment group and the control group were treated with routine western medicine. The main methods of treatment were glucocorticoid, hypotension, lipid-lowering, immunosuppressant and symptomatic support therapy. The patients in the treatment group were treated with Danqi Huoxue Lishui decoction on the basis of western medicine treatment. The treatment period was 8 weeks. In the course of treatment, the changes of TCM symptoms should be monitored in real time, such as urine protein quantity, urine red blood cell, glomerular filtration rate, blood creatinine, urea nitrogen, prothrombin time and ANP. Both groups were given the same dietary guidance during medication. The result is 1: 1. Comparison of overall efficacy: the effective rate of the treatment group was 93.33 and that of the control group was 71.42 and P0.05.The overall curative effect was significantly better than that of the control group, and the difference was statistically significant. Two groups before and after treatment 24 hours urine protein quantitative comparison: two groups before and after treatment have the obvious reduction, in the reduction albuminuria level has the statistical difference P05 or 0.01, the treatment group is superior to the control group. 3. Comparison of plasma albumin between the two groups before and after treatment: plasma albumin increased, the difference was statistically significant (P0.05 or 0.01), the therapeutic effect of the treatment group was significantly better than that of the control group. 4. Comparison of atrial natriuretic peptide (ANPs) before and after treatment: there were significant differences between the two groups before and after treatment. The effect of ANP in treatment group was better than that in control group. Comparison of urine erythrocyte count before and after treatment in two groups: the count level of urine red blood cell in patients was significantly decreased, and there was a significant difference between the two groups by statistical test before and after treatment (P 0.01). The therapeutic effect of reducing urine erythrocyte level in the treatment group was significantly better than that in the control group. 6. 6. Comparison of serum creatinine and urea nitrogen between the two groups before and after treatment: before and after treatment, there was a significant difference between the two groups. There was no statistical difference between the treatment group and the control group. Conclusion: the drugs of promoting blood circulation and promoting water can effectively improve the symptoms of patients with primary renal edema and blood stasis syndrome, reduce urine protein excretion, reduce urine red blood cells, reduce the levels of serum creatinine and urea nitrogen, and improve the renal function of the patients.
【学位授予单位】：青岛大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R256.51

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