祛瘀化浊汤治疗CKD-Ⅳ期湿浊瘀血证伴血管钙化的临床观察

发布时间：2018-06-21 00:24

本文选题：慢性肾脏病 + 血管钙化　；参考：《黑龙江中医药大学》2017年硕士论文

【摘要】：目的:观察祛瘀化浊汤改善慢性肾脏病4期湿浊瘀血证患者的残肾功能、矿物质代谢及血管钙化的疗效。方法:筛选2016年3月-2016年12月黑龙江中医药大学附属第一医院肾病科门诊患者,选取符合慢性肾脏病4期合并血管钙化,中医辩证属于阴阳俱虚,兼湿浊瘀血证的患者60例。完善患者初始时刻各项理化指标,给予祛瘀化浊汤、西医基础治疗及生活饮食控制。4周为一个疗程,所有患者均给予6个疗程的系统中西医结合治疗。观察患者治疗前后肾小球滤过率、中医症状评分、钙、磷,全段甲状旁腺激素(iPTH),颈动脉内-中膜厚度(IMT)及阻力指数(RI),并做出疗效评价。结果:祛瘀化浊汤对慢性肾脏病4期湿浊瘀血证患者治疗效果较好,总体有效率达94.44%,治疗后各种中医症状有所改善(P0.05)。血肌酐、肾小球滤过滤、血钙、iPTH经过治疗后均有明显改善(P0.01),患者血磷水平在治疗前后无明显改善(P0.05)。患者钙磷乘积在治疗后有所提高(P0.05),治疗后IMT及RI均有不同程度的改善(P0.05)。结论:祛瘀化浊汤可以有效保护慢性肾脏病患者残余肾功能,纠正矿物质代谢紊乱以及PTH异常升高,延缓患者血管钙化,显著改善患者各种不适症状及全身状态,延缓病情进展。
[Abstract]:Objective: to observe the effect of Quyu Huazhuo decoction on residual renal function, mineral metabolism and vascular calcification in patients with dampness and blood stasis syndrome in 4 stages of chronic kidney disease. Methods: from March 2016 to December 2016, 60 patients with chronic kidney disease combined with vascular calcification in the first affiliated Hospital of Heilongjiang University of traditional Chinese Medicine were selected. Improve the initial time of the patients physical and chemical indicators, given Quyu Huazhuo decoction, Western medicine basic treatment and diet control for 4 weeks as a course of treatment, all patients were given 6 courses of integrated Chinese and Western medicine treatment. The glomerular filtration rate, TCM symptom score, calcium, phosphorus, total parathyroid hormone IPTHD, IMT (IMT) and resistance index (RI) were observed before and after treatment, and the curative effect was evaluated. Results: Quyu Huazhuo decoction had a better effect on the patients with dampness and blood stasis syndrome of chronic kidney disease stage 4, the total effective rate was 94.444.After the treatment, all kinds of TCM symptoms were improved (P 0.05). Serum creatinine, glomerular filtration, serum calcium and iPTH were all significantly improved after treatment, and no significant improvement was found in serum phosphorus level before and after treatment. The product of calcium and phosphorus increased after treatment (P 0.05), IMT and RI improved in different degree after treatment. Conclusion: Quyu Huazhuo decoction can effectively protect the residual renal function of patients with chronic kidney disease, correct the disorder of mineral metabolism and the abnormal increase of PTH, delay the vascular calcification of the patients, and significantly improve the patients' symptoms of discomfort and the state of the whole body. Delay the progress of the disease.
【学位授予单位】：黑龙江中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R277.5

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