程锦国益气活血化瘀汤治疗慢性肾炎气虚血瘀型的临床观察
发布时间：2018-09-04 20:46
【摘要】：目的本研究通过观察程锦国益气活血化疲汤对慢性肾炎气虚血瘀型的中医症状积分及尿红细胞计数、24小时尿蛋白定量、血浆白蛋白、肾功能、体液免疫指标等实验室指标水平的影响,客观评价益气活血化瘀汤对慢性肾炎气虚血瘀型的治疗作用,并探讨其作用机制。探讨程锦国教授益气活血化瘀汤治疗慢性肾炎气虚血瘀型的疗效。方法从2014年10月到2015年12月在温州市中医院肾内科门诊及住院的患者中筛选,随机分为对照组(30例)和治疗组(30例),对照组用单纯西医治疗(科索亚片),治疗组给予在科索亚片的基础上加用益气活血化瘀汤,两组均治疗6个月。观察两组患者中医症状积分及尿红细胞计数、24小时尿蛋白定量、血浆白蛋白、肾功能、体液免疫指标等实验室指标水平的变化,并对比两组疗效。结果1.疾病疗效评价:治疗组总有效率86.67%,对照组总有效率66.67%,两组有显著性差异(P0.05)。益气活血化瘀汤的疾病疗效优于对照组。2.证候疗效评价:治疗组总有效率83.33%,对照组总有效率50.00%,两组有非常显著性差异(P0.01)。益气活血化瘀汤的证候疗效明显优于对照组。3.中医症状总积分评价:治疗后两组中医症状总积分有非常显著性差异(P0.01),益气活血化瘀汤对中医症状的改善明显优于对照组。4.单项症状积分评:治疗后两组在疲倦乏力、自汗、面色黧黑或晦暗、腰痛、肢体麻木症状改善方面,有非常显著性差异(P0.01),在气短、懒言改善方面,有显著性差异(P0.05),益气活血化瘀汤对于各项症状的改善明显优于对照组。5.血尿疗效评价:治疗后两组尿红细胞计数有非常显著性差异(P0.01),益气活血化疲汤改善血尿明显优于对照组。6.蛋白尿疗效评价:治疗后两组24小时尿蛋白定量有显著性差异(P0.05),益气活血化瘀汤改善蛋白尿优于对照组。7.肾功能及血白蛋白评价:治疗后两组血浆白蛋白、肌酐及尿素氮有显著性差异(P0.05),益气活血化瘀汤降低肌酐、尿素氮、提高血白蛋白优于对照组。8.免疫指标评价:治疗后免疫球蛋白IgG、IgA、补体C3两组有显著性差异(P0.05),益气活血化瘀汤对血清IgG、IgA、C3改善优于对照组。结论治疗组能有效改善慢性肾炎气虚血疲型患者的临床症状,尤其在疲倦乏力、自汗、面色黧黑或晦暗、腰痛、肢体麻木的症状改善方面,明显优于对照组,亦能有效减少血尿和蛋白尿,改善白蛋白,稳定肾功能,调节免疫,提高患者的生存质量,表明益气活血化瘀汤是治疗慢性肾炎气虚血瘀型的有效方剂,为临床治疗慢性肾炎气虚血疲型提供了新的、安全的治疗方法。
[Abstract]:Objective to observe the effect of Cheng Jinguo Yiqi Huoxue Huazhi decoction on TCM symptom score and urine erythrocyte count of chronic nephritis with Qi deficiency and blood stasis syndrome and 24 hours urine protein quantification, plasma albumin and renal function. The effect of humoral immunity index and other laboratory indexes on the therapeutic effect of Yiqi Huoxue Huayu decoction on qi deficiency and blood stasis type of chronic nephritis was evaluated objectively and its mechanism was discussed. To explore the therapeutic effect of Cheng Jinguo Professor Yiqi Huoxue Huayu decoction in treating chronic nephritis with qi deficiency and blood stasis. Methods from October 2014 to December 2015, the patients were selected from outpatients and inpatients of Department of Renal Medicine, Wenzhou traditional Chinese Medicine Hospital. They were randomly divided into control group (30 cases) and treatment group (30 cases). The control group was treated with western medicine alone (Kosova tablet), the treatment group was treated with Yiqi Huoxue Huayu decoction on the basis of Kosova tablet, both groups were treated for 6 months. To observe the changes of TCM symptom score and urine red blood cell count 24 hours urine protein quantity, plasma albumin, renal function, humoral immunity index and so on, and to compare the curative effect between the two groups. Result 1. The total effective rate of the treatment group was 86.67 and that of the control group was 66.67.The difference between the two groups was significant (P0.05). The curative effect of Yiqi Huoxue Huayu decoction was better than that of control group. The total effective rate of the treatment group was 83.33 and that of the control group was 50.00.The difference between the two groups was very significant (P0.01). The syndrome effect of Yiqi Huoxue Huayu decoction was better than that of control group. The total integral evaluation of TCM symptoms: after treatment there was a very significant difference between the two groups (P0.01), Yiqi Huoxue Huayu decoction to improve TCM symptoms was significantly better than the control group. 4. Single symptom score: after treatment, there were significant differences between the two groups in terms of fatigue and fatigue, self-sweating, dark complexion, low back pain, limb numbness (P0.01), improvement of shortness of breath and lazy speech. There was significant difference (P0.05), Yiqi Huoxue Huayu decoction for the improvement of symptoms was significantly better than the control group. 5. Evaluation of the curative effect of hematuria: after treatment, the two groups had very significant difference in urine red blood cell count (P0.01), Yiqi Huoxue Huapi decoction improved hematuria obviously better than the control group. 6. Evaluation of the therapeutic effect of proteinuria: there was significant difference between the two groups after treatment (P0.05), the improvement of proteinuria by Yiqi Huoxue Huayu decoction was better than that of the control group. 7. Renal function and serum albumin evaluation: after treatment, there were significant differences in plasma albumin, creatinine and urea nitrogen between the two groups (P0.05). Yiqi Huoxue Huayu decoction decreased creatinine, urea nitrogen, and increased serum albumin. Evaluation of immune index: after treatment immunoglobulin IgG,IgA, complement C3 had significant difference (P0.05), Yiqi Huoxue Huayu decoction improved serum IgG,IgA,C3 better than control group. Conclusion the treatment group can effectively improve the clinical symptoms of chronic nephritis patients with qi deficiency and blood exhaustion, especially in the aspects of fatigue and fatigue, self-sweating, dark or dark complexion, low back pain and limb numbness, which are obviously superior to those in the control group. It can also effectively reduce hematuria and proteinuria, improve albumin, stabilize renal function, regulate immunity and improve the quality of life of patients. It shows that Yiqi Huoxue Huayu decoction is an effective prescription for treating chronic nephritis with qi deficiency and blood stasis. It provides a new and safe method for the treatment of chronic nephritis qi deficiency and blood exhaustion.
【学位授予单位】：浙江中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R249;R277.5
本文编号：2223283
[Abstract]:Objective to observe the effect of Cheng Jinguo Yiqi Huoxue Huazhi decoction on TCM symptom score and urine erythrocyte count of chronic nephritis with Qi deficiency and blood stasis syndrome and 24 hours urine protein quantification, plasma albumin and renal function. The effect of humoral immunity index and other laboratory indexes on the therapeutic effect of Yiqi Huoxue Huayu decoction on qi deficiency and blood stasis type of chronic nephritis was evaluated objectively and its mechanism was discussed. To explore the therapeutic effect of Cheng Jinguo Professor Yiqi Huoxue Huayu decoction in treating chronic nephritis with qi deficiency and blood stasis. Methods from October 2014 to December 2015, the patients were selected from outpatients and inpatients of Department of Renal Medicine, Wenzhou traditional Chinese Medicine Hospital. They were randomly divided into control group (30 cases) and treatment group (30 cases). The control group was treated with western medicine alone (Kosova tablet), the treatment group was treated with Yiqi Huoxue Huayu decoction on the basis of Kosova tablet, both groups were treated for 6 months. To observe the changes of TCM symptom score and urine red blood cell count 24 hours urine protein quantity, plasma albumin, renal function, humoral immunity index and so on, and to compare the curative effect between the two groups. Result 1. The total effective rate of the treatment group was 86.67 and that of the control group was 66.67.The difference between the two groups was significant (P0.05). The curative effect of Yiqi Huoxue Huayu decoction was better than that of control group. The total effective rate of the treatment group was 83.33 and that of the control group was 50.00.The difference between the two groups was very significant (P0.01). The syndrome effect of Yiqi Huoxue Huayu decoction was better than that of control group. The total integral evaluation of TCM symptoms: after treatment there was a very significant difference between the two groups (P0.01), Yiqi Huoxue Huayu decoction to improve TCM symptoms was significantly better than the control group. 4. Single symptom score: after treatment, there were significant differences between the two groups in terms of fatigue and fatigue, self-sweating, dark complexion, low back pain, limb numbness (P0.01), improvement of shortness of breath and lazy speech. There was significant difference (P0.05), Yiqi Huoxue Huayu decoction for the improvement of symptoms was significantly better than the control group. 5. Evaluation of the curative effect of hematuria: after treatment, the two groups had very significant difference in urine red blood cell count (P0.01), Yiqi Huoxue Huapi decoction improved hematuria obviously better than the control group. 6. Evaluation of the therapeutic effect of proteinuria: there was significant difference between the two groups after treatment (P0.05), the improvement of proteinuria by Yiqi Huoxue Huayu decoction was better than that of the control group. 7. Renal function and serum albumin evaluation: after treatment, there were significant differences in plasma albumin, creatinine and urea nitrogen between the two groups (P0.05). Yiqi Huoxue Huayu decoction decreased creatinine, urea nitrogen, and increased serum albumin. Evaluation of immune index: after treatment immunoglobulin IgG,IgA, complement C3 had significant difference (P0.05), Yiqi Huoxue Huayu decoction improved serum IgG,IgA,C3 better than control group. Conclusion the treatment group can effectively improve the clinical symptoms of chronic nephritis patients with qi deficiency and blood exhaustion, especially in the aspects of fatigue and fatigue, self-sweating, dark or dark complexion, low back pain and limb numbness, which are obviously superior to those in the control group. It can also effectively reduce hematuria and proteinuria, improve albumin, stabilize renal function, regulate immunity and improve the quality of life of patients. It shows that Yiqi Huoxue Huayu decoction is an effective prescription for treating chronic nephritis with qi deficiency and blood stasis. It provides a new and safe method for the treatment of chronic nephritis qi deficiency and blood exhaustion.
【学位授予单位】：浙江中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R249;R277.5
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