加味升阳益胃汤治疗慢性肾脏病3-4期脾肾亏虚、湿浊内蕴证患者临床疗效的观察
发布时间：2018-10-15 11:43
【摘要】：目的：观察加味升阳益胃汤对慢性肾脏病3-4期脾肾亏虚、湿浊内蕴证患者的血肌酐(Serum creatinine,Scr)、尿素氮(Blood urea nitrogen,BUN)、24小时尿蛋白定量(24 hours urinary protein quantitative,PRO)、尿红细胞(Red blood cell in urine,BLD)、尿酸(Uric acid, UA)、肾小球滤过率(estimated Glomerular filtration rate,eGFR)、总胆固醇(Total cholesterol, TC)、甘油三酯(Triglyceride,TG)、高密度脂蛋白(high density lipoprotein,HDL)、低密度脂蛋白(low density lipoprotein,LDL)、载脂蛋白al(Apoprotein-al,Apo-al)、载脂蛋白b(Apoprotein-b,Apo-b)等的影响；从而进一步评价加味升阳益胃汤对治疗慢性肾脏病3-4期脾肾亏虚、湿浊内蕴证患者的临床应用价值。方法：本研究选取了I晦床辨证为慢性肾脏病3-4期脾肾亏虚、湿浊内蕴证的住院及门诊患者60例,随机分成治疗组和对照组,每组各30例。对照组予以西医常规治疗,治疗组在对照组基础之上,加用加味升阳益胃汤,日一剂,早晚分服各一剂,持续疗程为3个月。观察两组患者治疗前后临床总疗效、中医症状改善情况,肾功能(血肌酐、尿素氮、尿酸、肾小球滤过率),肾损害指标(尿蛋白、尿红细胞),血脂代谢(总胆固醇、甘油三酯、高密度脂蛋白、低密度脂蛋白、载脂蛋白a1、载脂蛋白b)水平的变化情况。结果： (1)治疗组临床总疗效有效率为86.21%,对照组为63.30%,治疗组优于对照组(P0.05)；且治疗组在改善中医症状倦怠乏力、食少纳呆、腰膝酸软、肢体困重、大便不实等方面优于对照组(P0.05)； (2)经3个月治疗后,治疗组在降低Scr、BUN水平,改善eGFR方面优于对照组,两组差值比较具有统计学意义(P0.05)； (3)治疗组与对照组相比,在降低24小时尿蛋白定量方面具有显著统计学差异(P0.01),治疗组优于对照组； (4)经3个月治疗后,两组患者治疗后血脂代谢水平较治疗前差异均有统计学意义(P0.05),其中治疗组TC、TG、LDL、Apo-b下降更为显著(P0.01)且优于对照组(P0.05)。结论：加味升阳益胃汤可改善慢性肾脏病3-4期脾肾亏虚、湿浊内蕴证患者的临床症状；降低患者血肌酐、尿素氮水平,改善肾小球滤过率；降低24小时尿蛋白定量水平；加味升阳益胃汤可改善慢性肾脏病3-4期脾肾亏虚、湿浊内蕴证患者血脂代谢水平。
[Abstract]:Objective: to observe the effect of Jiawei Shengyang Yiwei decoction on deficiency of spleen and kidney in the period of 3-4 chronic kidney disease. Serum creatinine (Serum creatinine,Scr), urea nitrogen (Blood urea nitrogen,BUN), 24 hours urine protein (24 hours urinary protein quantitative,PRO), urine red blood cell (Red blood cell in urine,BLD), uric acid (Uric acid, UA), glomerular filtration rate (estimated Glomerular filtration rate,eGFR), total cholesterol (Total cholesterol, TC), triglyceride (Triglyceride,TG), high density in patients with dampness accumulation syndrome Lipoprotein (high density lipoprotein,HDL), low density lipoprotein (low density lipoprotein,LDL), apolipoprotein al (Apoprotein-al,Apo-al), apolipoprotein b (Apoprotein-b,Apo-b) and so on; Further evaluate the clinical application value of Jiawei Shengyang Yiwei decoction in treating the patients with deficiency of spleen and kidney and dampness accumulation in 3-4 period of chronic kidney disease. Methods: in this study, 60 inpatients and outpatients with the syndrome of deficiency of spleen and kidney and dampness and accumulation of dampness were randomly divided into treatment group and control group with 30 cases in each group. The control group was treated with routine western medicine, and the treatment group was treated with modified Shengyang Yiwei decoction on the basis of the control group, one dose per day, one dose in the morning and evening, and one dose in the morning and evening. The course of treatment lasted for 3 months. To observe the total clinical curative effect, the improvement of TCM symptoms, renal function (serum creatinine, urea nitrogen, uric acid, glomerular filtration rate), renal damage index (urine protein, urine red blood cell), blood lipid metabolism (total cholesterol, triglyceride), and observe the two groups before and after treatment. Changes in high density lipoprotein, low density lipoprotein, apolipoprotein a 1 and apolipoprotein b. Results: (1) the total effective rate was 86.21 in the treatment group, 63.30 in the control group, which was superior to that in the control group (P0.05); After 3 months of treatment, the treatment group was superior to the control group in lowering the level of Scr,BUN and improving eGFR. The difference between the two groups was statistically significant (P0.05); (3). There was significant difference in reducing 24 hour urine protein quantity (P0.01), the treatment group was better than the control group, (4) after 3 months treatment, There were significant differences in blood lipid metabolism between the two groups after treatment (P0.05), in which the TC,TG,LDL,Apo-b in the treatment group was significantly decreased (P0.01) and better than that in the control group (P0.05). Conclusion: modified Shengyang Yiwei decoction can improve the clinical symptoms of the patients with deficiency of spleen and kidney and dampness and accumulation of kidney in the period of 3-4 chronic kidney disease, decrease the level of serum creatinine, urea nitrogen, improve glomerular filtration rate, decrease the quantitative level of urinary protein in 24 hours. Jiawei Shengyang Yiwei decoction can improve the level of blood lipid metabolism in patients with deficiency of spleen and kidney and dampness in 3-4 stages of chronic kidney disease.
【学位授予单位】：福建中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R277.5
本文编号：2272444
[Abstract]:Objective: to observe the effect of Jiawei Shengyang Yiwei decoction on deficiency of spleen and kidney in the period of 3-4 chronic kidney disease. Serum creatinine (Serum creatinine,Scr), urea nitrogen (Blood urea nitrogen,BUN), 24 hours urine protein (24 hours urinary protein quantitative,PRO), urine red blood cell (Red blood cell in urine,BLD), uric acid (Uric acid, UA), glomerular filtration rate (estimated Glomerular filtration rate,eGFR), total cholesterol (Total cholesterol, TC), triglyceride (Triglyceride,TG), high density in patients with dampness accumulation syndrome Lipoprotein (high density lipoprotein,HDL), low density lipoprotein (low density lipoprotein,LDL), apolipoprotein al (Apoprotein-al,Apo-al), apolipoprotein b (Apoprotein-b,Apo-b) and so on; Further evaluate the clinical application value of Jiawei Shengyang Yiwei decoction in treating the patients with deficiency of spleen and kidney and dampness accumulation in 3-4 period of chronic kidney disease. Methods: in this study, 60 inpatients and outpatients with the syndrome of deficiency of spleen and kidney and dampness and accumulation of dampness were randomly divided into treatment group and control group with 30 cases in each group. The control group was treated with routine western medicine, and the treatment group was treated with modified Shengyang Yiwei decoction on the basis of the control group, one dose per day, one dose in the morning and evening, and one dose in the morning and evening. The course of treatment lasted for 3 months. To observe the total clinical curative effect, the improvement of TCM symptoms, renal function (serum creatinine, urea nitrogen, uric acid, glomerular filtration rate), renal damage index (urine protein, urine red blood cell), blood lipid metabolism (total cholesterol, triglyceride), and observe the two groups before and after treatment. Changes in high density lipoprotein, low density lipoprotein, apolipoprotein a 1 and apolipoprotein b. Results: (1) the total effective rate was 86.21 in the treatment group, 63.30 in the control group, which was superior to that in the control group (P0.05); After 3 months of treatment, the treatment group was superior to the control group in lowering the level of Scr,BUN and improving eGFR. The difference between the two groups was statistically significant (P0.05); (3). There was significant difference in reducing 24 hour urine protein quantity (P0.01), the treatment group was better than the control group, (4) after 3 months treatment, There were significant differences in blood lipid metabolism between the two groups after treatment (P0.05), in which the TC,TG,LDL,Apo-b in the treatment group was significantly decreased (P0.01) and better than that in the control group (P0.05). Conclusion: modified Shengyang Yiwei decoction can improve the clinical symptoms of the patients with deficiency of spleen and kidney and dampness and accumulation of kidney in the period of 3-4 chronic kidney disease, decrease the level of serum creatinine, urea nitrogen, improve glomerular filtration rate, decrease the quantitative level of urinary protein in 24 hours. Jiawei Shengyang Yiwei decoction can improve the level of blood lipid metabolism in patients with deficiency of spleen and kidney and dampness in 3-4 stages of chronic kidney disease.
【学位授予单位】：福建中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R277.5
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