加减翘荷汤治疗CKD1-3期合并外感邪热患者的临床疗效观察
发布时间：2018-11-16 12:16
【摘要】：目的：运用加减翘荷汤对慢性肾脏病(CKD)1-3a期患者的外感邪热证进行治疗,观察患者外感邪热症状的转归过程,评估其临床疗效；同时观察加减翘荷汤对慢性肾脏病患者肾功能的影响。方法：收集CKD1-3a期合并外感邪热证的患者66名,分为对照组(33名)和治疗组(33名)。对66名患者的慢性肾脏病均采用的现代西医对慢性肾脏病的治疗方法作为常规治疗。在常规治疗前提下,对照组用常规西药治疗对患者的外感邪热证进行治疗,治疗组用每日一剂加减翘荷汤对患者的外感邪热进行治疗,两组均以14天为治疗观察期。治疗过程中,对照组和治疗组各有2名患者被剔除。治疗3天后对患者的外感邪热临床症状进行判定；治疗7天后对患者的C反应蛋白(CRP)进行检测；治疗14天后对患者的外感症候病程和血肌酐(Scr)、肾小球滤过率(eGFR)、尿蛋白定量、尿红细胞、尿转铁蛋白、尿免疫球蛋白的指标变化进行对比。结果：①治疗3天后,两组在外感临床症候疗效比较上,有统计学差异(P0.01)。②治疗7天后,两组组内比较,患者CRP均较治疗前下降(P0.05),但组间比较无差异(P0.05)。③治疗14天后,两组患者外感邪热症候病程的比较有差异(P0.05)。④治疗14天后,同组比较,对照组,尿蛋白定量、尿红细胞、尿转铁蛋白较治疗前升高(P0.05),血肌酐、eGFR、尿免疫球蛋白无明显差异(P0.05)。⑤治疗14天后,同组比较,治疗组血肌酐、尿红细胞、尿转铁蛋白均有下降(P0.05),eGFR升高(P0.05),尿蛋白定量、尿免疫球蛋白无明显差异(P0.05)。⑥治疗14天后,组间比较,两组患者的尿免疫球蛋白无明显差异,治疗组对血肌酐、eGFR、尿蛋白定量、尿红细胞、尿转铁蛋白的疗效均优于对照组(P0.05)。结论：①加减翘荷汤对CKD1-3a期患者的外感邪热证的临床疗效优于单纯西药治疗。②两种治疗方法对慢性肾脏病患者CRP的作用无差异。③单纯西药治疗外感邪热证后可观察到CKD1-3a期患者的肾脏损伤加重,可能是由于邪热由表循经下传,以及部分西药对肾脏具有一定的损害引起的。④应用加减翘荷汤疗外感邪热证后可观察到CKD1-3a期患者的肾脏损伤减轻。⑤外感邪热犯肺对CKD1-3a期患者的尿免疫球蛋白无显著影响,对肾小管损伤未见明显影响。
[Abstract]:Objective: to treat the patients with exogenous pathogenic heat syndrome of chronic kidney disease (CKD) stage 1-3a by adding and reducing Qiao-he decoction, observe the process of the outcome of the patients' symptoms of exogenous pathogenic heat, and evaluate its clinical efficacy. At the same time, the effect of Jiajianqiahe decoction on renal function of patients with chronic kidney disease was observed. Methods: 66 CKD1-3a patients with exogenous heat syndrome were divided into control group (33 cases) and treatment group (33 cases). All 66 patients with chronic kidney disease were treated with modern western medicine as routine therapy. On the premise of routine treatment, the control group was treated with routine western medicine for the syndrome of exogenetic pathogenic heat, and the treatment group was treated with one dose per day plus Xianqiahe decoction. The two groups were treated with 14 days of treatment. During the course of treatment, 2 patients in the control group and 2 patients in the treatment group were excluded. After 3 days of treatment, the clinical symptoms of exogenous fever were determined, and the C-reactive protein (CRP) was detected after 7 days of treatment. After 14 days of treatment, the course of external symptoms and serum creatinine (Scr),) glomerular filtration rate (eGFR), urinary protein quantity, urine erythrocyte, urinary transferrin and urinary immunoglobulin were compared. Results: 1 after 3 days of treatment, there was a significant difference in the curative effect of external symptoms between the two groups (P0.01). After 7 days of treatment, the CRP of the two groups was lower than that before treatment (P0.05). However, there was no difference between the two groups (P0.05). 3 after 14 days of treatment, there was a difference between the two groups in the course of exogenous heat syndrome (P0.05). After 14 days of treatment, the control group, the urine protein quantitative, the urine red blood cell, the control group, the urine protein quantity, the urine red blood cell, the urine protein quantity, the urine red blood cell, Urinary transferrin was higher than that before treatment (P0.05), but there was no significant difference in serum creatinine and eGFR, urine immunoglobulin (P0.05). Urinary transferrin decreased (P0.05), eGFR increased (P0.05), urine protein quantitative, urinary immunoglobulin no significant difference (P0.05). After 14 days of treatment, there was no significant difference between the two groups of urine immunoglobulin. The therapeutic effect of the treatment group on serum creatinine, eGFR, urine protein, urine erythrocyte, urinary transferrin was better than that of the control group (P0.05). Conclusion: 1 the clinical effect of Jiajiaohe decoction on exogenous heat syndrome in CKD1-3a patients is better than that of western medicine alone. 2 there is no difference between the two treatment methods on CRP in patients with chronic kidney disease. 3 the treatment of exogenous heat with western medicine alone is not different. The severity of renal injury in patients with CKD1-3a can be observed after the syndrome. It may be that the evil heat is transmitted down the meridian. And some western medicine have certain damage to the kidney. 4 after the treatment of exogenous heat syndrome by adding and reducing Qiao-he decoction, it can be observed that renal damage can be alleviated in patients with CKD1-3a stage. 5 the urine immunity of patients with CKD1-3a stage caused by exogenous pathogenic fever invading the lung can be observed. There was no significant effect on immunoglobulin, There was no obvious effect on renal tubular injury.
【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：2335496
[Abstract]:Objective: to treat the patients with exogenous pathogenic heat syndrome of chronic kidney disease (CKD) stage 1-3a by adding and reducing Qiao-he decoction, observe the process of the outcome of the patients' symptoms of exogenous pathogenic heat, and evaluate its clinical efficacy. At the same time, the effect of Jiajianqiahe decoction on renal function of patients with chronic kidney disease was observed. Methods: 66 CKD1-3a patients with exogenous heat syndrome were divided into control group (33 cases) and treatment group (33 cases). All 66 patients with chronic kidney disease were treated with modern western medicine as routine therapy. On the premise of routine treatment, the control group was treated with routine western medicine for the syndrome of exogenetic pathogenic heat, and the treatment group was treated with one dose per day plus Xianqiahe decoction. The two groups were treated with 14 days of treatment. During the course of treatment, 2 patients in the control group and 2 patients in the treatment group were excluded. After 3 days of treatment, the clinical symptoms of exogenous fever were determined, and the C-reactive protein (CRP) was detected after 7 days of treatment. After 14 days of treatment, the course of external symptoms and serum creatinine (Scr),) glomerular filtration rate (eGFR), urinary protein quantity, urine erythrocyte, urinary transferrin and urinary immunoglobulin were compared. Results: 1 after 3 days of treatment, there was a significant difference in the curative effect of external symptoms between the two groups (P0.01). After 7 days of treatment, the CRP of the two groups was lower than that before treatment (P0.05). However, there was no difference between the two groups (P0.05). 3 after 14 days of treatment, there was a difference between the two groups in the course of exogenous heat syndrome (P0.05). After 14 days of treatment, the control group, the urine protein quantitative, the urine red blood cell, the control group, the urine protein quantity, the urine red blood cell, the urine protein quantity, the urine red blood cell, Urinary transferrin was higher than that before treatment (P0.05), but there was no significant difference in serum creatinine and eGFR, urine immunoglobulin (P0.05). Urinary transferrin decreased (P0.05), eGFR increased (P0.05), urine protein quantitative, urinary immunoglobulin no significant difference (P0.05). After 14 days of treatment, there was no significant difference between the two groups of urine immunoglobulin. The therapeutic effect of the treatment group on serum creatinine, eGFR, urine protein, urine erythrocyte, urinary transferrin was better than that of the control group (P0.05). Conclusion: 1 the clinical effect of Jiajiaohe decoction on exogenous heat syndrome in CKD1-3a patients is better than that of western medicine alone. 2 there is no difference between the two treatment methods on CRP in patients with chronic kidney disease. 3 the treatment of exogenous heat with western medicine alone is not different. The severity of renal injury in patients with CKD1-3a can be observed after the syndrome. It may be that the evil heat is transmitted down the meridian. And some western medicine have certain damage to the kidney. 4 after the treatment of exogenous heat syndrome by adding and reducing Qiao-he decoction, it can be observed that renal damage can be alleviated in patients with CKD1-3a stage. 5 the urine immunity of patients with CKD1-3a stage caused by exogenous pathogenic fever invading the lung can be observed. There was no significant effect on immunoglobulin, There was no obvious effect on renal tubular injury.
【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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