消风蠲痹汤治疗尿酸性肾病患者的临床疗效观察
发布时间：2018-12-24 10:17
【摘要】：目的：通过对尿酸性肾病患者的临床治疗与观察,分析比较消风蠲痹汤与苯溴马隆两组患者的实验室检查、中医症候积分、临床疗效等,明确消风蠲痹汤的临床疗效。为该方在临床上的推广提供切实的临床依据。方法：收集2015年3月至2015年12月广东省中西医结合医院肾病风湿科住院及门诊治疗的患者,临床诊断为尿酸性肾病,中医辨证为脾肾亏虚,湿热痹阻型,符合纳入标准及排除标准的受试者60例。随机分为中药组(消风蠲痹汤组)和对照组(苯溴马隆组),每组各30例。中药组：西医常规治疗,加用消风蠲痹汤,水煎剂口服,日一剂,早晚餐后半小时后服用,连续治疗4周；对照组：西医常规治疗,加苯溴马隆口服,起始剂量50mg/天,可加量至100mg/天,连续治疗4周。在治疗前后分别记录入组人员的中医证候量表评分,收集治疗前后的血清肌酐(SCr)、尿素氮(BUN)、血尿酸(BUA)、胱抑素C (Cys-c),β2微球蛋白(β 2-MG)等。对所有资料作详细记录并对其进行统计分析。结果：1.治疗前两组患者中医证候积分水平具有可比性,差异无统计学意义(P0.05);治疗后两组中医证候临床疗效比较,对照组共26例,总有效24例(91.31%),其中显效5例(19.23%),有效19例(73.08%),无效2例(7.69%)：中药组共25例,总有效23例(92%),其中显效16例(64%),有效7例(28%),无效2例(8%)。两组患者经治疗后中医证候均有改善,其中中药组优于对照组,差异具有统计学意义(P0.05)。2.两组治疗前SCr、BUN、BUA、Cys-c,β2-MG水平具有可比性,差异无统计学意义(P0.05);治疗后两组SCr、BUN、BUA、Cys-c,β2-MG均较治疗前下降,差异有统计学意义(P0.05),且中药组的SCr、BUN、Cys-c、β2-MG下降水平明显,优于对照组,组间差异具有统计学意义(P0.05)：两组BUA下降水平差异无统计学意义(P0.05)。结论：中药消风蠲痹汤在配合常规西医治疗的基础上,对于尿酸性肾病的临床症状及肾功能实验室指标均有改善,疗效显著,且优于苯溴马隆组的疗效；在治疗过程中两组均未见明显不良反应。消风蠲痹汤在改善患者临床症状、降尿酸、保护肾功能等方面疗效显著。
[Abstract]:Objective: through the clinical treatment and observation of patients with uric acid nephropathy, the clinical efficacy of Xiaofeng Juanbi decoction and benzbromine Malone was analyzed and compared. To provide a practical clinical basis for the clinical promotion of the prescription. Methods: from March 2015 to December 2015, the patients with nephropathy and rheumatism in Department of Nephrology and Rheumatology of Guangdong Provincial Integrated Chinese and Western Medicine Hospital were collected. The patients were diagnosed as uric acid nephropathy, and the syndrome differentiation of TCM was deficiency of spleen and kidney, obstruction of dampness and heat. 60 subjects met the inclusion criteria and exclusion criteria. They were randomly divided into traditional Chinese medicine group (Xiaofeng Juanbi decoction group) and control group (benzbromarone group) with 30 cases in each group. Traditional Chinese medicine group: Western medicine routine treatment, plus Xiaofeng Juanbi decoction, water decoction oral, one dose a day, morning and evening meal half an hour after taking, continuous treatment for 4 weeks; The control group was treated with routine western medicine, taking benbromalone orally for 4 weeks. The initial dose was 50mg/ day, and the dosage could be added to 100mg/ day for 4 weeks. The scores of TCM syndrome scale were recorded before and after treatment. Serum creatinine, (SCr), urea nitrogen, (BUN), (BUA), cystatin C (Cys-c) and 尾 2 microglobulin (尾 2-MG) were collected before and after treatment. Make detailed records of all materials and make statistical analysis of them. Results: 1. Before treatment, the TCM syndromes integral level of the two groups was comparable, the difference was not statistically significant (P0.05); After treatment, there were 26 cases in control group, 24 cases (91.31%) were effective, 5 cases (19.23%) were effective, 19 cases (73.08%) were effective, 2 cases (7.69%) were ineffective. The total effective rate was 92% (23 / 23), including 16 cases (64%), 7 cases (28%) and 2 cases (8%). Two groups of patients after treatment of TCM syndrome improved, the Chinese medicine group is better than the control group, the difference is statistically significant (P0.05). The levels of SCr,BUN,BUA,Cys-c, 尾 2-MG were comparable between the two groups before treatment (P0.05). After treatment, the SCr,BUN,BUA,Cys-c, 尾 2-MG of the two groups were significantly lower than that of the control group (P0.05), and the SCr,BUN,Cys-c, 尾 2-MG level of the TCM group was significantly lower than that of the control group. The difference between the two groups was statistically significant (P0.05): there was no significant difference in the decrease of BUA between the two groups (P0.05). Conclusion: the traditional Chinese medicine Xiaofeng Juanbi decoction can improve the clinical symptoms and renal function laboratory indexes of uric acid nephropathy on the basis of routine western medicine treatment, and the curative effect is significant, and is superior to the effect of benbromalone group. No significant adverse reactions were observed in both groups during the course of treatment. Xiaofeng Juanbi decoction is effective in improving clinical symptoms, reducing uric acid and protecting renal function.
【学位授予单位】：广州中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R277.5
本文编号：2390500
[Abstract]:Objective: through the clinical treatment and observation of patients with uric acid nephropathy, the clinical efficacy of Xiaofeng Juanbi decoction and benzbromine Malone was analyzed and compared. To provide a practical clinical basis for the clinical promotion of the prescription. Methods: from March 2015 to December 2015, the patients with nephropathy and rheumatism in Department of Nephrology and Rheumatology of Guangdong Provincial Integrated Chinese and Western Medicine Hospital were collected. The patients were diagnosed as uric acid nephropathy, and the syndrome differentiation of TCM was deficiency of spleen and kidney, obstruction of dampness and heat. 60 subjects met the inclusion criteria and exclusion criteria. They were randomly divided into traditional Chinese medicine group (Xiaofeng Juanbi decoction group) and control group (benzbromarone group) with 30 cases in each group. Traditional Chinese medicine group: Western medicine routine treatment, plus Xiaofeng Juanbi decoction, water decoction oral, one dose a day, morning and evening meal half an hour after taking, continuous treatment for 4 weeks; The control group was treated with routine western medicine, taking benbromalone orally for 4 weeks. The initial dose was 50mg/ day, and the dosage could be added to 100mg/ day for 4 weeks. The scores of TCM syndrome scale were recorded before and after treatment. Serum creatinine, (SCr), urea nitrogen, (BUN), (BUA), cystatin C (Cys-c) and 尾 2 microglobulin (尾 2-MG) were collected before and after treatment. Make detailed records of all materials and make statistical analysis of them. Results: 1. Before treatment, the TCM syndromes integral level of the two groups was comparable, the difference was not statistically significant (P0.05); After treatment, there were 26 cases in control group, 24 cases (91.31%) were effective, 5 cases (19.23%) were effective, 19 cases (73.08%) were effective, 2 cases (7.69%) were ineffective. The total effective rate was 92% (23 / 23), including 16 cases (64%), 7 cases (28%) and 2 cases (8%). Two groups of patients after treatment of TCM syndrome improved, the Chinese medicine group is better than the control group, the difference is statistically significant (P0.05). The levels of SCr,BUN,BUA,Cys-c, 尾 2-MG were comparable between the two groups before treatment (P0.05). After treatment, the SCr,BUN,BUA,Cys-c, 尾 2-MG of the two groups were significantly lower than that of the control group (P0.05), and the SCr,BUN,Cys-c, 尾 2-MG level of the TCM group was significantly lower than that of the control group. The difference between the two groups was statistically significant (P0.05): there was no significant difference in the decrease of BUA between the two groups (P0.05). Conclusion: the traditional Chinese medicine Xiaofeng Juanbi decoction can improve the clinical symptoms and renal function laboratory indexes of uric acid nephropathy on the basis of routine western medicine treatment, and the curative effect is significant, and is superior to the effect of benbromalone group. No significant adverse reactions were observed in both groups during the course of treatment. Xiaofeng Juanbi decoction is effective in improving clinical symptoms, reducing uric acid and protecting renal function.
【学位授予单位】：广州中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R277.5
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