大黄牡蛎汤灌肠治疗对慢性肾衰竭各中医分型血清钙、磷水平的影响
发布时间：2019-06-11 09:05
【摘要】：目的:通过检测慢性肾衰竭各中医分型患者中血钙、磷在大黄牡蛎汤灌肠前、后的变化,以研究灌肠治疗对钙磷代谢的影响,从而为慢性肾衰竭不同证型的患者提供一种新型而有效的升钙、降磷的方法。方法:选择慢性肾衰竭患者70例,其西医临床诊断符合《中药新药临床研究指导原则(试行)》[9],其中医辨证分型符合《慢性肾衰竭的诊断、辨证分型及疗效评定》(试行方案)(中华中医药学会肾病分会)[10]。根据设定的方案,采用随机分组分为治疗组(用大黄牡蛎汤进行灌肠)和对照组,清晨空腹抽取每组患者的静脉血,记录下治疗前各组血液中钙、磷的值,对照组给予一些基础病的治疗,治疗组在治疗基础病的前提下,还要采用大黄牡蛎汤灌肠治疗(1次/日),疗程都为1月,再次抽取患者空腹时的静脉血,记录下治疗后各组血液中钙、磷的数值。同时选择10例健康志愿者,清晨空腹抽血,记录下血钙、磷的值,以比较治疗前慢性肾衰竭患者与健康志愿者之间钙磷的代谢情况。结果:各中医分型的慢性肾衰竭患者血Ca均下降,血P均升高(P0.01),不同中医证型的患者与正常组比较均存在显著差异。脾肾气虚证组中治疗组的患者血钙显著升高(P0.05),统计有明显差异,血磷下降不明显,统计无明显差异;脾肾阳虚组治疗组的患者血钙明显升高,血磷明显下降(P0.05),统计均有明显差异;气阴两虚组血磷显著下降(P0.05),统计有明显差异,血钙升高不明显,统计无明显差异;肝肾阴虚和阴阳两虚的患者血钙、血磷变化均不明显,统计无明显差异。结论:大黄牡蛎汤灌肠对脾肾阳虚患者血钙、血磷的调节有明显作用,而对脾肾气虚证患者升高血钙有作用,对气阴两虚证患者有明显降磷作用,对肝肾阴虚证和阴阳两虚证的患者血钙和血磷的影响不明显。
[Abstract]:Objective: to detect the changes of serum calcium and phosphorus in patients with chronic renal failure before and after enema by rhubarb Oyster soup, and to study the effect of enema on calcium and phosphorus metabolism. So as to provide a new and effective method to increase calcium and reduce phosphorus for patients with different syndromes of chronic renal failure. Methods: 70 patients with chronic renal failure were selected. The clinical diagnosis of western medicine was in accordance with the guiding principles of clinical research of new traditional Chinese medicine (trial). [9]. The syndrome differentiation of traditional Chinese medicine was in accordance with the diagnosis of chronic renal failure. Syndrome differentiation and curative effect Evaluation (trial Scheme) (Chinese Society of traditional Chinese Medicine Nephropathy Branch) [10]. According to the set plan, the patients in the treatment group (enema with rhubarb Oyster soup) and the control group were randomly divided into treatment group (rhubarb Oyster soup enema) and control group. The venous blood of each group was taken on an empty stomach in the morning, and the values of calcium and phosphorus in the blood of each group before treatment were recorded. The control group was given the treatment of some basic diseases, and the treatment group was treated with rhubarb Oyster soup enema (once a day) on the premise of the treatment of basic diseases. The course of treatment was 1 month. The venous blood of the patients on an empty stomach was taken again. The values of calcium and phosphorus in blood of each group after treatment were recorded. At the same time, 10 healthy volunteers were selected and fasting blood samples were taken in the morning to record the values of blood calcium and phosphorus in order to compare the metabolism of calcium and phosphorus between patients with chronic renal failure and healthy volunteers before treatment. Results: the blood Ca of patients with chronic renal failure was decreased and the blood P was increased (P 0.01). There were significant differences between the patients with different TCM syndromes and the normal group. In the spleen and kidney qi deficiency syndrome group, the blood calcium of the patients in the treatment group was significantly increased (P 0.05), and there was significant difference in statistics, but there was no significant difference in the decrease of blood phosphorus and no significant difference in statistics. In the spleen and kidney yang deficiency group, the blood calcium and phosphorus in the treatment group were significantly higher than those in the control group (P 0.05), and there were significant differences in statistics. In the group of deficiency of both qi and yin, blood phosphorus decreased significantly (P 0.05), and there was significant difference in statistics, but there was no significant difference in serum calcium and blood phosphorus in patients with deficiency of yin and kidney and deficiency of yin and yang, and there was no significant difference in statistics between patients with deficiency of yin and kidney and deficiency of both yin and yang, and there was no significant difference in blood phosphorus between patients with deficiency of yin and kidney. Conclusion: rhubarb Oyster soup enema has obvious effect on the regulation of blood calcium and blood phosphorus in patients with deficiency of spleen and kidney yang, but also on the increase of blood calcium in patients with deficiency of spleen and kidney qi and deficiency of qi and yin, and has obvious effect on reducing phosphorus in patients with deficiency of both qi and yin. There was no significant effect on blood calcium and phosphorus in patients with yin deficiency of liver and kidney and deficiency of yin and yang.
【学位授予单位】：山西医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R277.5
本文编号：2497075
[Abstract]:Objective: to detect the changes of serum calcium and phosphorus in patients with chronic renal failure before and after enema by rhubarb Oyster soup, and to study the effect of enema on calcium and phosphorus metabolism. So as to provide a new and effective method to increase calcium and reduce phosphorus for patients with different syndromes of chronic renal failure. Methods: 70 patients with chronic renal failure were selected. The clinical diagnosis of western medicine was in accordance with the guiding principles of clinical research of new traditional Chinese medicine (trial). [9]. The syndrome differentiation of traditional Chinese medicine was in accordance with the diagnosis of chronic renal failure. Syndrome differentiation and curative effect Evaluation (trial Scheme) (Chinese Society of traditional Chinese Medicine Nephropathy Branch) [10]. According to the set plan, the patients in the treatment group (enema with rhubarb Oyster soup) and the control group were randomly divided into treatment group (rhubarb Oyster soup enema) and control group. The venous blood of each group was taken on an empty stomach in the morning, and the values of calcium and phosphorus in the blood of each group before treatment were recorded. The control group was given the treatment of some basic diseases, and the treatment group was treated with rhubarb Oyster soup enema (once a day) on the premise of the treatment of basic diseases. The course of treatment was 1 month. The venous blood of the patients on an empty stomach was taken again. The values of calcium and phosphorus in blood of each group after treatment were recorded. At the same time, 10 healthy volunteers were selected and fasting blood samples were taken in the morning to record the values of blood calcium and phosphorus in order to compare the metabolism of calcium and phosphorus between patients with chronic renal failure and healthy volunteers before treatment. Results: the blood Ca of patients with chronic renal failure was decreased and the blood P was increased (P 0.01). There were significant differences between the patients with different TCM syndromes and the normal group. In the spleen and kidney qi deficiency syndrome group, the blood calcium of the patients in the treatment group was significantly increased (P 0.05), and there was significant difference in statistics, but there was no significant difference in the decrease of blood phosphorus and no significant difference in statistics. In the spleen and kidney yang deficiency group, the blood calcium and phosphorus in the treatment group were significantly higher than those in the control group (P 0.05), and there were significant differences in statistics. In the group of deficiency of both qi and yin, blood phosphorus decreased significantly (P 0.05), and there was significant difference in statistics, but there was no significant difference in serum calcium and blood phosphorus in patients with deficiency of yin and kidney and deficiency of yin and yang, and there was no significant difference in statistics between patients with deficiency of yin and kidney and deficiency of both yin and yang, and there was no significant difference in blood phosphorus between patients with deficiency of yin and kidney. Conclusion: rhubarb Oyster soup enema has obvious effect on the regulation of blood calcium and blood phosphorus in patients with deficiency of spleen and kidney yang, but also on the increase of blood calcium in patients with deficiency of spleen and kidney qi and deficiency of qi and yin, and has obvious effect on reducing phosphorus in patients with deficiency of both qi and yin. There was no significant effect on blood calcium and phosphorus in patients with yin deficiency of liver and kidney and deficiency of yin and yang.
【学位授予单位】：山西医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R277.5
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