【作者】 李峥；

【导师】 焦安钦；

【作者基本信息】 山东中医药大学 ， 中医内科学， 2011， 硕士

【摘要】 目的:观察在西医基础治疗上,予加味桂枝茯苓丸为主方随症加减,治疗血瘀湿浊型慢性肾衰的临床疗效,探讨中西医结合治疗本病的优势和可行性,为进一步改良及推广配方打下基础。方法:本研究收集慢性肾衰患者符合中医血瘀湿浊型患者60例,并随机分为2组,试验组、对照组各30例。对照组予控制血压、升血红蛋白、纠正水电解质紊乱等西医基础治疗,试验组在西医基础治疗上加用加味桂枝茯苓丸,疗程为二个月。观察临床症状、体征及实验室检查指标的变化,并对症状及体征进行量化评分,作出疗效评价。结果:加味桂枝茯苓丸治疗血瘀湿浊型慢性肾衰,总有效率试验组明显优于对照组, P<0.01,统计学差异显著;显效率试验组优于对照组,P<0.05,有统计学差异。加味桂枝茯苓丸在改善脾肾亏虚,血瘀湿浊型慢性肾衰竭的中医各证候方面、降低尿蛋白定量和提高血浆白蛋白水平方面以及对肌酐清除率、血肌酐、尿素氮、电解质、酸碱平衡的调节有明显作用,且安全性好,不良反应发生率低。结论:加味桂枝茯苓丸配合西医基础治疗慢性肾衰血瘀湿浊型,能显著改善患者面色晦暗、腰痛、肢体困重、脘腹胀满等症状,从而显示出中西医结合治疗本病的优势,但是否有助于提高慢性肾衰缓解率有待大样本的进一步研究。更多还原

【Abstract】 Objective: to observe the basic therapy in western medicine,grant guizhi poria cocos pill with add and subtract,give priority to party blood stasis syndrome treatment of chronic renal failure with wet chaotic,explore the clinical curative effect of combining traditional Chinese and western medicine treatment of the disease,the superiority and feasibility for further improvement and promotion formula to lay the foundation.Methods: the study collect patients with chronic renal failure with wet chaotic TCM blood stasis,and 60 cases of patients were randomly divided into two groups, each group,the control group,30 cases. The control group to control blood pressure, litres of hemoglobin,drop proteinuria based therapy,such as western medicine group based in western medicine treatment combined with flavored guizhi poria cocos pills, treatment for two months. Observe clinical symptoms,signs and laboratory index changes,and symptoms and signs,make a grade quantitatively effect assessment.Results: flavored guizhi poria cocos pill treatment and blood stasis wet chaotic, the total effective rate of chronic renal failure,apparently intellectual than in control group (53.33%),the treatment group compared with controls statistically significant (P < 0.01);Clinical control 6.70% 16.67%,better than control. Flavored guizhi poria cocos shot in the spleen and kidney deficiency,and improve blood stasis wet muddy type of chronic renal failure TCM every syndrome,lower urine protein quantitative and improving plasma albumin levels of creatinine clearance,and serum creatinine,blood urea nitrogen regulation have obvious therapy,and good safety and adverse reaction rate low.Conclusion: flavored with western medicine foundation guizhi poria cocos pill treatment of chronic renal failure and blood stasis wet muddy type,can significantly improve patients’ pale skin armor noontide,fault,the body is trapped heavy,wan abdominal distension full,and such clinical manifestations of this show the advantage of combining traditional Chinese and western medicine treatment,whether to help improve chronic renal failure remission rates further research needs to be large sample.更多还原