【作者】 赖宗甫；

【导师】 关彤；

【作者基本信息】 广州中医药大学 ， 中医临床基础， 2012， 硕士

【摘要】 目的本临床对照研究探讨防己黄芪汤加减治疗肾病综合征患者的临床疗效；通过与保肾汤比较,观察防己黄芪汤加减治疗肾病综合征患者的临床疗效。方法研究对象为肾病综合征患者。病例来源均为2011年2月至10月在台湾中医均为中医门诊就诊的肾病综合征患者。将60例符合纳入标准的成人PNS患者随机分配到治疗组和对照组。对照组30例予保肾汤治疗,治疗组30例予防己黄芪汤加减治疗,口服8周。以患者中医证侯积分、浮肿消退天数、24h尿蛋白定量、血浆白蛋白、血脂、肾功能为观察指标,于治疗前、疗程结束时分别对两组患者各项指标进行评定。临床研究结束后,临床资料及时汇总,输入计算机,用EpiData3.01软件建立数据库,进行数据管理,用SPSS软件进行统计分析。对两组治疗后临床总疗效、临床症状、体征疗效等进行统计分析、比较,最后客观评价临床疗效及其安全性。统计方法：分类资料用χ~2检验,等级资料用两样本比较Wilcoxon秩和检验(校正),两样本均数比较用t检验或Wilcoxon秩和检验,自身前后比较用配对t检验或Wilcoxon配对秩和检验。统计计算采用SPSS17.0统计软件完成统计分析。结果本研究共有合格受试者例,治疗组30例,对照组30例；两组脾肾阳虚中医证候疗效比较,差异有显著性意义,治疗组疗效优于对照组。患者临床疗效治疗组临床痊愈率为23.3%,显效率为56.6%,有效率13.3%,总有效率为93.4%；对照组临床痊愈率为16.6%,显效率为53.3%,有效率为16.6%,总有效率为86.7%。两组比较,差异有显著性意义。两组临床总疗效比较,差异有显著性意义,治疗组疗效优于对照组。患者临床总疗效治疗组临床痊愈率30%,显效率46.6%,有效率16.6%,总有效率93.4%；对照组临床痊愈率20.0%,显效率43.3%,有效率23.3%,总有效率86.7%。两组比较,差异有显著性意义。其总有效率优于对照药。在临床疾病疗效和中医证侯疗效方面,治疗组优于对照(P<0.05)。两组治疗对患者的中医证侯均有较好的改善作用(P<0.05),改善程度治疗组优于对照组(P<0.05)。治疗组的水肿消退天数少于对照组(P<0.05)。两组治疗均能减少24小时尿蛋白,治疗组优于对照组(P<0.05),治疗中未观察到不良反应。结论加味防己黄芪汤治疗成人肾病综合征优于对照药法。加味防己黄芪汤有促进水肿消退、改善中医证候、减少尿蛋白的作用。研究中未观察到治疗药对肾功能及血液系统有明显损害,临床应用安全。更多还原

【Abstract】 ObjectiveThis clinical study contrast the astragalus tonga have reduced treatment nephrotic syndrome patients for clinical curative effect; Through the comparison with renal soup, observe the astragalus tonga have reduced treatment nephrotic syndrome patients for clinical curative effect.MethodsThe research object for patients with nephrotic syndrome. Cases are for2011years source February to October in Taiwan are traditional Chinese medicine for Chinese medicine clinic patients with nephrotic syndrome.60patients with accord with standard of adults PNS into patients were randomly assigned to the treatment group and control group.30cases in the kidney to soup treatment, the treatment group of30cases to prevent astragalus tonga have reduced treatment, oral8weeks. Patients with traditional Chinese medicine syndrome integral, bloated subsidise24h urine protein days, quantitative, plasma albumin, blood fat and renal function index for observation, in the end, treatment before treatment respectively in two groups each index patients were evaluated. After the clinical research, clinical material timely summary, into the computer and software is built with Epi Data3.01database, data management, with SPSS software for statistical analysis. In two groups of clinical treatment effect, the total clinical symptoms and signs efficacy analysis and comparison of the statistics, and finally an objective evaluation of clinical curative effect and its safety. Statistical methods:classification material with2inspection, level with two sample data comparison Wilcoxon rank and inspection (correct), two sample mean differences with more t test or Wilcoxon rank and inspection, compared with before and after their matching t test or Wilcoxon matching rank and inspection. Statistics for the calculation SPSS17.0statistical software statistical analysis.ResultsThe study participants were qualified example,30cases in treatment group and control group in30cases). Two groups of spleen and kidney Yang curative effect of TCM syndrome comparison, significant difference, the curative effect of treatment group was better than control. The clinical curative effect of treatment clinical cure rate was23.3%, the significant efficiency is56.6%, the effective rate was13.3%, the total effective rate was93.4%; The control group clinical cure rate was16.6%, the significant efficiency is53.3%, and the effective rate was16.6%, the total effective rate was86.7%. Two groups of comparisons, significant difference. Two groups of clinical total curative effect more, significant difference, the curative effect of treatment group was better than control. The clinical curative effect always clinical cure rate was30%in treatment group and46.6%significant efficiency, the effective rate was16.6%, the total effective rate of93.4%; The control group clinical cure rate was20.0%,43.3%significant efficiency, the effective rate was23.3%, the total effective rate of86.7%. Two groups of comparisons, significant difference. Its total efficient superior to that of the control medicine. In the clinical curative effect of traditional Chinese medicine and syndrome curative effect, the treatment group than controls (P<0.05). Two groups of patients with traditional Chinese medicine treatment of syndrome are better improving function (P<0.05), the improvement of the treatment group was better than control group (P<0.05). The treatment group edema is gone days less than in control group (P<0.05). Two groups of treatment can reduce the24h urine are protein, the treatment group than in control group (P<0.05), the treatment was not observed in adverse reactions.ConclusionModified Fangji And Astragalus Deeoetion in the treatment of adults nephrotic syndrome is superior to that of the control method of medicine. Add to the flavor and astragalus soup have promote edema has faded, improvement of TCM syndrome, reduce the role of the urinary protein. The study was not observed treatment for kidney function and the blood system medicine have obvious damage, clinical application security.更多还原