【作者】 曾湘杰；

【导师】 汤水福；

【作者基本信息】 广州中医药大学 ， 中医临床基础， 2008， 硕士

【摘要】 目的探讨中医辨证论治对非透析慢性肾衰竭患者微炎症状态的影响。方法30例符合纳入标准的慢性肾衰竭患者进行辩证分型后,给予对应方药治疗,在此基础上,针对患者不同情况加用改善肾脏循环,纠正电解质、酸碱平衡紊乱,降压,纠正贫血等常规西医对症处理对症治疗,试验时间长度为4周,试验前后抽取晨起空腹静脉血,测定超敏C反应蛋白(Hs-CRP),肌酐(CREA),血清白蛋白(ALB),血红蛋白(Hb)等,并采用SPSS11.5对结果进行统计分析。结果(1)通过相关分析,治疗前及治疗后Hs-CRP与CREA值均呈强正线性相关关系(P＜0.01),Hs-CRP与ALB在治疗前呈负线性相关关系(P＜0.01);(2)试验结束时,30例患者的Hs-CRP、CREA水平明显降低,ALB、Hb水平明显升高,经过配对检验,差异均具有显著统计学意义(P＜0.05)。结论(1)慢性肾衰竭患者普遍存在微炎症状态,且与肾功能、营养状况等因素密切相关。(2)辩证诊治是中医治疗慢性肾衰竭患者微炎症状态的主要方法。(3)根据中医辨证论治方法治疗慢性肾衰竭患者,可一定程度上降低慢性肾衰竭患者Hs-CRP、CREA浓度,升高ALB、Hb浓度,改善患者贫血和营养不良状况,改善并延缓肾功能的进展和恶化,从而改善患者的微炎症状态。更多还原

【Abstract】 Objective: To study the effects of treatment based on differentiation of syndromes(TDS) in non-dialysis chronic renal failure(CRF) patients with microinflammation state.Methods Thirty non-dialysis CRF patients in our center were enrolled. First we differentiated of patients’ syndromes, then patients were given the corresponding traditional Chinese medicine prescription treatment at the base of differentiation of syndromes , on the other hand , for different circumstances, patients were given medicine to improve kidney cycle, correct electrolyte and acid-base balance disorder, improve anemia, and other conventional Western medicine symptomatic treatment at the same time, the treatment time lasted 4-weeks totally. At last, we tested the serum levels of High-sensitivity C-reactive protein(Hs-CRP),creatinine(CREA),albumin(ALB) and hemoglobin(Hb) in CRF patients before and after TDS. Finally analyzed the results.Results (1)According to correlation analysis, Hs-CRP and CREA values showed strong positive linear relationship before and after TDS (P<0. 01) while Hs-CRP and serum ALB showed negative linear relationship before TDS (P<0.01); (2)At the end of trial, the level of Hs-CRP and CREA were significantly lowered, ALB and Hb level were increased. With matching test, the differences are statistically significant significance (P<0.05).Conclusion (1) Microinflammatory state exist in CRF patients extensively and there is a close correlations with renal function, nutritional status and other factors are closely related. (2) TDS is one of important treatment ways to CRF patients with microinflammation state. (3) TDS can reduce serum levels of Hs-CRP, CREA and increase ALB, Hb concentration, and can improve the situation in patients with anemia and malnutrition, and delay the progress and deterioration of renal function , thus improving patients with microinflammation state.更多还原