保肾巴布剂穴位敷贴治疗慢性肾脏病肾阳虚证肾阴虚证的临床疗效

【作者】 曹晓慧；

【导师】 巴元明；

【作者基本信息】 湖北中医学院 ， 中医内科学， 2008， 硕士

【摘要】 目的观察保肾巴布剂穴位敷贴疗法对慢性肾脏病肾阳虚证肾阴虚证患者的临床疗效、不良反应,对其有效性和安全性作出评价,并与单纯西医治疗的对照组比较,探索一种治疗慢性肾脏病肾阳虚证肾阴虚证经济安全、疗效可靠、适宜推广的外治法。方法本研究患者8 0例,均来源于湖北省中医院肾内科门诊及住院病人,符合慢性肾脏病西医诊断标准及中医辨证分型标准。随机分为两组:保肾巴布剂穴位敷贴治疗组(简称为A组),西医治疗对照组(简称为B组),每组各40例。A组在西医常规治疗的基础上,予保肾巴布剂敷贴于双肾俞,命门,双复溜穴,隔天敷贴1次,每次6-8个小时,治疗时间定在三伏期间,中医辨证分型为肾阳虚证、肾阴虚证,分别用保肾1号巴布剂、保肾2号巴布剂敷贴。B组仅予西医常规治疗,不予敷贴治疗。两组疗程为1个月,治疗前后查尿常规、血生化、血糖、24小时尿蛋白定量等指标,并记录治疗前后患者临床症状及体征的变化,作出疗效评价。结果1 A组总有效率为82.5%,B组总有效率为65.0%,A组总体疗效与B组相比均有显著性差异(P＜0.05)。2两组治疗前后的临床症状总积分相比均有显著性差异(P＜0.05),A组与B组相比有显著性差异(P＜0.05),表明两组均能有效改善患者临床症状,A组疗效优于B组。3 A组对肾阳虚证有效率为87.0%,与B组(66.7%)相比有显著性差异(P＜0.05),表明A组对肾阳虚证的效果优于B组,A组对肾阴虚证有效率为76.50%,虽较B组(63.1%)相比明显,但在统计学上无显著性差异(P＞0.05),表明A组对肾阴虚证的效果与B组相近。4两组中慢性肾小球肾炎患者治疗后24hupq、尿红细胞计数较治疗前均下降,具有显著性差异(P＜0.05),而A组与B组相比又有显著性差异(P＜0.05),表明A组在减少尿蛋白、尿血的作用上优于B组;两组中糖尿病肾病患者治疗后24hupq、空腹血糖及餐后两小时血糖较治疗前均有明显下降(P＜0.05),A组在降低24hupq、降低空腹血糖作用上优于B组(P＜0.05),在降低餐后两小时血糖作用上与B组相近(P＞0.05);两组病例中高血压肾病患者治疗后收缩压及24hupq较治疗前有明显降低(P＜0.05),舒张压治疗前后无变化(P＞0.05),在降低收缩压效果方面,A、B两组之间比较无显著性意义(P＞0.05),在减少24hupq上,A组优于B组(P＜0.05)。5两组治疗后患者的BUN、Scr较治疗前均有不同程度的降低(P＜0.05),A组对于BUN的疗效优于B组(P＜0.05),对Scr的疗效与B组相比没有显著差异(P＞0.05)。6安全性检测:治疗组与对照组治疗后肝功能、心电图、血常规、粪常规检测均无明显异常变化,治疗前虽有个别项目异常存在,但治疗后无加重;所有患者敷贴处皮肤无发红、水疱、疼痛、破溃等发生,表明保肾巴布剂安全有效,无毒副作用。结论临床观察表明:保肾巴布剂穴位敷贴治疗慢性肾脏病肾阳虚证肾阴虚证有较好的疗效。保肾巴布剂穴位敷贴疗法能明显改善慢性肾脏病患者临床症状,减少蛋白尿,控制血糖、血压,改善肾功能,提高患者生活质量,临床应用安全有效、无毒副作用,是治疗慢性肾脏病的一种简便有效方法,值得临床推广应用。更多还原

【Abstract】 OBJECTIVETo observe the curative effect and saftly of Baoshen Ba Bu plaster to treat chronic kidney diseases(CKD),(insufficiency type of kidney-Yang、insufficiency type of kidney-Yin)by point application in dog-days,,and search an easy economy safe effective method in treating CKD.METHODSAll 80 patients were randomly divided into two groups:therapeutic group of Baoshen’ Ba Bu plaster point application(GroupA,n=40),routine medicine control group(GroupB,n=40).According to requirement of disease two groups were treated with routine medicine.GroupA took Baoshen’ Ba Bu plaster point appilication in dog-days,six to eight hours each time,every tow days.each.GroupB took routine medicine.The therapeutic period of two groups was one monthes.Then observing the difference of both curative and safe indexes between before and after treatments.RESULTS1.The total effective rate of groupA was 82.5%and that of groupB was 65.0%.There was significant difference between groupA and groupB(p＜0.05),which indicated that the total effect of groupA was better than that of groupB.2.There was significant difference between before and after treatments in the total scores of two groups(p＜0.05),and there was significant score difference between groupA and groupB(p＜0.05),which indicated that two groups could improve the symptoms,and group A had better effect than groupB.3.The total effective rate on insufficiency type of kidney-Yang of groupA was 87.0%,that of groupB was 66.7%.There was significant difference between groupA and groupB(p＜0.05),which indicated that the effect on insufficiency type of kidney-Yang of groupA was better than that of groupB.The total effective rate on insufficiency type of kidney-Yin of group A was 76.5%,that of group B was 63.1%.There was no significant difference between group A and group B(p＞0.05),which indicated that the effect on insufficiency type of kidney-Yin of group A was close to that of group B.4.The two groups of CGN patients decrease 24hupq and RBC counting of urine,and the effect of groupA was better than that of groupB(p＜0.05);The two groups of DN could decrease the 24hupq and blood sugar(p＜0.05),The effect of groupA was better than that of groupB(p＜0.05).The two groups of HTN could decrease the 24hupq and blood pressure.But Statistical analysis showed that they didn’t have obvious discrepancy on lowering blood pressure(p＞0.05),then the effect on decreasing 24hupq of group A was better than that of group B(p＜0.05).5.Two groups could decrease BUN and Scr.The effect on decreasing BUN of groupA was better than that of groupB(p＜0.05).but the effect on decreasing Scr of group A was close to that of group B(p＞0.05).6.There was no abnormality between before and after treatments among two groups which indicated that Baoshen’ Ba Bu plaster point application was a safe、effect、no side effect and no toxicity treatment method for CKD.CONCLUSIONThe clinical observation showed that Baoshen’ Ba Bu piaster point application had good effect on CKD(insufficiency type of kidney-Yang、insufficiency type of kidney-Yin).It could efficiently improve the symptoms,decrease 24hupq and blood sugar,improve renal function.And there was no any side effect of Baoshen’ Ba Bu plaster.Baoshen’ Ba Bu plaster point application was an effective convenient and safe treatment method for CKD.更多还原