| 倪佳宁,魏升,钟光辉,蔡旭东.温阳化瘀方辅治脾肾亏虚血瘀型慢性肾脏病3期的临床观察[J].浙江中西医结合杂志,2020,30(3): |
| 温阳化瘀方辅治脾肾亏虚血瘀型慢性肾脏病3期的临床观察 |
| Clinical observation of chronic kidney disease 3 stage of spleen kidney deficiency and blood stasis type by adjuvant therapy of Wenyang Huayu Decoction |
| 投稿时间：2019-10-24 修订日期：2020-02-08 |
| DOI： |
| 中文关键词: 温阳化瘀方,脾肾亏虚血瘀型,慢性肾脏病3期 |
| 英文关键词:Wenyang Huayu Decoction, spleen kidney deficiency and blood stasis, chronic kidney disease stage 3 |
| 基金项目:宁波市自然科学基金（2017A610187） |
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| 摘要点击次数: 649 |
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| 中文摘要: |
| 目的：观察慢性肾脏病一体化西药治疗及慢病随访管理基础上，加以温阳化瘀方治疗脾肾亏虚血瘀型慢性肾脏病3期的临床疗效。方法：将宁波市中医院慢性肾脏病管理中心随访的62例脾肾亏虚血瘀型慢性肾脏病3期患者按随机对照原则分为中西医治疗组和西药治疗组各31例，两组均予以肾脏病一体化西药治疗及慢病随访管理，中西治疗组在此基础上加用温阳化瘀方，疗程8周。疗程结束后，通过统计学处理分析比较两组患者治疗前后客观指标血红蛋白、血清白蛋白、血肌酐、血尿素氮、肾小球滤过率、尿总蛋白/尿肌酐及主观指标中医证候积分、SF-36生活质量评分的变化情况。结果：（1）客观指标比较：两组患者经治疗后各项指标均有改善，而中西医治疗组较西药治疗组在血清白蛋白[(44.05±3.25)g/L比(41.65±3.75)g/L，P<0.05]、血肌酐[(128.68±25.46)umol/L比(143.55±25.10)umol/L，P<0.05]、肾小球滤过率 [(51.83±12.04) ml/min比(42.95±9.58) ml/min，P<0.05]、尿总蛋白/尿肌酐[(686.65±457.10)mg/g比(971.81.67±619.41) mg/g，P<0.05]的变化更具统计学意义；（2）主观指标：中西医治疗组治疗后较治疗前[(13.42±4.23)分比（21.84±4.37）分，P<0.05]以及西药治疗组治疗后较治疗前[(19.23±3.90)分比(21.61±4.29)分，P<0.05]在中医证候总积分上均有显著下降，具有统计学意义；而中西医治疗组较西药治疗组的改善更为显著[(13.42±4.23)分比(19.23±3.90)分，P<0.05]，具有统计学意义；中西医治疗组治疗后较治疗前[(627.95±104.10)分比（487.78±125.18）分，P<0.05]以及西药治疗组治疗后较治疗前[(557.94±92.71)分比(507.08±100.68)分，P<0.05] 在SF-36生活质量总评分均有明显上升（P<0.05），具有统计学意义；而中西医治疗组较西药治疗组的改善更为显著[(627.95±104.10)分比(557.94±92.71)分，P<0.05]，具有统计学意义；（3）中医证候总积分与SF-36生活质量总评分具有负相关（P<0.05）。结论：西药治疗联合慢病随访病管理基础上辅以温阳化瘀方，可以更好地减少尿蛋白、提高血清白蛋白，延缓肾功能进展，以及通过改善中医临床症状提高患者生活质量。 |
| 英文摘要: |
| Objective: To observe the clinical effect of Wenyang Huayu Decoction in adjuvant treatment of spleen and kidney deficiency and blood stasis type of CKD（chronic kidney disease） 3 stage. Methods: According to the principle of random control, 62 patients with spleen kidney deficiency and blood stasis chronic kidney disease in CKD 3 stage were divided into Chinese and Western treatment group and Western medicine treatment group, each group was treated with western medicine and chronic kidney disease management. On this basis, Chinese and Western treatment group was treated with Wenyang Huayu Decoction for 8 weeks. At the end of the treatment course, the objective indexes including hemoglobin, serum albumin, serum creatinine, blood urea nitrogen, glomerular filtration rate, urinary total protein / urinary creatinine, subjective indexes including TCM symptom score and SF-36 quality of life score of the two groups before and after treatment were compared by statistical analysis. Results: (1) Comparison of objective indexes: after treatment, all indexes of the two groups were improved, while the changes of serum albumin[(44.05±3.25)g/L vs (41.65±3.75)g/L，P<0.05], serum creatinine [(128.68±25.46) umol/L vs (143.55±25.10) umol/L，P<0.05] and glomerular filtration rate [(51.83±12.04) ml/min vs (42.95±9.58) ml/min，P<0.05]，urinary total protein / urinary creatinine [(686.65±457.10)mg/g vs (971.81.67±619.41) mg/g，P<0.05] in the Chinese and Western medicine treatment group were more significant than those in the western medicine treatment group (P < 0.05); (2) Subjective indexes: the total scores of TCM symptoms in the two groups were decreased after treatment（P<0.05）, while the changes in the Chinese and Western medicine treatment group were more significant than those in the western medicine treatment group[(13.42±4.23) score vs (19.23±3.90) score，P<0.05]. The total score of SF-36 quality of life in the two groups increased after treatment（P<0.05）, but the improvement in the Chinese and Western medicine treatment group was more significant than that in the western medicine treatment group [(627.95±104.10) score vs (557.94±92.71) score，P<0.05]; (3) The total score of TCM syndrome was negatively correlated with the total score of SF-36 quality of life (P < 0.05). Conclusion: Wenyang Huayu Decoction can reduce urinary protein, improve serum albumin, delay the progress of renal function, and improve the quality of life of patients by improving the clinical symptoms of traditional Chinese medicine. |
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