复方猪苓汤治疗慢性肾小球肾炎的临床研究.doc

复方猪苓汤治疗慢性肾小球肾炎的临床研究
专业:中医临床基础
研究生:陈英晖
导师:张喜奎教授
摘要
目的:通过观察复方猪苓汤治疗慢性肾炎阴虚水热互结证患者的临床疗效。运用复方猪苓汤与单纯猪苓汤对慢性肾炎阴虚水热互结证患者疗效优劣之比较,探索治疗慢性肾炎阴虚水热互结证更为有效的治法及方药。
材料与方法:临床诊断为慢性肾炎阴虚水热互结证患者60例,作为研究对象,随机分成治疗组(复方猪苓汤治疗)、对照组(猪苓汤治疗),每组各30例,治疗3个月后观察治疗前后尿蛋白、尿红细胞、血肌酐、血尿素氮、中医证候积分变化及总体疗效分析,用统计学分析两组间各项指标的差异。
结果:(1)在降低中医证候积分方面,两组在治疗前后自身比较均有显著性差异(P<),而组间比较则无显著性差异(P>)。(2)在改善尿蛋白方面,治疗组在治疗前后有显著性差异(P<),对照组在治疗前后也有显著性差异(P<),组间比较有显著性差异,治疗组疗效优于对照组(P<)。(3)在改善尿红细胞方面,治疗组在治疗前后有显著性差异(P<),对照组在治疗前后也有显著性差异(P<),而组间比较则无显著性差异(P>)。(4)在改善血肌酐方面,治疗组在治疗前后有显著性差异(P<),对照组在治疗前后无显著性差异(P>),组间比较:两组无显著性差异(P>)。(5)在改善血尿素氮方面,治疗组在治疗前后有显著性差异(P<),对照组在治疗前后无显著性差异(P>),组间比较:两组无显著性差异(P>)。
结论:通过临床研究发现:(1)复方猪苓汤及单纯猪苓汤均能有效地治疗慢性肾炎阴虚水热互结证。(2)复方猪苓汤在改善临床症状方面与单纯猪苓汤相似,而对于改善尿蛋白,血肌酐,血尿素氮的作用优于单纯猪苓汤。(3)复方猪苓汤在总体疗效上优于单纯猪苓汤,似可提示脾肾气虚是慢性肾炎阴虚水热互结证存在的另一基本病机,此为治疗
慢性肾炎阴虚水热互结证提供新思路。
主题词
肾小球肾炎/中医药疗法
慢性病
猪苓汤/治疗应用
祛湿利水药/治疗应用
补气药/治疗应用
阴虚/中医药疗法
湿热/中医药疗法
健脾/方法
Clinical observation of chronic glomerulonephritis treated pound Polyporus Umbellatus Decoction
ABSTRACT
Objective: To observe the clinical effect pound Polyporus Umbellatus Decoction in treating the syndrome of Yin-deficiency and water-bined in the chronic glomerulonephritis Patients.
Methods : 60 cases of chronic glomerulonephritis patients with the syndrome of water and bined ,were randomly divided into treatment group (30) treated pound Polyporus Umbellatus Decoction and control group (30) treated by Polyporus Umbellatus Decoction respectively for 3 months. The urine protein, urine red blood cell, serum creatinine (SCR) and blood urea nitrogen (BUN) were measured before and after the treatment. The changes of accumulating grade of TCM syndrome were observed at the same time.
Result: (1) In reducing the accumulating grade of TCM syndrome, there was significant difference in both groups (P<). While no difference between the two groups (P>). (2) The levers of the urine protein were significantly reduced in both groups (P<)