大柴胡汤合当归芍药散加减治疗慢性肾功能衰竭临床观察
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摘要
目的:观察大柴胡汤合当归芍药散加减治疗慢性肾功能衰竭(chronic renal failure,CRF)的临床疗效。方法:选取2017年6月至2018年12月济宁市中医院肾病科门诊及住院治疗的CRF患者60例,按照随机数字表法分为试验组和对照组,每组30例。对照组给予尿毒清颗粒治疗,试验组给予大柴胡汤合当归芍药散加减治疗。观察两组患者临床疗效、中医证候积分、肌酐清除率(creatinine clearance rate,CCR)、血尿素氮(blood urea nitrogen,BUN)、血肌酐(serum creatinine,Scr)、血清总胆固醇(total cholesterol,TC)、三酰甘油(three acyl glycerin,TG)变化情况。结果:两组患者临床疗效比较,试验组有效率90. 00%,对照组有效率63. 33%,试验组高于对照组,差异有统计学意义(P <0. 05);试验组治疗后中医证候评分、BUN、Scr较对照组明显降低,CCR较对照组明显升高,差异有统计学意义(P <0. 05),治疗后试验组中TC、TG较对照组虽有一定幅度降低,但无显著性差异(P> 0. 05)。结论:大柴胡汤合当归芍药散加减治疗慢性肾功能衰竭疗效确切,能有效改善患者临床症状和肾功能指标。
Objective: To observe the clinical curative effect of Major Bupleurum Decoction and Modified Chinese Angelica and Peony Powder on chronic renal failure( CRF). Methods: Sixty CRF patients in outpatient and inpatient department of Nephrology of Jining Hospital of TCM from June 2017 to December 2018 were selected and divided into the experimental group and the control group according to random number table method,with 30 cases in each group. The control group was treated with Niaoduqing Granule( NDQG),while the experimental group was treated with Major Bupleurum Decoction and Modified Chinese Angelica and Peony Powder. The changes of clinical efficacy,TC syndrome score,creatinine clearance rate( CCR),blood urea nitrogen( BUN),serum creatinine( Scr),total cholesterol( TC),and triacyl glycerin( TG) of the two groups were observed. Results: In terms of clinical efficacy,The effective rate was 90. 00% in the experimental group and 63. 33% in the control group,the experimental group was higher than the control group,and the difference was statistically significant( P < 0. 05). After the treatment,the scores of TCM syndromes,BUN and Scr in the experimental group were significantly lower than those in the control group,and CCR was significantly higher than that in the control group and all the differences were statistically significant( P < 0. 05). After the treatment,TC and TG in the experimental group were lower than those in the control group,but there was no significant difference( P > 0. 05). Conclusion: Major Bupleurum Decoction and Modified Chinese Angelica and Peony Powder has a remarkable efficacy on CRF,can effectively improve the clinical symptoms and renal function indicators of patients.
Objective: To observe the clinical curative effect of Major Bupleurum Decoction and Modified Chinese Angelica and Peony Powder on chronic renal failure( CRF). Methods: Sixty CRF patients in outpatient and inpatient department of Nephrology of Jining Hospital of TCM from June 2017 to December 2018 were selected and divided into the experimental group and the control group according to random number table method,with 30 cases in each group. The control group was treated with Niaoduqing Granule( NDQG),while the experimental group was treated with Major Bupleurum Decoction and Modified Chinese Angelica and Peony Powder. The changes of clinical efficacy,TC syndrome score,creatinine clearance rate( CCR),blood urea nitrogen( BUN),serum creatinine( Scr),total cholesterol( TC),and triacyl glycerin( TG) of the two groups were observed. Results: In terms of clinical efficacy,The effective rate was 90. 00% in the experimental group and 63. 33% in the control group,the experimental group was higher than the control group,and the difference was statistically significant( P < 0. 05). After the treatment,the scores of TCM syndromes,BUN and Scr in the experimental group were significantly lower than those in the control group,and CCR was significantly higher than that in the control group and all the differences were statistically significant( P < 0. 05). After the treatment,TC and TG in the experimental group were lower than those in the control group,but there was no significant difference( P > 0. 05). Conclusion: Major Bupleurum Decoction and Modified Chinese Angelica and Peony Powder has a remarkable efficacy on CRF,can effectively improve the clinical symptoms and renal function indicators of patients.
引文
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[12]周逊.朱辟疆治疗慢性肾衰竭经验撷萃[J].江苏中医药,2011,43(5):14-16.
[13]张佩青,迟继铭,宋立群,等.张琪教授辨证治疗慢性肾衰竭的临床疗效研究[J].中国中西医结合肾病杂志,2015,16(3):242-244.
[14]杜珍芳,翟惟凯,黄敏.“固本泄浊饮”治疗慢性肾衰竭30例临床研究[J].江苏中医药,2012,44(8):22-23.
[15]袁霞,薛昌森,傅玉素,等.小柴胡汤在慢性肾功能衰竭中的运用[J].黑龙江中医药,1996,25(1):11-12.
[16]先小乐,肖相如.浅谈小柴胡汤治疗慢性肾衰竭的认识[J].山东中医杂志,2013,32(11):845-846.
[2]陈孝文,梁东,刘华锋.慢性肾衰竭[M].北京:中国医药科技出版社,2006:147.
[3] MARRA G,SILVA Y M,EDEFONTI A C,et al. Comparison of the epidemiology of chronic renal failure(CRF)in low and high-income countries[J]. Clin Nephrol,2010,74(1):S157.
[4] FEEST T. Epidemiology and causes of chronic renal failure[J].Medicine,2007,35(8):438-441.
[5]王静,程现昆,赵春慧,等.慢性肾脏病患者的人文关怀[J].中国医学伦理学,2011,24(3):339-340.
[6]郑筱萸.中药新药临床研究指导原则[M].北京:中国医药科技出版社,2002:149-151.
[7]马莹,孙伟.现代中医对慢性肾衰竭辨证分型治疗进展[J].辽宁中医药大学学报,2012,14(6):235-237.
[8]齐振强,任鲁颖,冯国庆,等.慢性肾功能衰竭中医临床研究进展[J].中华中医药学刊,2016,34(8):2006-2009.
[9]徐英.张大宁治疗慢性肾功能衰竭的思路与方法[J].北京中医,2006,25(9):536-537.
[10]刘琼,孙伟.孙伟教授治疗慢性肾脏病经验[J].吉林中医药,2010,30(1):14-16.
[11]蔡浔远,王茂泓,吴国庆,等.慢性肾衰竭病机及中医药治疗探析[J].中国中西医结合肾病杂志,2002,3(9):559-560.
[12]周逊.朱辟疆治疗慢性肾衰竭经验撷萃[J].江苏中医药,2011,43(5):14-16.
[13]张佩青,迟继铭,宋立群,等.张琪教授辨证治疗慢性肾衰竭的临床疗效研究[J].中国中西医结合肾病杂志,2015,16(3):242-244.
[14]杜珍芳,翟惟凯,黄敏.“固本泄浊饮”治疗慢性肾衰竭30例临床研究[J].江苏中医药,2012,44(8):22-23.
[15]袁霞,薛昌森,傅玉素,等.小柴胡汤在慢性肾功能衰竭中的运用[J].黑龙江中医药,1996,25(1):11-12.
[16]先小乐,肖相如.浅谈小柴胡汤治疗慢性肾衰竭的认识[J].山东中医杂志,2013,32(11):845-846.