本文選題：慢性腎臟病　切入點：脾胃氣機升降理論　出處：《廣州中醫(yī)藥大學》2016年碩士論文

【摘要】：目的：從中醫(yī)脾胃氣機升降理論出發(fā),臨床觀察健脾益腎、升清降濁法對慢性腎臟病(CKD)3-5期患者的各項實驗室指標和癥候積分的影響,客觀評價健脾益腎、升清降濁法對慢性腎臟病3-5期患者的療效,為中醫(yī)藥治療慢性腎臟病提供新的思路和方法。方法：本研究采用隨機對照的研究方法,根據(jù)西醫(yī)慢性腎臟病3-5期診斷標準及中醫(yī)脾腎氣虛夾濕濁證的診斷標準,選取50例符合脾腎氣虛夾濕濁的慢性腎臟病3-5期患者作為研究對象,隨機分為治療組25例,對照組25例。兩組均給予改善腎臟循環(huán)、降壓、降糖、降脂、糾正貧血、糾正電解質(zhì)紊亂及酸堿失衡、糾正貧血、糾正鈣磷代謝紊亂等對癥支持治療。治療組在對癥支持治療的基礎(chǔ)上,以健脾益腎、升清降濁中藥湯劑內(nèi)服進行治療。8周后收集治療組和對照組前后中醫(yī)癥候積分及尿素氮(blood urea nitrogen, BUN)、血肌酐(Serum creatinine, Scr)、腎小球濾過率(GFR)、血紅蛋白(Hemoglobin, HGB)、白蛋白((Serum Albumin, ALB)等實驗室指標的變化,并運用SPSS 22.0對數(shù)據(jù)進行統(tǒng)計分析,評價健脾益腎、升清降濁法對慢性腎臟病3-5期患者的臨床療效。結(jié)果：治療組和對照組兩組患者臨床總療效對比,治療組總有效率優(yōu)于對照組總有效率(P0.05)。兩組患者在治療前后臨床癥候積分均有改善,治療組優(yōu)于對照組,具有統(tǒng)計學意義(P0.05)。兩組治療前后BUN、Scr、GFR、HGB、ALB均有改善,具有統(tǒng)計學意義(P0.05),治療后組間比較BUN、Scr、GFR、HGB差異具有統(tǒng)計學意義(P0.05), ALB無統(tǒng)計學意義(P0.05)。結(jié)論：以“脾胃氣機升降理論”為基礎(chǔ),運用健脾益腎、升清降濁法可以改善慢性腎臟病3-5期患者癥候積分,有效改善患者臨床癥狀,降低尿素氮、血肌酐,提高腎小球率過濾和血紅蛋白水平,改善患者腎功能和貧血,延緩慢性腎臟病的進展。
[Abstract]:Objective: to observe the effects of the methods of invigorating spleen and tonifying kidney, raising spleen and removing turbidity on the laboratory indexes and syndromes of patients with chronic kidney disease (CKD) in phase 3-5, and to evaluate objectively the effect of strengthening spleen and tonifying the kidney, based on the theory of rising and lowering spleen and stomach qi in traditional Chinese medicine. The therapeutic effect of Shengqing Jiangzhuo method on patients with chronic kidney disease at 3-5 stages provides a new way of thinking and method for the treatment of chronic kidney disease with traditional Chinese medicine. According to the criteria of 3 to 5 stages of chronic kidney disease in western medicine and the diagnostic criteria of spleen and kidney qi deficiency and dampness turbidity in traditional Chinese medicine, 50 cases of chronic kidney disease in 3 to 5 stages of spleen and kidney qi deficiency and dampness were selected as research objects, and were randomly divided into treatment group (25 cases). 25 cases in the control group were treated with improved renal circulation, hypotension, hypoglycemia, lipid reduction, correction of anemia, correction of electrolyte disturbance and acid-base imbalance, correction of anemia, Correction of disorders of calcium and phosphorus metabolism and other symptomatic support treatment. The treatment group in the treatment group on the basis of symptomatic support treatment to strengthen the spleen and kidney, After oral administration of Shengqingjiangzhuo traditional Chinese medicine decoction for 8 weeks, the changes of TCM syndromes integral, blood urea nitrogenin, bunn, serum creatinine serum creatinine, Scrine, glomerular filtration rate, hemoglobulin, HGBM, albumin Serum Albumin, and so on were collected before and after treatment in the treatment group and the control group. SPSS 22.0 was used to analyze the data, to evaluate the clinical effect of strengthening spleen and tonifying kidney, raising clear and reducing turbidity in patients with chronic kidney disease in three to five stages. Results: the total clinical curative effect of treatment group and control group was compared with that of control group. The total effective rate of the treatment group was better than that of the control group (P 0.05). The clinical symptom scores of the two groups were improved before and after treatment, and the treatment group was superior to the control group (P 0.05). After treatment, the difference of BUNScr-Scr-GFRG-HGB was statistically significant (P 0.05), but ALB had no statistical significance (P 0.05). Conclusion: based on the theory of "spleen and stomach Qi rising and lowering", we can use the theory of strengthening spleen and nourishing the kidney to strengthen the spleen and nourish the kidney. The method of raising clear and reducing turbidity can improve symptom score of patients with chronic kidney disease in 3-5 stages, effectively improve clinical symptoms, reduce urea nitrogen, serum creatinine, increase glomerular filtration and hemoglobin level, improve renal function and anemia of patients. Delay the progress of chronic kidney disease.
【學位授予單位】：廣州中醫(yī)藥大學
【學位級別】：碩士
【學位授予年份】：2016
【分類號】：R277.5

【參考文獻】

相關(guān)期刊論文 前10條

1 孫政華;邵晶;郭玫;;黨參化學成分及藥理作用研究進展[J];安徽農(nóng)業(yè)科學;2015年33期

2 焦劍;;張大寧教授治療慢性腎功能衰竭的經(jīng)驗[J];天津中醫(yī)藥;2015年06期

3 孫曉光;彭建中;;趙紹琴慢性腎病辨治理論和經(jīng)驗的傳承發(fā)展[J];世界中西醫(yī)結(jié)合雜志;2015年03期

4 童楠;;童安榮主任醫(yī)師從升降治療慢性腎衰竭的學術(shù)思想[J];中國中西醫(yī)結(jié)合腎病雜志;2015年02期

5 宋立群;，

本文編號：1675379