从络论治膜性肾病低危患者临床研究
|
摘要
目的:以"肾络瘀阻"为病机,益气化瘀通络为治法,观察中医及中西医结合方案治疗特发性膜性肾病低危患者的临床疗效。方法:采用随机、对照的临床研究方法,将96例患者随机分为西药组、中西医结合治疗组和中药组。西药组给予缬沙坦,结合组在西药组基础上予中药汤剂芪苓通络方治疗,中药组予芪苓通络方,比较3组患者治疗前后临床疗效、中医症状积分、24 h尿蛋白定量、血浆白蛋白、肾功能指标的变化。结果:中药组、结合组治疗效果优于西药组(P<0.05,P<0.05);治疗后24 h尿蛋白定量均下降,血浆白蛋白(ALB)升高,与西药组比较差别有统计学意义(P<0.05,P<0.05);中药组、结合组各项指标差别无统计学意义(P>0.05);血肌酐(Scr)、尿素氮(BUN)均有下降,与西药组比较差别无统计学意义(P>0.05)。结论:中医、中西医结合方案治疗特发性膜性肾病低危患者均可减轻患者临床症状、减少尿蛋白、保护肾功能,而中医方案更经济安全。
Objective: "Kidney collateral stasis"is the pathogenesis of IMN. Adopting the method of benefiting Qi,resolving stasis and dredging collaterals,we observe the curative effect of the traditional Chinese medicine,Chinese and Western medicine program treating low-risk patients of IMN. Methods: By a randomized and comparative research methods,totally 96 patients were randomly dividedas the Western medicine group,Traditional Chinese medicine group and Chinese and Western medicine group. The Western medicine group was treated by Trochisci Levamisoli Hydrochloridi.Chinese and Western medicine group was treated by Trochisci Levamisoli Hydrochloridi and Qiling Tongluo Decoction.Traditional Chinese medicine group was treated by Qiling Tongluo Decoction. The effects,symptom scores in Chinese medicine,24 h urinary protein,plasma albumin and renal function were observed before and after the treatment. Result:Traditional Chinese medicine group and Chinese and Western medicine group was better than the Western medicine group after treatment( P < 0. 05,P < 0. 05). 24 h urinary protein was decreased and ALB level was increased after treatment.There were significant differences as compared with the Western medicine group( P < 0. 05,P < 0. 05). There were no significant differences between two groups( P > 0. 05). Urea nitrogen and serum creatinine declined. There were no significant differences in three groups( P > 0. 05). Conclusion: Solutions of traditional Chinese medicine and Chinese and Western medicine group can improve the symptom,reduce urine protein and protect renal function. The traditional Chinese medicine program is more economical,safe and effective.
Objective: "Kidney collateral stasis"is the pathogenesis of IMN. Adopting the method of benefiting Qi,resolving stasis and dredging collaterals,we observe the curative effect of the traditional Chinese medicine,Chinese and Western medicine program treating low-risk patients of IMN. Methods: By a randomized and comparative research methods,totally 96 patients were randomly dividedas the Western medicine group,Traditional Chinese medicine group and Chinese and Western medicine group. The Western medicine group was treated by Trochisci Levamisoli Hydrochloridi.Chinese and Western medicine group was treated by Trochisci Levamisoli Hydrochloridi and Qiling Tongluo Decoction.Traditional Chinese medicine group was treated by Qiling Tongluo Decoction. The effects,symptom scores in Chinese medicine,24 h urinary protein,plasma albumin and renal function were observed before and after the treatment. Result:Traditional Chinese medicine group and Chinese and Western medicine group was better than the Western medicine group after treatment( P < 0. 05,P < 0. 05). 24 h urinary protein was decreased and ALB level was increased after treatment.There were significant differences as compared with the Western medicine group( P < 0. 05,P < 0. 05). There were no significant differences between two groups( P > 0. 05). Urea nitrogen and serum creatinine declined. There were no significant differences in three groups( P > 0. 05). Conclusion: Solutions of traditional Chinese medicine and Chinese and Western medicine group can improve the symptom,reduce urine protein and protect renal function. The traditional Chinese medicine program is more economical,safe and effective.
引文
[1]郑筱萸.中药新药临床研究指导原则[S].北京:中国医药科技出版社,2002:157-162.
[2]常成成,魏聪,吴以岭.脉络学说“孙络-微血管”概念及其临床指导意义[J].中医杂志,2016,57(1):101-103.
[3]吴以岭.脉络学说构建及其指导血管病变防治研究[J].中国中西医结合杂志,2017,37(2):147-148.
[4]丁英钧,蔡冀民,潘莉,等.慢性肾脏病“肾络瘀阻”共有病机学说及临床意义[J].时珍国医国药,2011,22(3):690-691.
[5]刘勇明,吕晓东,庞立健.基于“络虚邪瘀”病机观的慢性复杂性疾病治疗辨识[J].中国中医基础医学杂志,2016,22(8):1034-1036.
[6]刘妍,吕晓东,庞立健.慢性复杂性疾病中医共性证治探究[J].时珍国医国药,2016,27(3):669-671.
[7]贾秀琴,张晓丽,杨继红.基于现代文献的慢性肾脏病肾络研究[J].中国中西医结合肾病杂志.2016,17(8):751-752.
[8]杨冠琦,吕静.原发性肾小球就疾病从络病论治浅谈[J].中国中西医结合肾病杂志,2017,18(2):146-147.
[9]秦淑敏,林静瑜,黄可儿.黄芪的免疫调节作用研究概述[J].中华中医药学刊,2017,35(3):700-702.
[10]房宇,刘尧.黄芪的免疫调节作用研究进展[J].亚太传统医药,2012,8(7):208-210.
[11]孙邈,孙海申.对中药“血肉有情之品”临床应用的几点认识[J].临床医药文献杂志,2017,4(50):9895-9896
[12]张亚萍,唐振宇,李永亮.论叶天士对张仲景通络法的继承与发挥[J].上海中医药杂志,2017,51(9):37-39.
[13]史磊,张天锡,杜聪颖.中药全蝎活性成分、药理作用及临床应用研究进展[J].辽宁中医药大学学报,2015,17(4):89-91.
[14]汪慧惠,包红,于俊生,等.蝉蜕僵蚕对大鼠系膜增生性肾炎作用的实验研究[J].四川中医,2014,32(2):69-71.
[15]赵子佳,周桂荣,王玉,等.蝉蜕的化学成分及药理作用研究[J].吉林中医药,2017,37(5):491-493.
[16]张倩,范华平,张秀侠.益肾通络方对膜性肾病大鼠肾组织中乙酰肝素酶、转化生长因子β1表达的影响[J].中国中西医结合肾病杂志,2015,16(3):228-229.
[17]刘翀羽.藤类药的应用研究[J].山西中医,2015,31(7):59-60.
[2]常成成,魏聪,吴以岭.脉络学说“孙络-微血管”概念及其临床指导意义[J].中医杂志,2016,57(1):101-103.
[3]吴以岭.脉络学说构建及其指导血管病变防治研究[J].中国中西医结合杂志,2017,37(2):147-148.
[4]丁英钧,蔡冀民,潘莉,等.慢性肾脏病“肾络瘀阻”共有病机学说及临床意义[J].时珍国医国药,2011,22(3):690-691.
[5]刘勇明,吕晓东,庞立健.基于“络虚邪瘀”病机观的慢性复杂性疾病治疗辨识[J].中国中医基础医学杂志,2016,22(8):1034-1036.
[6]刘妍,吕晓东,庞立健.慢性复杂性疾病中医共性证治探究[J].时珍国医国药,2016,27(3):669-671.
[7]贾秀琴,张晓丽,杨继红.基于现代文献的慢性肾脏病肾络研究[J].中国中西医结合肾病杂志.2016,17(8):751-752.
[8]杨冠琦,吕静.原发性肾小球就疾病从络病论治浅谈[J].中国中西医结合肾病杂志,2017,18(2):146-147.
[9]秦淑敏,林静瑜,黄可儿.黄芪的免疫调节作用研究概述[J].中华中医药学刊,2017,35(3):700-702.
[10]房宇,刘尧.黄芪的免疫调节作用研究进展[J].亚太传统医药,2012,8(7):208-210.
[11]孙邈,孙海申.对中药“血肉有情之品”临床应用的几点认识[J].临床医药文献杂志,2017,4(50):9895-9896
[12]张亚萍,唐振宇,李永亮.论叶天士对张仲景通络法的继承与发挥[J].上海中医药杂志,2017,51(9):37-39.
[13]史磊,张天锡,杜聪颖.中药全蝎活性成分、药理作用及临床应用研究进展[J].辽宁中医药大学学报,2015,17(4):89-91.
[14]汪慧惠,包红,于俊生,等.蝉蜕僵蚕对大鼠系膜增生性肾炎作用的实验研究[J].四川中医,2014,32(2):69-71.
[15]赵子佳,周桂荣,王玉,等.蝉蜕的化学成分及药理作用研究[J].吉林中医药,2017,37(5):491-493.
[16]张倩,范华平,张秀侠.益肾通络方对膜性肾病大鼠肾组织中乙酰肝素酶、转化生长因子β1表达的影响[J].中国中西医结合肾病杂志,2015,16(3):228-229.
[17]刘翀羽.藤类药的应用研究[J].山西中医,2015,31(7):59-60.