益气祛瘀化浊法治疗慢性肾功能衰竭（瘀浊阻滞、脾肾气虚型）的临床研究
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摘要
目的:通过运用中药益气祛瘀降浊方剂治疗慢性肾功能衰竭(CRF)的临床研究,探讨益气祛瘀降浊法治疗慢性肾功能衰竭的有效性和安全性。
方法:将以确定为瘀浊阻滞、脾肾气虚证的慢性肾功能衰竭失代偿期和肾衰竭期的67例患者随机分为治疗组34例(益气祛瘀降浊方剂治疗组)和对照组33例(肾衰宁胶囊治疗组),疗程为8周。观察治疗前后症状积分及血尿素氮(BUN)、血肌酐(Scr)、内生肌酐清除率(Ccr)、血红蛋白(Hb)、血钙(Ca2+)、血磷(P3+)及血浆白蛋白(Alb)的变化,所得结果采用意向性分析,作出疗效评价。
结果:
1.临床综合疗效评价,治疗组总有效率为67.6%,与对照组63.6%相比稍高,其差异无明显统计学意义(P＞0.05)。
2.治疗组能改善患者的临床症状,中医症候总有效率为67.6%,与对照组54.5%相比稍高,其差异无统计学意义(P＞0.05)。
3.两组治疗前后肾功能指标比较,治疗组BUN、Scr较治疗前有所下降,Ccr较治疗前有所上升,其差异均无统计学意义(P＞0.05);对照组BUN、Scr较治疗前有所下降,其差异无统计学意义(P＞0.05),Ccr有所上升,其差异有统计学意义(P＜0.05)。两组间比较,治疗组在降低BUN和Scr,升高Ccr方面与对照组差异不明显(P＞0.05)。
4.治疗组P~(3+)、Ca~(2+)、Alb较治疗前其差异无统计学意义(P＞0.05),Hb较治疗前其差异有统计学意义(P＜0.05);对照组P~(3+)、Ca~(2+)、Alb较治疗前其差异亦无统计学意义(P＞0.05),Hb较治疗前其差异亦有统计学意义(P＜0.05)。两组间比较,治疗组在升高Hb方面与对照组差异不明显(P＞0.05)。
结论:益气祛瘀降浊法治疗瘀浊阻滞、脾肾气虚型的慢性肾功能衰竭失代偿期和肾衰竭期患者在改善临床症状、改善肾性贫血等方面具有疗效确切,副作用少等优势。
Objective:The purpose of this clinical experiment is to observe the efficiency and safety of the TCM therapy named "replenishing Qi,eliminating blood stasis and expelling turbid" on chronic renal failure(CRF).
Methods:67 patients with CRF were randomly divided into two group.Replenishing Qi,eliminating blood stasis and expelling turbid therapeutic group han 34 cases.Shenshuaining capsules control group had 33 cases.The therapeutic period was 8 weeks.Observing the change of clinical symptome,BUN,Scr,Ccr,Hb,Ca2+,P3+and Alb.At last observed the difference of therapeutic effect between therapeutic group and control group.
Results:
1.With comprehensive clinical analysis,the efficiency(67.6%) in the therapeutic group patients was higher than that(63.6%) in the control group patients(P＞0.05).
2.On the change of clinical symptoms,the therapeutic group patients(67.6)was more than that(54.5%) of the control group patients(P＞0.05).
3.In the therapeutic group patients,after treatment,BUN and Scr were reduce(P＞0.05),at the same time Ccr increased(P＞0.05).On the other hand in the control group patients Scr and BUN was reduced too(P＞0.05),but Ccr increased markedly(P＜0.05).When compared with the control group,the therapeutic group had a insignificantly better results(P＞0.05).
4.Compared with pretherapy,the therapeutic group had a significant difference in the contents of increasing Hb(P＜0.05).The control group had a significant difference in the contents of increasing Hb(P＜0.05) too.
Conclusion:The methods of "replenishing Qi,eliminating blood stasis and expelling turbid" could improve renal function,reduce clinical symptoms.And these methods had a similar curative effect compared with.Shenshuaining capsules control group.T hese methods had fewer side effects.
方法:将以确定为瘀浊阻滞、脾肾气虚证的慢性肾功能衰竭失代偿期和肾衰竭期的67例患者随机分为治疗组34例(益气祛瘀降浊方剂治疗组)和对照组33例(肾衰宁胶囊治疗组),疗程为8周。观察治疗前后症状积分及血尿素氮(BUN)、血肌酐(Scr)、内生肌酐清除率(Ccr)、血红蛋白(Hb)、血钙(Ca2+)、血磷(P3+)及血浆白蛋白(Alb)的变化,所得结果采用意向性分析,作出疗效评价。
结果:
1.临床综合疗效评价,治疗组总有效率为67.6%,与对照组63.6%相比稍高,其差异无明显统计学意义(P＞0.05)。
2.治疗组能改善患者的临床症状,中医症候总有效率为67.6%,与对照组54.5%相比稍高,其差异无统计学意义(P＞0.05)。
3.两组治疗前后肾功能指标比较,治疗组BUN、Scr较治疗前有所下降,Ccr较治疗前有所上升,其差异均无统计学意义(P＞0.05);对照组BUN、Scr较治疗前有所下降,其差异无统计学意义(P＞0.05),Ccr有所上升,其差异有统计学意义(P＜0.05)。两组间比较,治疗组在降低BUN和Scr,升高Ccr方面与对照组差异不明显(P＞0.05)。
4.治疗组P~(3+)、Ca~(2+)、Alb较治疗前其差异无统计学意义(P＞0.05),Hb较治疗前其差异有统计学意义(P＜0.05);对照组P~(3+)、Ca~(2+)、Alb较治疗前其差异亦无统计学意义(P＞0.05),Hb较治疗前其差异亦有统计学意义(P＜0.05)。两组间比较,治疗组在升高Hb方面与对照组差异不明显(P＞0.05)。
结论:益气祛瘀降浊法治疗瘀浊阻滞、脾肾气虚型的慢性肾功能衰竭失代偿期和肾衰竭期患者在改善临床症状、改善肾性贫血等方面具有疗效确切,副作用少等优势。
Objective:The purpose of this clinical experiment is to observe the efficiency and safety of the TCM therapy named "replenishing Qi,eliminating blood stasis and expelling turbid" on chronic renal failure(CRF).
Methods:67 patients with CRF were randomly divided into two group.Replenishing Qi,eliminating blood stasis and expelling turbid therapeutic group han 34 cases.Shenshuaining capsules control group had 33 cases.The therapeutic period was 8 weeks.Observing the change of clinical symptome,BUN,Scr,Ccr,Hb,Ca2+,P3+and Alb.At last observed the difference of therapeutic effect between therapeutic group and control group.
Results:
1.With comprehensive clinical analysis,the efficiency(67.6%) in the therapeutic group patients was higher than that(63.6%) in the control group patients(P＞0.05).
2.On the change of clinical symptoms,the therapeutic group patients(67.6)was more than that(54.5%) of the control group patients(P＞0.05).
3.In the therapeutic group patients,after treatment,BUN and Scr were reduce(P＞0.05),at the same time Ccr increased(P＞0.05).On the other hand in the control group patients Scr and BUN was reduced too(P＞0.05),but Ccr increased markedly(P＜0.05).When compared with the control group,the therapeutic group had a insignificantly better results(P＞0.05).
4.Compared with pretherapy,the therapeutic group had a significant difference in the contents of increasing Hb(P＜0.05).The control group had a significant difference in the contents of increasing Hb(P＜0.05) too.
Conclusion:The methods of "replenishing Qi,eliminating blood stasis and expelling turbid" could improve renal function,reduce clinical symptoms.And these methods had a similar curative effect compared with.Shenshuaining capsules control group.T hese methods had fewer side effects.
引文
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