尿血宁方加味治疗隐匿性肾炎血尿的疗效观察
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摘要
目的:观察尿血宁方加味治疗隐匿性肾炎血尿的治疗作用,探讨中药治疗隐匿性肾炎血尿的优势及治疗机制。
方法:选择2007年9月～2009年3月江苏省中医院肾内科住院及门诊资料较为完整的患者30例为研究对象,均符合隐匿性肾小球肾炎、肾小球源性血尿的诊断标准,在基础治疗的同时加用中药益肾清利化瘀止血的尿血宁方加味,4周为1疗程,治疗12周,定期检查患者尿沉渣RBC计数,观察患者治疗前后尿沉渣RBC计数变化及治疗前后中医症状、体征及证候积分变化。对隐匿性肾炎伴蛋白尿者酌情加用雷公藤多甙治疗。
结果:1)治疗前后尿沉渣RBC计数较治疗前明显减少,总有效率83.4%,且在治疗第4周时疗效有显著差异(P＜0.01),第4、8、10、12周与治疗前比有明显下降趋势,第12周时尿沉渣RBC计数下降至最低点;2)在是否加用雷公藤的对比中,两组在不同时间点对减少尿沉渣RBC计数的作用有明显统计学意义(P＜0.01),两种方法间、不同时间点对减少尿沉渣RBC计数的作用无明显区别,差别无统计学意义(P＞0.05);3)尿血宁方加味对气阴两虚证疗效较好,肺肾气虚证、肝肾阴虚证次之,脾肾气虚证最差;兼证中对湿热证疗效较好,对兼瘀血者效果差;4)尿血宁方加味可显著改善患者临床症状,中医证候积分总有效率为66.7%;其中对倦怠乏力、五心烦热症状改善有明显统计学意义(P＜0.01),而对便溏、咽喉肿痛的治疗效果与治疗前比较无统计学意义(P＞0.05)。
结论:长期应用尿血宁方加味治疗隐匿性肾小球肾炎血尿可有效降低尿沉渣RBC计数,稳定病情;隐匿性肾炎血尿伴蛋白尿者加用雷公藤多甙有助于临床疗效的提高;尿血宁方对气阴两虚证疗效优于其他证型,兼证中对湿热证疗效优于瘀血证;尿血宁方可不同程度的改善腰痛、咽喉肿痛等中医证候,对倦怠乏力、五心烦热的改善尤为明显。
Objective: To observe the niaoxuening Formula on the hematuria in patients with occult glomerulonephritis symptoms, signs, urine levels of efficacy, to explore Traditional Chinese Medicine(TCM) in the treatment of occult glomerulonephritis advantages in hematuria and problems in current clinical studies.
Methods: Select 30 renal patients and out-patients with a more comprehensive study who are in compliance with the diagnostic criteria of occult glomerulonephritis, endogenous glomerular hematuria,and treatment in Western medicine will be the basis for the use of niaoxuening Formula at the same time, two weeks for one course of treatment, treatment of 3 months, inspect regularly RBC in urinary sediment and urinary protein.sediment RBC, the symptomation and the sign scores of Traditional Chinese Medicine were compared before treatment and after treatment. Occult glomerulonephritis with proteinuria can be treated with Tripterygium wilfordii..
Results: 1)RBC in urinary sediment after treatment than before treatment a significant decrease in the total effective rate 83.33%, and in the treatment of the fourth weeks when there is significant difference in efficacy (P <0.01), the treatment in 4,8,10,12 weeks is a clear downward trend than before treamnent, sediment RBC of 12 weeks is minimize; 2) In whether the use of TW contrast, the two groups at different times to reduce the role of sediment RBC has obvious statistical significance (P <0.01), between the two methods, different times to reduce the role of sediment RBC free significant difference, the difference was not significant (P> 0.05); 3)The effection by using niaoxuening formula is best in Qi-Yin deficiency syndrome,follow in lung and kindey Qi deficiency and liver and kidney Yin deficiency syndrome, and worst in spleen and kidney Qi deficiency syndrome; and evidence of better efficacy of damp-heat syndrome, and bleed syndrome of persons bad effect; 4)Niaoxuening formula could improve significantly in clinical symptoms, and syndrome points total effective rate was 66.67%; the comparison before and after treatment, the languid lazy and shortness of breath and five feverish centres, the difference was statistically significant. the comparison before and after treatment of throat Sore Pain was not statistically significant (P > 0.05)
Conclusion: The long-term treatment of occult glomerulonephritis in patients with hematuria by using niaoxuening formula can reduce sediment RBC, and the condition become stabilized. Occult glomerulonephritis with hematuria plus proteinuria TW help improve the clinical efficacy. the niaoxuening Formula evidence on the efficacy of Qi-Yin Deficiency Syndromes better than the other. And evidence, the efficacy Of damp-heat syndrome is superior to bleed syndrome Syndrome . At the same time, can be different degrees of improvement of Chinese medicine syndromes , the languid lazy and shortness of breath and five feverish improvement are particularly .
方法:选择2007年9月～2009年3月江苏省中医院肾内科住院及门诊资料较为完整的患者30例为研究对象,均符合隐匿性肾小球肾炎、肾小球源性血尿的诊断标准,在基础治疗的同时加用中药益肾清利化瘀止血的尿血宁方加味,4周为1疗程,治疗12周,定期检查患者尿沉渣RBC计数,观察患者治疗前后尿沉渣RBC计数变化及治疗前后中医症状、体征及证候积分变化。对隐匿性肾炎伴蛋白尿者酌情加用雷公藤多甙治疗。
结果:1)治疗前后尿沉渣RBC计数较治疗前明显减少,总有效率83.4%,且在治疗第4周时疗效有显著差异(P＜0.01),第4、8、10、12周与治疗前比有明显下降趋势,第12周时尿沉渣RBC计数下降至最低点;2)在是否加用雷公藤的对比中,两组在不同时间点对减少尿沉渣RBC计数的作用有明显统计学意义(P＜0.01),两种方法间、不同时间点对减少尿沉渣RBC计数的作用无明显区别,差别无统计学意义(P＞0.05);3)尿血宁方加味对气阴两虚证疗效较好,肺肾气虚证、肝肾阴虚证次之,脾肾气虚证最差;兼证中对湿热证疗效较好,对兼瘀血者效果差;4)尿血宁方加味可显著改善患者临床症状,中医证候积分总有效率为66.7%;其中对倦怠乏力、五心烦热症状改善有明显统计学意义(P＜0.01),而对便溏、咽喉肿痛的治疗效果与治疗前比较无统计学意义(P＞0.05)。
结论:长期应用尿血宁方加味治疗隐匿性肾小球肾炎血尿可有效降低尿沉渣RBC计数,稳定病情;隐匿性肾炎血尿伴蛋白尿者加用雷公藤多甙有助于临床疗效的提高;尿血宁方对气阴两虚证疗效优于其他证型,兼证中对湿热证疗效优于瘀血证;尿血宁方可不同程度的改善腰痛、咽喉肿痛等中医证候,对倦怠乏力、五心烦热的改善尤为明显。
Objective: To observe the niaoxuening Formula on the hematuria in patients with occult glomerulonephritis symptoms, signs, urine levels of efficacy, to explore Traditional Chinese Medicine(TCM) in the treatment of occult glomerulonephritis advantages in hematuria and problems in current clinical studies.
Methods: Select 30 renal patients and out-patients with a more comprehensive study who are in compliance with the diagnostic criteria of occult glomerulonephritis, endogenous glomerular hematuria,and treatment in Western medicine will be the basis for the use of niaoxuening Formula at the same time, two weeks for one course of treatment, treatment of 3 months, inspect regularly RBC in urinary sediment and urinary protein.sediment RBC, the symptomation and the sign scores of Traditional Chinese Medicine were compared before treatment and after treatment. Occult glomerulonephritis with proteinuria can be treated with Tripterygium wilfordii..
Results: 1)RBC in urinary sediment after treatment than before treatment a significant decrease in the total effective rate 83.33%, and in the treatment of the fourth weeks when there is significant difference in efficacy (P <0.01), the treatment in 4,8,10,12 weeks is a clear downward trend than before treamnent, sediment RBC of 12 weeks is minimize; 2) In whether the use of TW contrast, the two groups at different times to reduce the role of sediment RBC has obvious statistical significance (P <0.01), between the two methods, different times to reduce the role of sediment RBC free significant difference, the difference was not significant (P> 0.05); 3)The effection by using niaoxuening formula is best in Qi-Yin deficiency syndrome,follow in lung and kindey Qi deficiency and liver and kidney Yin deficiency syndrome, and worst in spleen and kidney Qi deficiency syndrome; and evidence of better efficacy of damp-heat syndrome, and bleed syndrome of persons bad effect; 4)Niaoxuening formula could improve significantly in clinical symptoms, and syndrome points total effective rate was 66.67%; the comparison before and after treatment, the languid lazy and shortness of breath and five feverish centres, the difference was statistically significant. the comparison before and after treatment of throat Sore Pain was not statistically significant (P > 0.05)
Conclusion: The long-term treatment of occult glomerulonephritis in patients with hematuria by using niaoxuening formula can reduce sediment RBC, and the condition become stabilized. Occult glomerulonephritis with hematuria plus proteinuria TW help improve the clinical efficacy. the niaoxuening Formula evidence on the efficacy of Qi-Yin Deficiency Syndromes better than the other. And evidence, the efficacy Of damp-heat syndrome is superior to bleed syndrome Syndrome . At the same time, can be different degrees of improvement of Chinese medicine syndromes , the languid lazy and shortness of breath and five feverish improvement are particularly .
引文
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