中医肾脏病临床研究的几个关键问题
|
摘要
中医肾脏病的临床研究长期以来争议较多,关键在于临床研究方向不甚明确。基于长期的中医肾脏病临床研究实践,我们主张将肾脏病分成复合证型,有利于研究的设计与统计分析,可提高临床研究的实际操作性;治法方面,温阳药的应用、祛风湿法与清热解毒利湿法的鉴别,扶正法的地位,治则的组合及其应用时点等值得进一步研究。相关中药的研究是较为常见的切入点,临床疗效评价体系尚有待进一步健全。总之,中医临床研究要从临床需求出发,以问题为导向设计方案,有体系、有步骤的实施,才能提高研究的水平。
Clinical research of traditional Chinese medicine(TCM) kidney disease is controversial for a long time due tothe unclear clinical research direction. Based on the long-term TCM clinical practice of kidney disease, we proposed thatthe kidney disease should be simply divided into a composite type, which was easier for the research design andstatistical analysis. It also improved the actual practical ability in the clinical research. In the treatment aspect, furtherresearch should be conducted on the application of warm medicine, method of eliminating wind-dampness, method ofclearing heat, detoxify and removing dampness, the role of strengthening the body resistance, as well as the combinationof therapeutic principle and its application time. Related Chinese herbal medicine research is a common breakthroughpoint. The clinical efficacy evaluation system should be further improved. In a word, TCM clinical research should befrom the clinical demand and followed by problem-oriented design. The implementation should be systematic and step bystep in order to improve the research level.
Clinical research of traditional Chinese medicine(TCM) kidney disease is controversial for a long time due tothe unclear clinical research direction. Based on the long-term TCM clinical practice of kidney disease, we proposed thatthe kidney disease should be simply divided into a composite type, which was easier for the research design andstatistical analysis. It also improved the actual practical ability in the clinical research. In the treatment aspect, furtherresearch should be conducted on the application of warm medicine, method of eliminating wind-dampness, method ofclearing heat, detoxify and removing dampness, the role of strengthening the body resistance, as well as the combinationof therapeutic principle and its application time. Related Chinese herbal medicine research is a common breakthroughpoint. The clinical efficacy evaluation system should be further improved. In a word, TCM clinical research should befrom the clinical demand and followed by problem-oriented design. The implementation should be systematic and step bystep in order to improve the research level.
引文
1段其波,胡德胜,于杰,郭伟星.对中医临床研究现状及存在问题的思考.中医药学刊,2006,12(24):2281-2283.
2 李楠,马晓燕.慢性肾小球肾炎中医证型规律探讨.辽宁中医药大学学报,2011,:13(10):155-156.
3 陈继红,孙伟,魏连波,等.慢性肾脏病3期中医临床证型规律探讨.世界科学技术—中医药现代化,2012,14(5):1988-1991.
4 王跃娟,孙伟.慢性肾功能衰竭中医辨证分型研究进展.实用中医内科杂志,2007,21(7):10-12.
5 赵静,孙伟.孙伟治疗慢性肾脏病经验.中国中医药信息杂志,2009,16(1):87-88.
6 周海姗,彭文,王云满.慢性肾脏病的中医药诊疗进展.实用中医内科杂志,2012,26(4):6-11.
7 武淑梅,刘金辉,刘兰英.慢性肾衰中医治疗思路.临床合理用药,2015,8(9):141-142.
8 陈凯,姜春燕.中药减轻糖皮质激素副作用的研究.中华中医药杂志,2005,20(10):636-636.
9 许正锦,邱明山,郭宇英,许玉民.慢性肾脏病中医病因病机探讨.辽宁中医药大学学报,2011(10):137-139.
10 李佃贵,朱峰,刘建平等.浊毒论治探讨.山西中医,2008,24(11):1-3.
11 李兰波.浅谈慢性肾衰的治疗及饮食调摄.中国中医药现代远程教育,2011,9(18):108-109.
12 邓跃毅,杨洪涛,孙伟,何立群等,慢性肾脏病主要证型的中医辨证与治疗.中华肾病研究电子杂志,2013(5):9-12.
13 昊霞,林兵,王忠震,刘志宏,宋洪涛.雷公藤的免疫抑制活性及毒性的谱效关系研究.中国医院药学杂志,2016,36(7):547-552.
14 周静,陈钦开,徐建华,罗来敏.青风藤制剂治疗肾小球疾病的临床观察.中国中西医结合肾病杂志,2003,4(3):160-161.
15 李俊,胡家才.大黄对尿酸性肾病大鼠肾脏CTGF和HGF的影响.中国中西医结合肾病杂志,2010,11(9):761-764.
16 闵亚丽,于黔,肖俊.冬虫夏草在肾间质纤维化大鼠模型中的作用及其对TGF-β1、α-SMA的影响.中国中西医结合肾病杂志,2007,8(2):92-93.
17 顾左宁.雷公藤多苷片治疗肾性蛋白尿机制及案例分析.中国中西医结合肾病杂志,2008,9(8):744-745.
18 陈明人,甘淳.中医临床研究疗效评价的影响因素及其可信度问题思考.实用中西医结合临床,2002,2(6):57-57.
19 齐振强,任鲁颖,冯国庆,王祥生.慢性肾功能衰竭中医临床研究进展.中华中医药学刊,2016,34(8):2006-2009.
20 孙伟,高坤,周栋.中医药治疗慢性肾脏疾病的临床疗效评价研究.第十九次全国中医肾病学术交流会论文汇编,2006年.
21 黄访英.分阶段应用中药减轻激素治疗肾病综合征副作用的临证体会.中国中西医结合肾病杂志,2004,5(3):174-174.
22 周慧敏,倪兆慧.生物学标志物在慢性肾脏病中的研究进展.中国中西医结合肾病杂志,2009,10(2):175-177.
23 袁明生.肾功能指标对慢性肾脏病的诊断价值研究.中国实验诊断学,2015(3):451-453.
2 李楠,马晓燕.慢性肾小球肾炎中医证型规律探讨.辽宁中医药大学学报,2011,:13(10):155-156.
3 陈继红,孙伟,魏连波,等.慢性肾脏病3期中医临床证型规律探讨.世界科学技术—中医药现代化,2012,14(5):1988-1991.
4 王跃娟,孙伟.慢性肾功能衰竭中医辨证分型研究进展.实用中医内科杂志,2007,21(7):10-12.
5 赵静,孙伟.孙伟治疗慢性肾脏病经验.中国中医药信息杂志,2009,16(1):87-88.
6 周海姗,彭文,王云满.慢性肾脏病的中医药诊疗进展.实用中医内科杂志,2012,26(4):6-11.
7 武淑梅,刘金辉,刘兰英.慢性肾衰中医治疗思路.临床合理用药,2015,8(9):141-142.
8 陈凯,姜春燕.中药减轻糖皮质激素副作用的研究.中华中医药杂志,2005,20(10):636-636.
9 许正锦,邱明山,郭宇英,许玉民.慢性肾脏病中医病因病机探讨.辽宁中医药大学学报,2011(10):137-139.
10 李佃贵,朱峰,刘建平等.浊毒论治探讨.山西中医,2008,24(11):1-3.
11 李兰波.浅谈慢性肾衰的治疗及饮食调摄.中国中医药现代远程教育,2011,9(18):108-109.
12 邓跃毅,杨洪涛,孙伟,何立群等,慢性肾脏病主要证型的中医辨证与治疗.中华肾病研究电子杂志,2013(5):9-12.
13 昊霞,林兵,王忠震,刘志宏,宋洪涛.雷公藤的免疫抑制活性及毒性的谱效关系研究.中国医院药学杂志,2016,36(7):547-552.
14 周静,陈钦开,徐建华,罗来敏.青风藤制剂治疗肾小球疾病的临床观察.中国中西医结合肾病杂志,2003,4(3):160-161.
15 李俊,胡家才.大黄对尿酸性肾病大鼠肾脏CTGF和HGF的影响.中国中西医结合肾病杂志,2010,11(9):761-764.
16 闵亚丽,于黔,肖俊.冬虫夏草在肾间质纤维化大鼠模型中的作用及其对TGF-β1、α-SMA的影响.中国中西医结合肾病杂志,2007,8(2):92-93.
17 顾左宁.雷公藤多苷片治疗肾性蛋白尿机制及案例分析.中国中西医结合肾病杂志,2008,9(8):744-745.
18 陈明人,甘淳.中医临床研究疗效评价的影响因素及其可信度问题思考.实用中西医结合临床,2002,2(6):57-57.
19 齐振强,任鲁颖,冯国庆,王祥生.慢性肾功能衰竭中医临床研究进展.中华中医药学刊,2016,34(8):2006-2009.
20 孙伟,高坤,周栋.中医药治疗慢性肾脏疾病的临床疗效评价研究.第十九次全国中医肾病学术交流会论文汇编,2006年.
21 黄访英.分阶段应用中药减轻激素治疗肾病综合征副作用的临证体会.中国中西医结合肾病杂志,2004,5(3):174-174.
22 周慧敏,倪兆慧.生物学标志物在慢性肾脏病中的研究进展.中国中西医结合肾病杂志,2009,10(2):175-177.
23 袁明生.肾功能指标对慢性肾脏病的诊断价值研究.中国实验诊断学,2015(3):451-453.