益肾化浊、通利解毒法治疗慢性肾功能衰竭的临床探究.pdfVIP

提 要 目的:以益肾化浊、通利解毒法为基本治法组方，通过治疗慢性肾功能衰竭的临 床研究，观察其疗效和安全性，以期为慢性肾衰竭提供一种有效的中医治疗方法并探 讨其作用机理，为临床提供一定的理论依据。方法:将慢性肾功能衰竭 60 例随机分为 治疗组和对照组，各 30 例。治疗组(益气泄浊解毒方)和对照组(尿毒清)，疗程为 8 周。两组均在西医常规治疗的基础上进行。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)、血浆白蛋白(Alb)、甘油三酯(TG) 胆固醇(CHOL)、低密度脂蛋白(LDL-C)、血流变的变化，作出疗效评价。结果:治疗 组总有效率为86.67%，明显优于对照组(P0.05)；治疗组在改善中医症状积分方面， 优于对照组(P0.05)；治疗组 BUN 、Scr 水平明显降低，Ccr 明显升高，优于对照组 (P0.05) ；治疗组Hb 、Alb 明显提高，优于对照组(P0.05)；治疗组高脂血、血流变 明显改善，优于对照组(P0.05)。治疗过程中未发现明显不良反应。结论:益肾化浊、 通利解毒法可以有效改善患者的临床症状、改善肾功能、缓解肾性贫血及低蛋白血症、 改善高脂血、血流变情况。其作用机理可能与改善肾脏血流动力学、改善高脂血症、 调节机体免疫力、抑制系膜细胞增殖及细胞外基质的蓄积等因素有关，从而起到延缓 肾小球硬化、抑制肾间质纤维化、保护肾功能的作用。 关键词 慢性肾功能衰竭；益肾化浊、通利解毒法；临床研究 Clinical Study on Treating Chronic Renal Failure with Yishenhuazhuo Tonglijiedu Methods Specialty：Internal Medicine of TCM Author ：Sun Peng Tutor：Professor Jiao An-qin Abstract Objective：Constructing decoction according to the fundamental therapeutic methods of Yishenhuazhuo Tonglijiedu,through the clinical research on treating chronic renal failure, to observe its curative effect and safety ,so as to provide an effective TCM treatment methods.Meanwhile,exploring the mechanism to provide some theoretical basis for clinical work . Methods: 60 paitients suffering CRF are divided into treatment group （Yiqixiezhuojiedu Decoction ）and control one （Niaoduqing ）at random . Each group has 30 patients,which are regularly treated by the same methods of modern medicime.The time for treatment is 8 weeks. By observing the changes of symptom scores,blood urea nitrogen (BUN), serum creatinine (Scr), endogenous creatinine clearance rate(Ccr), hemoglobin (Hb), plasma albumin (Alb), triglycerides (TG) cholesterol (CHOL), low-density lipoprotein (LDL- C),and hemorrheology, we make the assessm