【作者】 李媛；

【导师】 马居里；

【作者基本信息】 陕西中医学院 ， 中医内科学（专业学位）， 2013， 硕士

【摘要】 目的：本课题通过观察扶正泄浊保肾汤对慢性肾衰竭(慢性肾脏病2-4期)患者的临床症状积分、主要症状改善以及肾功能检测中肌酐（CREA）、尿素氮（BUN）、胱抑素C（Cys-C）指标的影响，证实其对慢性肾衰竭的疗效，为临床治疗提供数据依据从而用于指导临床。方法：按照纳入标准及排除标准选取慢性肾衰竭(慢性肾脏病2-4期)患者50例，采用随机、对照的方法，分为对照组20例，治疗组30例。对照组采用常规西医治疗，治疗组在常规西医治疗的基础上给予扶正泄浊保肾汤口服治疗。两组均观察时间8周，随访时间为12周。通过收集并对比分析每位患者治疗前、治疗第4周与治疗第8周时的临床症状积分、主要症状改善情况以及实验室检测肾功能中血清肌酐、尿素氮、胱抑素C指标，并采用SPSS19.0统计软件对数据结果进行统计分析，进行治疗前、中、后以及与对照组进行对照，观察扶正泄浊保肾汤对慢性肾衰竭患者临床症状的改善以及生化指标的变化情况。结果：通过对比分析，两组治疗后第4周、第8周分别与治疗前比较，临床症状积分以及血清肌酐、尿素氮、胱抑素C下降，具有统计学意义（P﹤0.05）；治疗第8周时，两组主要症状改善均有意义（P﹤0.05），治疗组较对照组无显著差异（P﹥0.05），但治疗组改善较对照组明显；在症状积分以及肾功能指标下降方面，两组差异均具有统计学意义（P﹤0.05），治疗组优于对照组；随访第12周时，治疗组与对照组比较，差异具有统计学意义（P﹤0.05）。观察发现，治疗组治疗第4周时，总有效率为73.3%；治疗第8周时，总有效率达到80%；对照组治疗第4周时，总有效率为65%；治疗第8周时，总有效率达到55%；两组治疗第4周、第8周时，总有效率比较有统计学意义（P﹤0.05）。研究证实常规西药联合扶正泄浊保肾汤治疗慢性肾衰竭疗效优于单纯运用常规西药治疗该病。结论：扶正泄浊保肾汤可明显改善慢性肾衰竭患者临床症状并且可显著降低患者血清肌酐、尿素氮、胱抑素C水平，进而可能起到延缓肾衰竭进展的作用。更多还原

【Abstract】 Objective: This topic through the observation of Fuzheng Xiezhuo BaoshenDecoction on the patients with chronic renal failure（2-4of chronic kidneydisease） improves the clinical symptoms、the main symptoms and renal functiontest (CREA), urea nitrogen (BUN), Cystatin C (Cys-C) the influence of the index,and confirms its efficacy on chronic renal failure to provide a data basisand a Clinical guidance.Method: According to the inclusion criteria and exclusion criteria,We chosedchronic renal failure（2-4of chronic kidney disease）in50cases ofhemodialysis patients whose were treated with Fuzheng Xiezhuo Baoshendecoction. Then we observed for8weeks and followed up for12weeks with thesepatients. Collecting and analyzing with each patient before treatment, fourthweeks and eighth weeks of treatment the clinical symptoms、the main symptomsand the laboratory detection of serum renal creatinine, urea nitrogen, serumcystatin C index, and using SPSS19.0statistical software for statisticalcomparison and analysis of data results in order to observe Fuzheng xiezhuoBaoshen Decoction on the improvement of clinical symptoms in patients withchronic renal failure and biochemical indexes.Results: By contrast, the treatment group,30patients with chronic renalfailure patients using conventional Western medicine combined Fuzheng XiezhuoBaoshen decoction for four weeks, eight weeks when compared with the controlgroup, the clinical symptom score and serum creatinine, blood urea nitrogen,cystatin C significantly decreased, with a significant (P <0.05),8weeks oftreatment, the two main symptoms improve both significant (P <0.05), thetreatment group than in the control group, no significant difference (P>0.05),but the improvement in the treatment group than the control group; symptom score as well as indicators of renal functiondecline, the difference betweenthe two groups was statistically significant (P <0.05), the treatment groupthan the control group.Follow-up of12weeks, patients serum creatinine, bloodurea nitrogen, cystatin C levels decreased compared with the control groupdifference (P <0.05); treatment group compared with control group, thedifference was statistically significant (P <0.05). Observed that thetreatment group four weeks, the total effective rate was73.3%;8weeks oftreatment, the total efficiency of80%; treatment week4of the control group,the total effective rate was65%;8th week, the total efficiency of55%. Thestudy confirmed the conventional western joint Fuzheng Xiezhuo Baoshendecoction the treatment of chronic renal failure effective than the use ofconventional Western medicine treatment of the disease.Conclusion: Fuzheng Xiezhuo Baoshen Decoction can obviously improve theclinical symptoms of patients with chronic renal failure and may significantlyreduce the serum creatinine, blood urea nitrogen, serum cystatin-C level inpatients with renal failure, maybe it will delay the progress of renal failure.更多还原