补肾活血法干预长期维持性血液透析肾性骨病患者中医证候的研究  

Therapy of tonifying kidney and activating blood circulation for intervening TCM syndromes in patients with renal bone disease having long-term maintenance hemodialysis

作　　者：刘世巍[1] 张宁[1] 李同侠[1] 任可[2] 李建民 姜春生[1] 罗燕楠[1] 

机构地区：[1]中国中医科学院望京医院肾内科,北京100102 [2]北京中医药大学东方医院 [3]北京中西医结合医院

出　　处：《北京中医药大学学报》2012年第11期786-790,共5页Journal of Beijing University of Traditional Chinese Medicine

基　　金：首都医学发展科研基金联合攻关项目(No.2005-SF-I-016)

摘　　要：目的分析长期维持性血液透析肾性骨病(RBD)患者的证候特点,观察补肾活血法对其中医证候的改善作用。方法采用量表对165例RBD患者中医症状进行横断面调查,对症状变量进行因子分析,得出RBD类证候群,采用区组随机法将患者分为中药组(84例)和对照组(81例),2组均给予常规综合治疗,中药组在此基础上加服补肾活血颗粒剂。疗程和追访期各3个月。结果分析症状变量后归纳出5个证候因子:肝肾阴虚证,浊毒内蕴证,肾阳虚衰证,水湿内停证,瘀血阻络证。与对照组比较,追访结束时中药组各证候评分均低于对照组,其中肝肾阴虚证(P<0.05)、水湿内停证(P<0.01)2组有显著性差异。综合时间与干预因素影响后分析,浊毒内蕴证(P<0.05)、肝肾阴虚证(P<0.01)、肾阳虚衰证(P<0.01)2组有显著性差异。结论肾性骨病患者主要证候表现为肝肾阴虚、浊毒内蕴、肾阳虚衰、水湿内停、瘀血阻络5个基本证型,补肾活血法能够有效改善上述证候。Objective To analysis the syndrome characteristics in patients with renal bone disease （RBD） having long-term maintenance hemodialysis （MHD）, and observe the curative effect of therapy of tonifying kidney and activating blood circulation. Methods A cross-section survey on TCM syndromes was carried out in 165 RBD patients by using scale. The symptom variables were given factor analysis for obtaining RBD syndrome groups. All patients were divided into Chinese medicinal group （CM group, n = 84） and control group （n = 81 ） by using random block method. The two groups were treated with routine comprehensive therapy and CM group was additionally given Bushen Huoxue Granules. ＇File therapeutic course and follow-up period were, respectively, three months. Results There were 5 syndrome factors concluded after analyzing symptom variables, including liver-kidney yin deficiency, turbid toxin accumulating in the interior, kidney yang deficiency, water-dampness stopping in the interior and static blood obstructing the collaterals. When followup was finished, the scores of all syndromes were lower in CM group than those in control group, and there were significant differences in syndrome of liver-kidney yin deficiency （P 〈0.05） and syndrome of water-dampness stopping in the interior （P 〈0.01 ）. The analysis considering time and intervening factors showed that there were significant differences in syndrome of turbid toxin accumulating in the interior （ P 〈 0. 05 ）, syndrome of liver-kidney yin deficiency （P 〈 0.01 ） and syndrome of kidney yang deficiency （P 〈 0.01 ）. Conclusion The major syndromes are summed up as liver-kidney yin deficiency, turbid toxin accumulating in the interior, kidney yang deficiency, water-dampness stopping in the interior and static blood obstructing the collaterals in the patients with RBD, and the therapy of tonifying kidney and activating blood circulation can effectively relieve the above mentioned syndromes.

关 键 词：肾性骨病 肾性骨营养不良 证候 因子分析 骨代谢 

分 类 号：R265.92[医药卫生—中医外科学]