肾经、膀胱经开合时间与中医治疗肾病综合征疗效的相关性研究  

Effect of TCM treatment on nephrotic syndrome at the time of opening-closing of Shaoyin kidney and Taiyang bladder meridian

作　　者：罗永兵[1] 邓淑霞[2] 沈宏春[1] 

机构地区：[1]泸州医学院中西医结合学院,四川泸州646000 [2]泸州医学院附属中医医院泌尿外科,四川泸州646000

出　　处：《泸州医学院学报》2015年第1期48-52,共5页Journal of Luzhou Medical College

基　　金：四川省科技厅项目(2014SZ0180)

摘　　要：目的:探究观察肾经、膀胱经开合时间与中医治疗肾病综合征疗效的关系,为中医药物治疗肾病综合征选择最优的用药时间提供理论基础。方法:选择原发性肾病综合征患者90例,随机分为观察组和对照组,每组各45例。两组均给予西医常规治疗,对照组加用真武汤合五苓散汤剂,分早晚餐前口服;观察组加用真武汤合五苓散汤剂,下午3点顿服,疗程为3周。随访1月,观察两组治疗前后治疗有效率,临床症状评分,SCr、ALB、24 h尿蛋白定量、血脂等生化指标。结果 :观察组总有效率(91.1%)高于对照组(86.7%),差异无统计学意义(P=0.502);观察组和对照组治疗后血肌酐、总胆固醇、甘油三酯和24 h尿蛋白定量均明显下降,血清白蛋白明显上升,差异具有统计学意义(P<0.001);但观察组血肌酐、总胆固醇、甘油三酯和24 h尿蛋白定量治疗后降低值明显高于对照组,血清白蛋白升高值明显高于对照组,且具有统计学差异(P<0.001)。观察组全身水肿消退时间(8.7±2.4)d小于对照组(10.3±2.8)d,差异具有统计学意义(P<0.01);观察组和对照组治疗后临床症状评分均有明显降低,差异具有统计学意义(P<0.05)。观察组治疗前后的临床症状评分降低值明显高于对照组,且差异具有统计学意义(P<0.001)。结论:肾、膀胱经开时(下午3点)服用真武汤合五苓散汤剂治疗肾病综合征疗效优于传统服药时间,肾、膀胱经开时时间是真武汤合五苓散合剂治疗肾病综合征疗效最佳时间。Objective： To investigate the effect of TCM treatment on nephrotic syndrome at the time of opening-closing of Shaoyin kidney and Taiyang bladder meridian, and to provide theoretical basis for optimal medication timing for TCM treatment against nephrotic syndrome. Methods： 90 patients with primary nephrotic syndrome were randomly divided into observation group（Group A） and control group（Group B）, with 45 cases in each group. Two groups were given conventional western medicine treatment. The group B additionally took Zhenwu decoction and Wuling powder before breakfast and dinner each day for three weeks, and the group A additionally took Zhenwu decoction and Wuling powder at 15 o＇clock each day for three weeks. With one month follow-up, treatment efficacy, clinical symptom scores, SCr, ALB, 24 h urine protein, blood lipids and other quantitative biochemical indicators of the two groups were observed before and after of the treatment. Results：The treatment efficacy rate of group A（91.1%） is higher than that of control group B（86.7%）,（P = 0.502）. After treatment, serum creatinine, total cholesterol, triglycerides, and 24 h urine protein of the two groups were significantly decreased, and quantitative serum albumin was significantly increased（P〈0.001）; both the two changes were more significant in group A than in group B（P〈0.001）. Anasarca fade time of the group A was shorter than that of the group B（P〈0.01）. The clinical symptom scores of the two groups decreased significantly after treatment（P〈0.05） and the decrease value of group A was significantly higher than that of group B（P〈0.001）. Conclusion： The time when the Shaoyin kidney and Taiyang bladder meridian are open（3 pm）, is the optimal medication timing for TCM treatment of nephrotic syndrome.

关 键 词：肾病综合征 经络开合 真武汤 五苓散 疗效评价 

分 类 号：R256.5[医药卫生—中医内科学]