维持性血液透析下尿毒症性心肌病患者的中医证候学分析及应用心保颗粒的疗效  

Analysis on TCM syndromes in the patients with uremic cardiomyopathy under maintenance hemodialysis and the efficacy of Xinbao granules

作　　者：倪约翰 马伟明[2] 谷红苹 康年松 NI Yuehan;MA Weimin;GU Hongpin;KANG Nianson(Department of Internal Medicine,Yuyao Hospital of TCM in Zhejiang Province,Yuyao 315400,China;Department of TCM,Yuyao People＇s Hospital in Zhejiang Province,Yuyao 315400,China)

机构地区：[1]浙江省余姚市中医医院内科,浙江余姚315400 [2]浙江省余姚市人民医院中医科,浙江余姚315400

出　　处：《中国现代医生》2018年第22期111-114,共4页China Modern Doctor

基　　金：浙江省中医药科技计划(2018ZA120)

摘　　要：目的探讨维持性血液透析的尿毒症性心肌病患者中医证型,观察心保颗粒对本病患者慢性肾功能衰竭症状的改善情况。方法纳入余姚地区3个血液净化中心的维持性血液透析尿毒症性心肌病患者共90例(各30例),对患者进行中医辨证分型分析。根据血液净化时间长短将患者分为0~104周、105~208周及209~312周三组。根据慢性肾衰竭症状分级量化表进行症状积分分析。将90例患者采用随机单盲单模拟方法分为治疗组及对照组(各45例),治疗组在常规治疗基础上予心保颗粒,对照组予模拟剂,治疗周期为12周,12周后比较两组慢性肾衰竭症状积分情况。结果尿毒症性心肌病正虚型以脾肾阳虚型为主(占86.67%);邪实证以血瘀证为主(占85.56%);脾肾阳虚型兼血瘀证占总数的80.00%。0~104周、105~208周及209~312周组慢性肾功能衰竭症状积分比较有统计学差异(P<0.001)。治疗12周后治疗组与对照组的慢性肾功能衰竭症状积分比较,差异有统计学意义(P<0.001)。结论维持性血液透析的尿毒症性心肌病患者的中医证型均表现为虚实夹杂型,其中脾肾阳虚型兼血瘀证最为多见。尿毒症性心肌病患者的血液净化时间越长,慢性肾功能衰竭症状积分越高。心保颗粒能改善维持性血液透析的尿毒症性心肌病患者的慢性肾功能衰竭症状,提高患者的生活质量。Objective To investigate the TCM syndromes of the patients with uremic cardiomyopathy under maintenance hemodialysis and to observe the improvement effect of Xinbao Granules on the symptoms of chronic renal failure in the patients.Methods A total of 90 patients（30 in each center）.with uremic cardiomyopathy under maintenance hemodialysis at three blood purification centers in Yuyao area were enrolled.TCM syndrome differentiation was analyzed for patients.According to the length of blood purification,the patients were divided into three groups,namely 0-104 weeks,105-208 weeks and 209-312 weeks,According to the grading and classification table of chronic kidney failure symptoms,the symptom scores were analyzed.90 patients were divided into treatment group and control group（45 cases in each group）by random single-blinded single-simulation method.The treatment group was given Xinbao granules on the basis of routine treatment.The control group was given simulant.The treatment cycle was 12 weeks.After12 weeks,symptom scores of chronic renal failure were compared between the two groups.Results The main type of weakened body resistance in uremic cardiomyopathy was spleen and kidney yang-deficiency（86.67%）;the main type of pathogenic excess was blood stasis（85.56%）;the yang deficiency of spleen and kidney complicated with blood stasis accounted for 80.00% of the total.The differences of symptom scores of chronic renal failure were statistically significant at 0-104 weeks,105-208 weeks and 209-312 weeks（P〈0.001）.After 12 weeks of treatment,there were statistically significant differences in symptom scores of chronic renal failure between the treatment group and the control group（P〈0.001）.Conclusion TCM syndromes of the patients with uremic cardiomyopathy under maintenance hemodialysis are manifested as intermingled deficiency and excess,and the yang deficiency of spleen and kidney complicated with blood stasis is the most common.The longer the length of blood purification in the patients with ure

关 键 词：维持性血液透析 尿毒症性心肌病 心保颗粒 慢性肾衰竭症状分级量化表 

分 类 号：R277.5[医药卫生—中医学]