基于疾病归经理论的一半汤治疗慢性肾炎蛋白尿的临床观察  

Clinical observation of Yiban Decoction in treating chronic nephritis proteinuria based on disease channel tropism theory

作　　者：潘静[1] 范高俊[1] PAN Jing;FAN Gao-jun(Department of Traditional Chinese Medicine,Wuhan Hospital of Traditional Chinese and Western Medicine,Wuhan 430022,China)

机构地区：[1]武汉市中西医结合医院中医部,武汉430022

出　　处：《中华中医药杂志》2020年第3期1567-1570,共4页China Journal of Traditional Chinese Medicine and Pharmacy

基　　金：武汉市临床医学科研项目(No.WZ14A04)。

摘　　要：目的:观察一半汤治疗慢性肾炎蛋白尿的临床疗效。方法:纳入符合慢性肾炎蛋白尿诊断标准的患者136例,随机入组,其中治疗1组(一半汤组)48例,治疗2组(二半汤组)45例,对照组(肾炎康复片组)43例,均相应治疗12周,进行疗效判定,观察并记录中医证候积分、尿蛋白、血常规等相关指标,进行统计学分析。结果:治疗后,3组在疾病疗效、中医证候疗效、尿红细胞计数、尿素氮、血肌酐方面差异无统计学意义;中医证候积分方面,治疗1组在改善口干咽燥、咽喉肿痛、疲倦乏力、五心烦热、浮肿、小便灼热或黄赤症状较对照组有显著改善(P<0.05),口干咽燥、咽喉肿痛、疲倦乏力症状较治疗2组有显著改善(P<0.05);治疗1组尿蛋白定性积分、24h尿蛋白定量、尿蛋白肌酐比值与对照组比较有显著降低(P<0.05),尿蛋白肌酐比值与治疗2组比较亦有显著降低(P<0.05);治疗1组血浆白蛋白与对照组、治疗2组比较均有显著升高(P<0.05)。结论:一半汤、二半汤、肾炎康复片均能显著改善慢性肾炎相关症状,控制蛋白尿,保护肾功能,且一半汤较二半汤能更显著地改善慢性肾炎的部分症状。Objective:To observe the clinical efficacy of Yiban Decoction in treating chronic nephritis proteinuria.Methods:A total of patients with proteinuria of chronic nephritis were collected.They were randomly divided into treatment group 1(Yiban Decoction group)48 cases,treatment group 2(Erban Decoction group)45 cases and control group(Shenyan Kangfu Tablet group)43 cases.After 12 weeks of treatment,the relevant indicators were observed and recorded for statistical analysis.Results:There were no significant differences in disease efficacy,TCM syndromes efficacy,urinary red blood cell count,urea nitrogen and serum creatinine between treatment group 1,treatment group 2 and control group.In the aspect of TCM symptom score,the improvement of symptoms such as dry mouth and throat,sore throat,dysphoria with feverish sensation in chest,edema,burning urine or yellowish-red in treatment group 1 was more significant than that in the control group(P<0.05).There were significant differences in improving symptoms of dry mouth and throat,sore throat,fatigue and lack of strength compared with group 2.Qualitative score of urinary protein,24h urinary protein quantification and ratio of urinary protein to creatinine in treatment group 1 were significantly different from those in control group(P<0.05),the ratio of urinary protein to creatinine in treatment group 1 was significantly different from that in treatment group 2(P<0.05).There were significant differences in plasma albumin between treatment group 1 and control group and treatment group 2(P<0.05).Conclusion:Yiban Decoction,Erban Decoction and Shenyan Kangfu Tablets can significantly improve the symptoms related to chronic nephritis,control proteinuria and protect renal function,and Yiban Decoction can significantly improve some symptoms of chronic nephritis compared with Erban Decoction.

关 键 词：管竞环 疾病归经理论 一半汤 慢性肾炎蛋白尿 临床疗效 

分 类 号：R277.5[医药卫生—中医学]