中药热熨治疗慢性肾脏病3~4期夜尿增多症临床观察  

Clinical Observation of Chinese Medication Hot Compress for Nocturia in Chronic Kidney Disease Stages 3-4

作　　者：徐小燕 周春亭 方玲莉 刘琼 XU Xiao-yan;ZHOU Chun-ting;WAN Ling-li;LIU Qiong(Jinhua Hospital of Traditional Chinese Medicine,Jinhua 321017,China)

机构地区：[1]金华市中医医院,金华321017

出　　处：《上海针灸杂志》2020年第6期706-710,共5页Shanghai Journal of Acupuncture and Moxibustion

基　　金：金华市中医药科研项目(2019jzk018)。

摘　　要：目的观察中药热熨治疗对慢性肾脏病(chronic kidney disease, CKD)3~4期脾肾阳虚型夜尿增多症的影响。方法将70例CKD3~4期脾肾阳虚型夜尿增多症患者随机分为对照组和治疗组,每组35例,对照组实施常规西医基础治疗加口服缩泉丸合金匮肾气丸汤剂加减;治疗组在对照组基础上采用自制中药热熨包在双侧肾俞、命门、腰阳关、八髎穴位上热熨治疗。比较两组治疗前后夜间尿量、夜间排尿次数、夜间尿量/白天尿量比值、尿渗透压、尿比重;治疗前后肾功能相关指标(血肌酐、尿素氮、肾小球滤过率)的变化;使用匹兹堡睡眠量表评价治疗前后睡眠质量情况。结果治疗组治疗后夜间尿量、夜间排尿次数、夜间尿量/白天尿量比值、尿渗透压、夜间睡眠评分和睡眠时长明显优于对照组(P<0.05);治疗组治疗后血肌酐、尿素氮、肾小球滤过率优于对照组(P<0.05)。结论在常规药物治疗基础上,中药热熨治疗对CKD3~4期脾肾阳虚型夜尿增多症患者有明显改善作用。Objective To observe the effects of Chinese medication hot compress in treating nocturia due to spleen-kidney yang deficiency in chronic kidney disease(CKD)stages 3-4.Method Seventy patients with nocturia due to spleen-kidney yang deficiency CKD stages 3-4 were randomized into a control group and a treatment group,with 35 cases in each group.The control group was intervened by routine Western medicine treatment plus oral administration of modified decoction of Suo Quan Wan combined with Jin Gui Shen Qi Wan;in addition to the intervention given to the control group,the treatment group was given self-made Chinese medication hot compress at bilateral Shenshu(BL23),Mingmen(GV4),Yaoyangguan(GV3)and Baliao points.Before and after treatment,the nocturnal urine volume,the number of nocturnal urination times,the ratio of nocturnal urine volume to daytime urine volume,urine osmotic pressure and urine specific gravity of the two groups were compared,as well as the changes in the indexes related to kidney function(serum creatinine,blood urea nitrogen and glomerular filtration rate);the sleep quality was evaluated by Pittsburgh Sleep Quality Index(PSQI)before and after treatment.Result After treatment,the nocturnal urine volume,the number of nocturnal urination times,the ratio of nocturnal urine volume to daytime urine volume,urine osmotic pressure,nocturnal sleep score and sleep duration were significantly better in the treatment group than in the control group(P<0.05);after treatment,the treatment group was superior to the control group comparing the serum creatinine,blood urea nitrogen and glomerular filtration rate(P<0.05).Conclusion Chinese medication hot compress can significantly improve nocturia due to spleen-kidney yang deficiency in chronic kidney disease(CKD)stages 3-4.

关 键 词：肾脏病 热敷 穴位贴敷法 中药热熨 多尿症 脾肾阳虚 肾功能试验 

分 类 号：R246.1[医药卫生—针灸推拿学]