小柴胡汤合五苓散联合西药治疗维持性血液透析临床研究  

Clinical Study on Xiaochaihu Tang and Wuling Powder Combined with Western Medicine for Maintenance Hemodialysis

作　　者：马金强 曹汉华 MA Jinqiang;CAO Hanhua

机构地区：[1]衢州市柯城区人民医院肾内科,浙江衢州324000

出　　处：《新中医》2021年第21期23-27,共5页New Chinese Medicine

摘　　要：目的:观察小柴胡汤合五苓散联合西药治疗维持性血液透析的临床疗效。方法:选取82例维持性血液透析患者为研究对象,按随机数字表法分为对照组及观察组各41例,对照组进行维持性血液透析治疗,口服西药;观察组在对照组基础上加服小柴胡汤合五苓散,2组均接受8周治疗。观察2组临床疗效,比较2组治疗前后血凝指标[同型半胱氨酸(Hcy)、D-二聚体(D-D)、纤维蛋白原(FIB)、超敏C-反应蛋白(hs-CRP)]、中医证候积分、肾功能指标[尿素氮(BUN)、血肌酐(SCr)、24 h尿量、肾小球滤过率(e GFR)、残余肾肌酐清除率(RRF)],观察2组治疗期间并发症发生情况。结果:治疗后,2组FIB、D-D、Hcy、hs-CRP指标值均较治疗前下降,观察组上述4项指标值均小于对照组,差异均有统计学意义(P<0.05)。治疗后,2组面色晦暗、肢体瘀点瘀斑、肌肤甲错、肢体麻木、局部感觉异常积分均较治疗前下降,观察组上述5项积分均低于对照组,差异均有统计学意义(P<0.05)。治疗后,2组RRF、24 h尿量均较治疗前下降,观察组SCr、BUN指标值较治疗前下降,对照组SCr、BUN指标值较治疗前上升,观察组eGFR指标值较治疗前上升,对照组eGFR指标值较治疗前下降,差异均有统计学意义(P<0.05);观察组SCr、BUN指标值低于对照组,eGFR、24 h尿量、RRF指标值均高于对照组,差异均有统计学意义(P<0.05)。观察组并发症总发生率为12.20%,对照组并发症总发生率为29.27%,2组比较,差异均有统计学意义(P<0.05)。观察组临床疗效总有效率为92.68%,对照组临床疗效总有效率为75.61%,2组比较,差异有统计学意义(P<0.05)。结论:小柴胡汤合五苓散联合西药能改善终末期肾病维持性血液透析患者临床症状,改善肾功能,降低并发症发生率。Objective:To observe the clinical effect of Xiaochaihu tang and Wuling powder combined with western medicine for patients undergoing maintenance hemodialysis.Methods:A total of 82 cases of patients undergoing maintenance hemodialysis were selected as the research objects,and divided into the control group and the observation group according to the random number table method,with 41 cases in each group.The control group was given maintenance hemodialysis treatment and oral administration of western medicine,and the observation group was additionally treated with Xiaochaihu tang and Wuling powder based on the treatment of the control group.Both groups were treated for eight weeks.The clinical effects in the two groups were observed.Before and after treatment,blood coagulation indexes including homocysteine(Hcy),D-dimer(D-D)and fibrinogen(FIB)and hypersensitive C-reactive protein(hs-CRP),Chinese medicine syndrome scores,kidney function indexes including blood urea nitrogen(BUN),serum creatinine(SCr),24-hour urinary volume,glomerular filtration rate(eGFR)and residual renal creatinine clearance rate(RRF)in the two groups were compared.During treatment,the incidences of complications were observed.Results:After treatment,the values of FIB,D-D,Hcy and hs-CRP in the two groups were decreased when compared with those before treatment,and the above four indexes in the observation group were lower than those in the control group,differences being significant(P<0.05).After treatment,the scores of dim complexion,petechia and ecchymosis in limbs,scaly skin,limb numbness and local paresthesia in the two groups were decreased when compared with those before treatment,and the above five scores in the observation group were lower than those in the control group,differences being significant(P<0.05).After treatment,RRF and 24-hour urinary volume in the two groups were decreased when compared with those before treatment;the indexes of SCr and BUN in the observation group were decreased when compared with those before treatment,and t

关 键 词：维持性血液透析 五苓散 小柴胡汤 血凝指标 肾功能 

分 类 号：R692.5[医药卫生—泌尿科学]