温阳利水通络法治疗肾病综合征脾肾阳虚夹瘀证临床研究  

Clinical Study on the Treatment of Nephrotic Syndrome with Spleen-Kidney Yang Deficiency and Blood Stasis with Method of Warming Yang and Promoting Urination and Dredging Collaterals

作　　者：公敏 吴鹏 黄琳 GONG Min;WU Peng;HUANG Lin(Ganzhou Hospital of Traditional Chinese Medicine,Ganzhou,Jiangxi,China,341000)

机构地区：[1]赣州市中医院,江西赣州341000

出　　处：《河南中医》2023年第3期415-418,共4页Henan Traditional Chinese Medicine

基　　金：赣州市指导性科技计划项目(GZ2020ZSF364)。

摘　　要：目的:观察温阳利水通络法治疗肾病综合征脾肾阳虚夹瘀证的临床疗效及对患者凝血功能、T淋巴细胞亚群的影响。方法:选取2020年1月至2021年10月赣州市中医院治疗的肾病综合征脾肾阳虚夹瘀证患者80例,按照随机数字表法分为治疗组和对照组,每组40例。对照组给予抑制免疫反应、调血脂、利尿消肿、抗凝血等对症治疗,治疗组在对照组治疗的基础上给予温阳利水通络法治疗。比较两组患者治疗前后24 h尿蛋白定量、血尿素氮(blood urea nitrogen,BUN)、血肌酐(serum creatinine,Scr)、血清白蛋白(albumin,ALB)、总胆固醇(total cholesterol,TC)、凝血酶原时间(prothrombin time,PT)、活化部分凝血酶原时间(activated partial prothrombin time,APTT)、凝血酶凝结时间(coagulation time of thrombin,TT)、纤维蛋白原(fibrinogen,FIB)、D-二聚体(D-dimer,D-D)、CD3^(+)、CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+)水平变化情况。结果:治疗组有效率为92.5%,对照组有效率为75.0%,治疗组有效率高于对照组,差异有统计学意义(P<0.05);两组治疗后ALB高于治疗前,BUN、TC、Scr、24 h尿蛋白定量低于治疗前,且治疗组治疗后ALB高于对照组,BUN、TC、Scr、24 h尿蛋白定量低于对照组,差异有统计学意义(P<0.05);两组治疗后PT、APTT高于治疗前,FIB、D-D低于治疗前,差异有统计学意义,且治疗组治疗后PT、APTT、D-D低于对照组,差异有统计学意义(P<0.05);两组治疗后CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)水平高于治疗前,CD8^(+)水平低于治疗前,且治疗组CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)水平高于对照组,CD8^(+)水平低于对照组,差异有统计学意义(P<0.05)。结论:温阳利水通络法治疗肾病综合征脾肾阳虚夹瘀证,可改善患者高凝状态,降低血栓风险性,对T淋巴细胞亚群具有一定调控作用,从而调节患者免疫功能。Objective:To observe the clinical efficacy of method of warming yang and promoting urination and dredging collaterals on spleen-kidney yang deficiency complicated with blood stasis syndrome,and its influence on coagulation function and T lymphocyte subsets of patients.Methods:A total of 80 patients with nephrotic syndrome of spleen-kidney yang deficiency and blood stasis treated in Ganzhou Hospital of Traditional Chinese Medicine from January 2020 to October 2021 were randomly divided into the treatment group and the control group,with 40 cases in each group.The control group was given symptomatic treatment such as inhibition of immune response,regulation of blood lipids,diuresis and detumescence,and anticoagulation,while the treatment group was given the treatment of warming yang,promoting urination and dredging collaterals on the basis of the treatment of the control group.The changes of 24-hour urine protein quantity,blood urea nitrogen(BUN),serum creatinine(Scr),serum albumin(ALB),total cholesterol(TC),prothrombin time(PT),activated partial prothrombin time(APTT) coagulation time of thrombin(TT),fibrinogen(FIB),D-dimer(D-D),CD3^(+),CD4^(+),CD8^(+),CD4^(+)/CD8^(+) of the two groups before and after treatment were compared.Results:The effective rate of the treatment group was 92.5%,which was higher than that of the control group:75.0%,and the difference was statistically significant(P<0.05).After treatment,the ALB of the two groups was higher than that before treatment,while the BUN,TC,Scr,24h urine protein content were lower than those before treatment,and the ALB of the treatment group was higher than that of the control group,while the BUN,TC,Scr,24 h urine protein content were lower than those of the control group,and all the differences were statistically significant(P<0.05);The PT,APTT and D-D of the two groups were higher than those before treatment,while the FIB and D-D were lower than those before treatment,and all the differences were statistically significant,and the PT,APTT and D-D of the treatment

关 键 词：肾病综合征 脾肾阳虚夹瘀证 温阳利水通络法 凝血功能 T淋巴细胞亚群 

分 类 号：R256.59[医药卫生—中医内科学]