慢性肾脏病血管内皮损伤病人中医证型分布规律及化瘀益肾方的保护作用  

Distribution of TCM Syndrome Types in Patients with Chronic Renal Disease with Vascular Endothelial Injury and the Protective Effect of Huayu Yishen Recipe

作　　者：刘溪 LIU Xi(Beijing Jingzhong Hospital of Integrated Traditional Chinese and Western Medicine,Beijing 100071,China)

机构地区：[1]北京京中中西医结合医院,北京100071

出　　处：《中西医结合心脑血管病杂志》2025年第4期609-614,共6页Chinese Journal of Integrative Medicine on Cardio-Cerebrovascular Disease

摘　　要：目的:探讨慢性肾脏病(CKD)血管内皮损伤病人中医证型分布规律及化瘀益肾方的保护作用。方法:选取2016年8月—2019年8月于我院肾脏科住院治疗的CKD血管内皮损伤病人600例为研究对象,分析中医四诊资料,将病人随机分为对照组(300例)和观察组(300例)。对比两组临床资料、内中膜厚度(CIMT)、中医证候评分变化。采用ORACLE 10g工具构建随机行走模型评价化瘀益肾方对CKD血管内皮损伤病人的保护作用。结果:CKD血管内皮损伤病人本虚证型以脾肾气虚证为主(298例,49.67%),依次为脾肾阳虚证(102例,17.00%)、气阴两虚证(98例,16.33%)、肝肾阴虚证(62例,10.33%)及阴阳两虚证(40例,6.67%)。CKD血管内皮损伤病人邪实证型以湿浊证(216例,36.00%)和血瘀证为主(202例,33.67%),其次为水气证(84例,14.00%)、湿热证(61例,10.17%)和浊毒证(37例,6.17%)。治疗后,两组血清肌酐(Scr)、血尿素氮(BUN)、尿酸(UA)均较治疗前明显降低(P<0.05),组间比较差异有统计学意义(P<0.05)。治疗后,对照组CIMT较治疗前明显增加(P<0.05),两组中医证候积分均降低,且组间比较差异有统计学意义(P<0.05)。随机行走模型评价显示观察组病人各指标较对照组改善明显,化瘀益肾方治疗CKD血管内皮损伤疗效确切。结论:CKD血管内皮损伤病人中医证型分布以肾阳虚型和心气虚型为主,化瘀益肾方可有效改善CKD血管内皮损伤病人肾功能及临床症状。Objective:To explore the distribution of traditional Chinese medicine(TCM)syndrome types in patients with vascular endothelial injury in chronic kidney disease(CKD),and the protective effect of Huayu Yishen Recipe.Methods:Six hundred patients with CKD vascular endothelial injury were selected as the research objects,and their four diagnostic materials were analyzed.The patients were randomly divided into control group(n=300)and observation group(n=300).The general information,intima-media thickness(CIMT),and TCM symptom scores before and after treatment were compared.ORACLE 10g tool was used to construct a random walk model to evaluate the protective effect of Huayu Yishen Recipe on CKD patients with vascular endothelial injury.ORACLE 10g tool was used to build a random walking model to evaluate the protective effect of Huayu Yishen Recipe on CKD patients with vascular endothelial injury.Results:The distribution of the deficiency syndrome types in CKD patients with vascular endothelial injury was characterized primarily by the spleen and kidney Qi deficiency syndrome(298 cases,49.67%),followed by the spleen and kidney Yang deficiency syndrome(102 cases,17.00%),Qi and Yin deficiency syndrome(98 cases,16.33%),liver and kidney Yin deficiency syndrome(62 cases,10.33%),and Yin and Yang deficiency syndrome(40 cases,6.67%).The distribution of pathogenic excess syndrome types in CKD patients with vascular endothelial injury showed that the damp turbid syndrome(216 cases,36.00%)and blood stasis syndrome(202 cases,33.67%)were the main types,followed by water retention and Qi stagnation syndrome(84 cases,14.00%),damp heat syndrome(61 cases,10.17%),and turbid toxin syndrome(37 cases,6.17%).After treatment,blood urea nitrogen(BUN),serum creatinine(Scr),and uric acid(UA)in control group and observation group decreased significantly(P<0.05),and the difference between the two groups was statistically significant(P<0.05).After treatment,CIMT in control group was significantly increased compared with that before treatment(P<0.05),

关 键 词：慢性肾脏病 化瘀益肾方 中医证型 血管内皮损伤 随机行走模型 

分 类 号：R277.5[医药卫生—中医学]