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1、提要目的:在西醫(yī)治療基礎上,予益氣通絡飲為主方隨癥加減,治療原發(fā)性局灶節(jié)段性腎小球硬化(pFSGS),觀察其臨床療效,探討中西醫(yī)結合治療本病的優(yōu)勢和可行性,為進一步改良及推廣配方打下基礎。方法:本研究收集pFSGS患者(經腎活檢病理診斷為局灶節(jié)段性腎小球硬化,排除繼發(fā)性疾病。)符合中醫(yī)氣虛血瘀型患者60例,并隨機分為2組,試驗組、對照組各30例。對照組予以控制血壓、抗凝、降蛋白尿等西醫(yī)基礎治療,試驗組在西醫(yī)基礎治療上加用益氣通絡飲并隨癥加減,療程為二個月。觀察兩組臨床癥狀、體征及實驗室檢查指標的變化情況。結果:pFSGS
2、氣虛血瘀型中醫(yī)量化評分:試驗組總有效率96.67%,對照組總有效率56.66,兩組比較有顯著統(tǒng)計學意義(p<0.01)。試驗組用藥后積分與用藥前積分相比具有顯著的統(tǒng)計學意義(p<0.01)。臨床緩解率實驗組總有效率86.67%,對照組總有效率80.00%,兩組比較差異無統(tǒng)計學意義(P>0.05):兩組治療前后血脂、血漿白蛋白、24h尿蛋白定量比較差異均有明顯統(tǒng)計學意義(P<0.01),且兩組組治療后比較差異均有明顯統(tǒng)計學意義(P<0.01)。結論:益氣通絡飲隨證加減配合西醫(yī)基礎治療pFSGS氣虛血瘀型,能顯著改善患者身倦
3、乏力、顏面或肢體浮腫、腰痛固定或刺痛等臨床表現(xiàn),降低24h尿蛋白定量,升高血漿白蛋白,糾正脂質代謝紊亂,從而顯示出中西醫(yī)結合治療本病的優(yōu)勢。關鍵詞益氣通絡飲;pFSGS;氣虛血瘀型;ClinicalStudyonPrimaryFocalSegmentalGlomerulosclerosis(FSGS)ofbloodstasisduetoqideficiencywithmethodsoftonifyingqiandinvigoratingthecirculationofblood,dredgingcollateralsan
4、ddissipatingagglomerateSpecial:InternalMedicineofIntegratedTCMandWesternMedicineStudent:LiuYanTutor:Prof.GuoZhaoanAbstractObjective:Toinvestigatetheeffectofyi-qi-tong-luo-yin(YQTLY)treatingpFSGSofbloodstasisduetoqideficiencyonthebasisofwesternmedicinetreatment.To
5、exploretheadvantagesandfeasibilityofcombiningtraditionalChineseandwesternmedicinetreatingpFSGSandlaythefoundationforfurtherimprovement.Methods:60patientswithpFSGSofbloodstasisduetoqideficiencywererandomlydividedinto2groups,experimentalgroupandcontrolgroup,eachgro
6、upwas30cases.Patientsincontrolgroupweretreatedbyroutinetherapy,whilepatientsinexperimentalgroupweretreatedbycombinationofYQTLYandroutinetherapy.Thecourseoftreatmentis2months.Thecurativeeffectandtherelatedindexesweredeterminedbeforeandaftertreatment,thechangeofpat
7、ients'clinicalsymptomswasrecorded.Results:Thetotaleffectiverateintheexperimentalgroup(96.67%)washigherthanthatinthecontrolgroup(56.66%,p<0.01).Itissignificantlydifferentbetweenthescoresofpro-treatmentandpost-treatment(p<0.01)intheexperimentalgroup.Thereisnosignif
8、icantdifferenceintheremissionofpFSGSbetweenthecontrolgroupandtheexperimentalgroup.Thereweresignificantdifferencebetweentwogroupson24hurineprotein,ALB,TCHandTGa