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1、提要目的:通过对加味当归芍药散治疗原发性肾病综合征(PNS)脾虚·血水互结型的临床观察,探讨加味当归芍药散治疗PNS的临床疗效,为临床治疗PNS提供客观依据。方法:采用前瞻性、随机对照的方法,纳入脾虚·血水互结型PNS患者60例,其中试验组30例,对照组30例,对照组给予标准激素治疗及对症治疗,试验组在西药治疗的基础上加用加味当归芍药散治疗,疗程均为8周。分别观察和检测两组患者治疗前后临床症状、体征的变化。分别于治疗前后检测两组患者24h尿蛋白定量、血脂、血浆白蛋白、APTT、D二聚体、肾功能等指标的变化。结果:1.试验组治疗原发性肾病综合征的总有效
2、率显著优于对照组(p<0.01)。2.在中医症状改善上,除了倦怠乏力项两组改善无明显差别外,余外诸项试验组均优于对照组(p<0.05或0.01)。3.试验组在降低24h尿蛋白定量、提高血浆白蛋白水平、降低甘油三酯、总胆固醇,延长APTT、PT,降低D二聚体水平上显著优于对照组(p<0.05或0.01)。结论:加味当归芍药散联合西药治疗原发性肾病综合征脾虚·血水互结型患者的疗效确切,可显著改善患者尿蛋白、血浆白蛋白、血脂的水平,改善患者高凝状态,改善水肿等临床症状和体征。加味当归芍药散在治疗脾虚·血水互结型PNS的临床治疗上是安全有效的。关键词原发性肾
3、病综合征;加味当归芍药散;临床观察ClinicalobservationofmodifieddangguishaoyaoPowerintreatmentofprimarynephroticsyndiomeSpeciality:InternalmedicineoftraditionalChineseMedicineAuthor:MaQian-qianTutor:ProfessorZhangFa-rongAbstractObjective:BasedontheModifiedDangguiShaoyaoPowderintreatingprimarynep
4、hroticsyndrome(PNS)syndromeofbloodstasisandspleendeficiencytypeclinicalobservation,researchofModifiedDangguiShaoyaoPowderforPNSclinicalcurativeeffect,providestheobjectivebasisfortheclinicaltreatmentofPNS.Methods:Aprospective,randomizedcontrolledmethod,bringintobloodstasisandspl
5、eendeficiencytype60PNSpatients,including30casesofExperimentalgroup,30casesinthecontrolgroup,thecontrolgroupreceivedstandardhormonetherapyandsymptomatictreatment,intheexperimentgroup,westernmedicinetreatmentbasedontheuseofModifiedDangguiShaoyaoPowdertreatment.Thecourseoftreatmen
6、twas8weeks.Twogroupswereobservedanddetectedbeforeandaftertreatmentofclinicalsymptoms,signsofchange.Beforeandaftertreatmentrespectivelytocheckthe24hquantityofurinaryprotein,serumlipids,plasmaalbumin,APTT,Dtwodimers,renalfunctionchanges.Results:1.TheExperimentalgroupModifiedDangg
7、uiShaoyaoPowderintreatmentofprimarynephroticsyndromeinthetotalefficiencywasbetterthanthecontrolgroup(P<0.01).2.IntraditionalChinesemedicinesymptomimprovement,inadditiontolanguidtwogroupsimprovedwithoutobviousdifference,outsidethetestgroupwasbetterthanthecontrolgroup(P<0.05or0.0
8、1).3.Experimentalgroupwassignificantlybetterthanthecon