结肠透析汤1号方证临床应用总结

Summary of Prescription and Syndrome in Clinical Application of Jiechang Touxi Decoction No.1

目的观察结肠透析汤1号临床疗效,明确结肠透析汤1号治疗科学依据。方法选择慢性肾功能衰竭(代偿期、失代偿期、衰竭期)中医辨证属脾肾气虚、脾肾阳虚患者120例,应用"结肠透析汤1号"行结肠透析治疗并观察疗效;应用"方证"对应、"方证"从化及"方证"相关分子生物学的理论分析和总结。结果结肠透析汤1号治疗脾肾气虚及脾肾阳虚证,证候积分疗效比较,总有效率分别为92.64%和94.23%(P>0.05);血肌酐降低疗效比较,总有效率分别为91.17%和92.31%(P>0.05);两证治疗前、后血肌酐值比较治疗后均优于治疗前(P<0.05)。结论临证有无疗效,决定于"方证"对应与否;"方证"以互为主客体的"主体选择"和"引导",构成不可分割的互溶、互化的交互关系;结肠透析汤1号治疗具有科学依据,进一步夯实了中医肾病疗效基础。

Objective To observe the clinical efficacy of Jiechang Touxi decoction No. 1 and clear about its therapeutic scientific basis of soup 1 colon dialysis therapy. Methods Selecting 120 cases of deficiency of spleen qi and kindey qi and yang deficiency of spleen and kidney with chronic renal failure （compensatory stage, diseompensation stage, failure stage） , and they used ＂Jieehang Touxi decoction No. 1＂ for colonic dialysis treatment. The therapeutic effect was observed. We made a molecular biology theoretical analysis and summary by applying homologous ＂prescription and syndrome＂, transformation in accord with constitution of ＂prescription and syndrome＂ and correlative ＂prescription and syndrome＂. Results Using Jiechang Touxi decoction No. 1 in the treatment of deficiency of spleen qi and klndey qi syndrome and yang deficiency of spleen and kidney syndrome, comparing with integral of syndrome of TCM, the total effective rate was 92.64% and 94.23% （P 〉0.05） , respectively. The total effective rate of the serum ereatinine decrease was 91. 17% and 92.31% （P 〉 O. 05） , respectively. After treatment, the serum creatinine values of the two syndromes were better than before treatment （ P 〈 0.05 ）. Conclusion The clinical effect was decided by homologous ＂ prescription and syndrome＂, and ＂ prescription and syndrome＂ was objectoriented ＂subject selection＂ and ＂guidance＂. They constituted an integral solubility, mutual relationship. The therapy of Jiechang Touxi decoction No. 1 had scientific basis, and further consolidated the foundation of Chinese herbal medicine in the treatment of nephropathy.