辨证分型治疗慢性肾小球肾炎57例临床观察

Clinical Observation on 57 Cases of Chronic Glomerulonephritis Syndromes

[目的]观察辨证分型治疗慢性肾小球肾炎疗效。[方法]使用前瞻性设计方法,将57例住院及门诊患者辨证分型治疗。脾肾气虚-健脾益肾补气,四君子汤(潞党参、茯苓各15g,白术10g,茅芦根20g,益母草、生黄芪、山药各15g,仙灵牌、车前子各10g,甘草5g);气阴两虚-益气养阴,参芪地黄汤(太子参、生黄芪各15g,生地、山药各10g,泽泻15g,丹皮、山萸肉各10g,凤尾草30g,茯苓、车前子各15g;血压高加天麻、钩藤、石决明、杜仲、牛膝;咽喉干痛加玄参、麦冬);脾肾阳虚-温阳健脾,实脾饮(大腹皮20g,木瓜、川厚朴各15g,法半夏、木香、茯苓、白术各10g,干姜8g,熟附子6g;气血乏力加黄芪、白术、山药各15g);肝肾阴虚-滋养肝肾,杞菊地黄汤(黄柏15g,茯苓、菊花、泽泻、丹皮、山药、熟地、枸杞子各10g;水肿加猪苓、滑石、泽泻各10g;血尿加白茅根、小蓟、旱莲草各10g);1剂/d,水煎300m L,早晚口服,150m L/次。连续治疗60d为1疗程。观测临床症状、尿蛋白、不良反应。治疗1疗程,判定疗效。[结果]显效33例,有效20例,无效4例,总有效率92.98%。[结论]辨证分型治疗慢性肾小球肾炎疗效满意,无严重不良反应,值得推广。

[Objective]To observe the Differential Diagnosis and Treatment of Chronic glomerulonephritis effect.[Methods]Using a prospective design,57 cases of inpatient and outpatient treatment of syndrome type.Spleen and kidney Qi-Qi spleen and kidney,four gentlemen soup（Dangshen Lu,Fuling 15 g,Baizhu 10 g,Maolugen 20 g,Yimucao,Shenghua ngqi,Shanyao 15 g,Xianlingpi,Cheqianzi each 10 g,Gancao 5g）;Qi-Qi Yin,Shenqidihuang soup（Taizishen,Shenghaungqi each 15 g,Shengdi,Shanyao 10 g,Zexie 15 g,Danpi,Shanzhuyu each 10 g,Fengweicao 30 g,Fuling,Cheqianzi each 15g;high blood pressure plus Tianma,Gouteng,Shijueming,Duzhong,Niuxi;sore throat plus Xuanshen,Maidong）;spleen and kidneyyang and spleen,the spleen drink（Dafupi 20 g,Mugua,Houpu each 15 g,Muxiang,Fuling,Baizhu 10 g,Ganjiang 8g,Shufuzi 6g;blood weak Huangqi,Baizhu,Shanyao 15g）;liver and kidney-nourishing liver kidney,Qijudihuang soup（Huangbai 15 g,Fuling,Juhua,Zexie,Danpi,Shanyao,Shudi,Gouqizi 10g;edema plus Zhuling,Huashi,Zexie 10g;hematuria plus Baimaogen,Xiaoji,Hanliancao 10g）;1/d,decoction 300 m L,sooner or later,oral,150 m L/times.60 d for a course of continuous treatment.Observation of clinical symptoms,urine protein,adverse reactions.One course of treatment,to determine efficacy.[Results]33 cases markedly effective in 20 cases,4 cases,the total efficiency of 92.98%.[Conclusion]Differentiation and Treatment of Chronic glomerulonephritis results were satisfactory,no serious adverse reactions,is worth promoting.