Clinical Nursing Intervention of Moxibustion on Abdominal Distension Symptoms in Heart Failure (Heart and Kidney Yang Deficiency and Blood Stasis Blocking Collaterals Syndrome)

Objective:To investigate the clinical nursing intervention effect of moxibustion on abdominal distension symptoms in heart failure(heart and kidney yang deficiency and blood stasis blocking collaterals syndrome).Methods:62 patients with heart failure(heart and kidney yang deficiency and blood stasis blocking collaterals syndrome)admitted to our hospital from February 2023 to February 2024 were selected and divided into the observation group(n=31)and the control group(n=31)by using the random numerical table method.The control group adopted conventional nursing interventions,and the observation group received the nursing program of the control group with the addition of moxibustion nursing interventions.The nursing effectiveness,quality of life scores,and nursing satisfaction were compared between the two groups.Results:The nursing effectiveness of the observation group was significantly higher than the control group(P<0.05);the quality of life score of the observation group was significantly higher than the control group(P<0.05);the nursing satisfaction of the observation group was significantly higher than that of the control group(P<0.05).Conclusion:The use of moxibustion nursing intervention in patients with heart failure(heart and kidney yang deficiency and blood stasis blocking collaterals syndrome)can effectively relieve the symptoms of abdominal distension,improve patients'quality of life,and increase nursing satisfaction,which has promotion and application values.

Network pharmacology-based exploration of molecular mechanisms underlying therapeutic effects of Jianpi Huatan Quyu recipe on chronic heart failure with spleen Qi deficiency syndrome

BACKGROUND Chronic heart failure is a complex clinical syndrome.The Chinese herbal compound preparation Jianpi Huatan Quyu recipe has been used to treat chronic heart failure;however,the underlying molecular mechanism is still not clear.AIM To identify the effective active ingredients of Jianpi Huatan Quyu recipe and explore its molecular mechanism in the treatment of chronic heart failure.METHODS The effective active ingredients of eight herbs composing Jianpi Huatan Quyu recipe were identified using the Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform.The target genes of chronic heart failure were searched in the Genecards database.The target proteins of active ingredients were mapped to chronic heart failure target genes to obtain the common drugdisease targets,which were then used to construct a key chemical componenttarget network using Cytoscape 3.7.2 software.The protein-protein interaction network was constructed using the String database.Gene Ontology and Kyoto Encyclopedia of Genes and Genomes enrichment analyses were performed through the Metascape database.Finally,our previously published relevant articles were searched to verify the results obtained via network pharmacology.RESULTS A total of 227 effective active ingredients for Jianpi Huatan Quyu recipe were identified,of which quercetin,kaempferol,7-methoxy-2-methyl isoflavone,formononetin,and isorhamnetin may be key active ingredients and involved in the therapeutic effects of TCM by acting on STAT3,MAPK3,AKT1,JUN,MAPK1,TP53,TNF,HSP90AA1,p65,MAPK8,MAPK14,IL6,EGFR,EDN1,FOS,and other proteins.The pathways identified by KEGG enrichment analysis include pathways in cancer,IL-17 signaling pathway,PI3K-Akt signaling pathway,HIF-1 signaling pathway,calcium signaling pathway,cAMP signaling pathway,NF-kappaB signaling pathway,AMPK signaling pathway,etc.Previous studies on Jianpi Huatan Quyu recipe suggested that this Chinese compound preparation can regulate the TNF-α,IL-6,MAPK,cAMP,and AMPK pathways to affect the mitochondrial structure of myocardial cells,oxidative stress,and energy metabolism,thus achieving the therapeutic effects on chronic heart failure.CONCLUSION The Chinese medicine compound preparation Jianpi Huatan Quyu recipe exerts therapeutic effects on chronic heart failure possibly by influencing the mitochondrial structure of cardiomyocytes,oxidative stress,energy metabolism,and other processes.Future studies are warranted to investigate the role of the IL-17 signaling pathway,PI3K-Akt signaling pathway,HIF-1 signaling pathway,and other pathways in mediating the therapeutic effects of Jianpi Huatan Quyu recipe on chronic heart failure.

Proteomics analysis of IBS-D with spleen and kidney yang deficiency

Objective:To investigate the molecular mechanism underlying the development of diarrhea-predominant irritable bowel syndrome (IBS-D) with spleen and kidney yang deficiency (SKYD) using a proteomics approach.Methods:Male Sprague-Dawley rats (n =22) were divided into IBS-D (n =12) and normal control (n =10) groups.SKYD was then modeled in IBS-D rats by a combination of acetic acid enema,bondage,rectal dilation,tail stimulation,and Senna gavage.Colon tissue samples were subsequently collected and examined by Q Exactive mass spectrometry to identify differentially expressed proteins between the two groups.Results:The occurrence of SKYD/IBS-D was associated with ribosomal protein S23 (Rps23),protein phosphatase 2 catalytic subunit alpha (Pp2a),and growth factor receptor-bound protein 2 (Grb2),which are involved in the ribosome,neurotrophin signaling,and Janus kinase-signal transducer and activator of transcription (JAK-STAT) signaling pathways.Conclusion:These data suggest that SKYD/IBS-D pathophysiology likely involves inflammation,cell growth,apoptosis,stress granule formation,immune activation,loss of epithelial cell integrity,and visceral hypersensitivity.

Progress of studies on cancer-related anemia in Chinese and Western medicine

Cancer-related anemia is a common complication in patients with a malignant tumor caused by the tumor itself or the tumor's treatment.It can seriously affect the quality of life of patients and even accelerate the progression of the tumor.Western medicine is often given a blood transfusion,erythropoietin,and iron agent in cancer-related anemia treatment,but there are also some problems such as increasing tumor-related mortality.Traditional Chinese medicine believes that cancer-related anemia's occurrence is related to the“Deficiency of Spleen and Kidney and Deficiency of Qi and Blood”,so clinical treatment is mainly to“Tonify Spleen and Kidney and Qi and Blood”.The combination of traditional Chinese and Western medicine is useful in cancer-related anemia's treatment,which provides a new idea and method for cancer-related anemia's clinical treatment.

基于脾火论辨治原发性干燥综合征

基于脾火论辨治原发性干燥综合征(pSS)。论述了脾火论的理论内涵,并区分脾火与阴火及其他脏腑之火的差异。阐释了脾火论与pSS的相关性,认为脾气亏虚,运化无权,脾不升清,郁而化火是pSS病机关键;久而病及他脏,导致络脉瘀滞是pSS的病机转化特点。以健脾益气,除火润燥,生津通络为pSS的治疗大法,为pSS的中医辨治提供思路与方法。

Warm needling moxibustion versus electroacupuncture for simple obesity due to yang deficiency of the spleen and kidney: a controlled clinical trial

Objective: To compare the therapeutic efficacy between warm needling moxibustion and electroacupuncture (EA) in the treatment of simple obesity due to yang deficiency of the spleen and kidney. Methods: Seventy patients with simple obesity due to yang deficiency of the spleen and kidney were randomly divided into a warm needling moxibustion group and an EA group, with 35 subjects in each group. Same major acupoints were selected for the two groups, including Shuifen (CV 9), Guanyuan (CV 4), Daheng (SP 15), Shuidao (ST 28), Shousanli (LI 10), Zusanli (ST 36), Sanyinjiao (SP 6) and Taixi (KI 3). The warm needling moxibustion group received warm needling moxibustion, while the EA group received EA treatment. The interventions were performed once every other day, with 15 treatments as one course. The therapeutic efficacy, body weight and body mass index (BMI) were then observed and compared. Results: The total effective rate in the warm needling moxibustion group was 85.7% versus 77.1% in the EA group, and the between-group difference was statistically significant (P<0.05). The warm needling moxibustion was remarkably superior to the EA in weight loss and lowering BMI, both with statistical significance (P<0.05, P<0.01). At the three-month follow-up, the body weight and BMI further decreased in the warm needling moxibustion group (both P<0.05), and the levels were lower than those in the EA group (P<0.05, P<0.01). Conclusion: Warm needling moxibustion can produce reliable and consistent efficacy in the treatment of simple obesity due to yang deficiency of the spleen and kidney. Compared with EA, warm needling moxibustion shows advantage in both short-term and long-term efficacies, and thus is worth promotion in clinical practice.

Lysine deficiency impaired growth performance and immune response and aggravated inflammatory response of the skin,spleen and head kidney in grown-up grass carp (Ctenopharyngodon idella)

This dissertation was primarily focused on the immune response,inflammatory response and molecular mechanisms in the skin,head kidney and spleen of grown-up grass carp(Ctenopharyngodon idella).Six iso-nitrogen diets differing in lysine concentrations(5.6,8.5,11.6,14.4,17.5 and 20.7 g/kg)were fed to 540 grass carp(164.85±0.79 g)for 60 d.After that,grass carp were challenged by Aeromonas hydrophila for 6 d.This study revealed that lysine deficiency(1)suppressed the growth performa,nce of the fish and decreased their ability to resist skin lesion morbidity,(2)impaired the immune organ s immune response by decreasing the gene expressions of mucin,liver-expressed antimicrobial peptide(LEAP)-2B,β-defensin-1 and LEAP-2A and the production of antibacterial compounds of grown-up grass carp,and(3)aggravated the inflammatory response of immune organs in the fish by increasing the gene expressions of pro-inflammatory cytokines(interferon y2[IFN-γ2],tumor necrosis factorα[TNF-α],interleukin[IL]-15,IL-17D,IL-12p40,IL-6 and IL-8)and down-regulating anti-inflammatory cytokines(IL-11,transforming growth factorβ1[TGF-β1],IL-10 and IL-4/13A),which were tightly correlated with signal transducer and activator of transcription(STAT)1 and STAT3 signaling pathway,respectively.The different phenomenon in the skin,spleen and head kidney of fish may be correlated with the difference in gene subtype.In addition,using quadratic regression analysis of percent weight gain(PWG),skin lesion morbidity,and the lysozyme activities in the spleen and head kidney,the dietary lysine requirements for grown-up grass carp were estimated to be 13.58,13.51,14.56 and 14.18 g/kg,respectively.

Clinical treatment of myasthenia gravis with deficiency of spleen and kidney based on combination of disease with syndrome theory

OBJECTIVE: To study the use of Jianjining in the treatment of myasthenia gravis (MG) patients with a deficiency of both spleen and kidney via the theory on the combination of disease with syndrome. METHODS: Sixty MG patients with a deficiency of both spleen and kidney were randomly divided into an treatment group (n=30) treated with Jianjining granules and Western Medicine (prednisone or pyridostigmine bromide) and a control group (n= 30) treated with Jianjining granules. The dosage of the three drugs was reduced over the course of treatment. After 3 and 6 months of treatment, the curative effect was evaluated with the muscle weakness severity scale (MWSS). RESULTS: The MWSS score after treatment declined significantly in both groups. The score in the treatment group was much lower than that in thecontrol group (P<0.05). The total effective rate was 63.33% (19/30) in the treatment group and 36.67% (11/30) in the control group after 3 months of treatment, and 80.00% (24/30) and 50.00% (15/30), respectively, after 6 months of treatment. The obvious and total effective rates in the treatment group were much higher than those in the control group (P<0.05). After 6 months of treatment, there were no obvious differences (P>0.05) in the obvious and effective rates between the 2 groups. However, the total effective rate in the treatment group was much higher than that in the control group (P<0.01). CONCLUSION: Using the theory on the combination of disease with syndrome, we found that the curative effect of Jianjining and Western Medicine on MG patients with deficiency of both spleen and kidney is worth further exploration.

不同剂量腺嘌呤建立脾肾阳虚型慢性肾衰竭大鼠模型的实验研究

目的比较不同剂量腺嘌呤灌胃对模型大鼠一般状态、生化指标及肾脏病理组织的影响,确定腺嘌呤灌胃制备脾肾阳虚型慢性肾衰竭(Chronic kidney disease,CRF)大鼠模型的最佳造模剂量。方法将24只SD雄性大鼠随机分为正常组与模型组,模型组大鼠分为M1组、M2组和M3组,每组6只。正常组给予等量生理盐水灌胃,M1组以腺嘌呤150 mg·kg^(-1)·d^(-1)灌胃、M2组以腺嘌呤200 mg·kg^(-1)·d^(-1)灌胃,M3组以腺嘌呤300 mg·kg^(-1)·d^(-1)灌胃。连续干预3周,造模前及造模后每周检测肌酐(Serum creatinine,Scr)、尿素氮(Blood urea nitrogen,BUN)、24 h尿蛋白定量(24-hour urinary protein quantification,24 h-UTP)水平,3周后取肾脏病理组织采用苏木-伊红(HE)和马松(Masson)染色法对大鼠肾脏组织病理学进行模型评估。结果与正常组大鼠比较,模型组大鼠均出现不同程度的精神萎靡不振,活动度降低,弓背蜷缩,毛发稀疏无光泽,耳缘及脚趾苍白发凉,小便频数,大便稀溏等现象。与正常组大鼠比较,各模型组大鼠体重均有不同程度的减轻(P<0.05),造模第2周,与M1组大鼠体重比较,M2组、M3组大鼠差异均有统计学意义(P<0.05)。与正常组大鼠比较,各模型组大鼠24 h尿量明显增多(P<0.05),Scr、BUN及24 h-UTP水平均升高(P<0.05),且M3组大鼠各指标升高最明显。各模型组大鼠Scr、BUN及24 h-UTP比较差异均有统计学意义(P<0.05)。肾脏病理染色结果显示各模型组大鼠的肾脏组织出现不同程度的改变,镜下见肾小球形态基本完整,部分肾小球结构破坏;部分近肾小管空泡变性严重,上皮萎缩,部分肾小管管腔扩张,管腔内见红染无结构的蛋白管型样物及较多红细胞;随着腺嘌呤灌注剂量增加,肾小球内可见大量黄绿色结晶沉淀物,存在肾间质炎性细胞浸润和纤维组织增生。结论腺嘌呤灌胃可成功建立脾肾阳虚型慢性肾衰竭动物模型,其中200 mg·kg^(-1)·d^(-1)灌胃组更接近临床脾肾阳虚型慢性肾衰竭发展进程,且死亡率较低,符合脾肾阳虚型慢性肾衰竭生理病理学特点。

防己黄芪汤联合丹参饮治疗脾肾气虚型慢性肾衰并发心衰患者肾脏血流、心功能的影响

目的探究防己黄芪汤联合丹参饮治疗脾肾气虚型慢性肾衰并发心衰患者肾脏血流、心功能的影响。方法选取2020年6月-2022年6月于本院就诊的脾肾气虚型慢性肾衰并发心衰患者82例,按照治疗方式将其分为对照组40例,联合组42例。对照组给予丹参饮治疗;联合组给予防己黄芪汤联合丹参饮治疗。评估患者中医证候积分水平;比较2组治疗前后肾功能、炎症因子、肾脏血流、心功能水平。结果治疗后,2组中医症候积分水平、肾功能水平、炎症因子水平、肾脏血流水平较治疗前均降低,且联合组较对照组下降程度更低(P<0.05);治疗后,2组心功能水平比较,左室射血分数(LVEF)水平上升,左心室收缩末期容积(LVESV)、左心室舒张末期内径(LVEDD)水平下降,且联合组优于对照组(P<0.05)。结论经防己黄芪汤联合丹参饮治疗后,脾肾气虚型慢性肾衰并发心衰患者中医证候积分水平降低,改善肾功能、改善炎症因子水平、肾脏血流水平,改善心功能水平,具有显著的优势,值得推广应用。

从抗抑郁角度论治肛门坠胀感

现代医学从炎症角度将肛门坠胀感与抑郁的发病机制联系在一起。中医理论则认为,出现肛门坠胀感或因肝失疏泄,气机不畅,气滞血瘀;或因心脾两虚,中气下陷。抑郁的发病病机与肛门坠胀相通。因此肛门坠胀可从心、脾、肝辨证论治,发挥抗抑郁作用,并加强心理干预及患者自我关怀,体现中医学整体观念与异病同治的理论特点,拓展肛门坠胀诊疗思路,为提升肛门坠胀的中医临床疗效、探寻肛门坠胀感心身同治的方式作出有益尝试。

大黄附子汤加减方对慢性肾衰竭患者血清miR-30a、miR-182表达水平的影响

目的:观察大黄附子汤加减方对慢性肾衰竭(CRF)患者血清微小RNA-30a(miR-30a)、微小RNA-182(miR-182)表达水平的影响。方法:选取109例CRF患者,按随机数字表法分为对照组55例及观察组54例,观察组脱落2例,纳入52例,对照组脱落3例,纳入52例。对照组采取常规治疗,观察组在对照组基础上应用大黄附子汤加减方治疗。2组均治疗12周。比较2组临床疗效及不良反应发生情况,比较2组治疗前后肾功能指标值[血肌酐(SCr)、尿素氮(BUN)、肾小球滤过率(eGFR)]、肾纤维化指标值[Ⅲ型前胶原(PC-Ⅲ)、层黏蛋白(LN)]、血清miR-30a、miR-182表达水平的变化,采用受试者工作特征曲线(ROC)分析miR-30a、miR-182表达水平对治疗效果的预测价值,采用Pearson检验分析miR-30a、miR-182表达水平与eGFR的相关性。结果:观察组临床疗效总有效率为86.54%,对照组临床疗效总有效率为67.31%,2组比较,差异有统计学意义(P<0.05)。治疗后,2组血清BUN、SCr水平均较治疗前下降(P<0.05),eGFR水平较治疗前升高(P<0.05);观察组血清BUN、SCr均低于对照组(P<0.05),eGFR水平高于对照组(P<0.05)。治疗后,2组血清PC-Ⅲ、LN水平均较治疗前下降(P<0.05),观察组血清PC-Ⅲ、LN水平均低于对照组(P<0.05)。治疗后,2组miR-30a、miR-182表达水平均较治疗前降低(P<0.05),观察组miR-30a、miR-182表达水平均低于对照组(P<0.05)。观察组治疗总有效45例、无效7例。与有效者比较,无效者入院时血清miR-30a、miR-182表达水平均升高(P<0.05)。ROC曲线显示,血清miR-30a、miR-182联合预测治疗效果的AUC、灵敏度、特异度依次为0.808、85.71%、75.60%。Pearson检验显示,观察组miR-30a、miR-182表达水平与eGFR呈负相关(P<0.05)。用药过程中,2组未见严重不良反应。结论:大黄附子汤加减方治疗CRF的临床疗效较好,有助于促进肾功能恢复,延缓肾纤维化进展,下调血清miR-30a、miR-182表达水平,且miR-30a联合miR-182检测对于治疗效果有较高的预测价值。

温针灸联合雌孕激素周期疗法治疗脾肾阳虚型卵巢早衰临床研究

目的:观察温针灸联合雌孕激素周期疗法治疗脾肾阳虚型卵巢早衰的疗效。方法:选取68例脾肾阳虚型卵巢早衰患者,按随机数字表法分为治疗组及对照组各34例。常规处理基础上,对照组予以雌孕激素周期疗法(地屈孕酮片+戊酸雌二醇片)治疗,治疗组在对照组基础上加用温针灸治疗。2组均治疗6个月。比较2组临床疗效及不良反应发生情况,比较2组治疗前后性激素水平[血清促卵泡生成素(FSH)、雌二醇(E_(2))、促黄体素生成素(LH)],中医证候积分、B超检查指标值的变化。结果:治疗组总有效率为88.24%,对照组为67.65%,2组比较,差异有统计学意义(P<0.05)。治疗后,2组E_(2)水平均较治疗前升高(P<0.05),LH、FSH水平均较治疗前下降(P<0.05);治疗组E_(2)水平高于对照组(P<0.05),LH、FSH水平均低于对照组(P<0.05)。治疗后,2组子宫内膜厚度、卵巢体积及窦状卵泡数均较治疗前升高(P<0.05),治疗组上述3项指标值均高于对照组(P<0.05)。治疗后,2组中医证候积分均较治疗前下降(P<0.05),治疗组中医证候积分低于对照组(P<0.05)。治疗组不良反应发生率为2.94%,对照组为8.82%,2组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:温针灸联合雌孕激素周期疗法治疗脾肾阳虚型卵巢早衰临床疗效确切,可促进卵巢功能恢复,改善性激素水平与卵巢储备功能,安全性高。

参乌益肾片治疗早中期慢性肾功能衰竭脾肾气阴两虚证临床研究

目的:观察参乌益肾片治疗早中期慢性肾功能衰竭(CRF)脾肾气阴两虚证临床疗效。方法:选取2022年1月—2023年6月安吉县人民医院接诊的早中期CRF脾肾气阴两虚证患者,共78例。按随机数字表法分成2组各39例。2组均给予常规治疗方案,对照组加用复方α-酮酸片,观察组在对照组治疗方案的基础上给予参乌益肾片治疗,2组均连续观察6个月。比较2组肾功能指标、脾肾气阴两虚证症状评分、血清同型半胱氨酸(Hcy)、超敏C-反应蛋白(hs-CRP)水平以及临床疗效。结果:治疗6个月后,2组血肌酐、尿素氮、24 h尿蛋白水平分别与治疗前比较均降低,差异均有统计学意义(P<0.05),观察组血肌酐、尿素氮、24 h尿蛋白水平均低于对照组,差异均有统计学意义(P<0.05)。治疗6个月后,2组脾肾气阴两虚证症状评分分别与治疗前比较均减少,差异均有统计学意义(P<0.05),观察组脾肾气阴两虚证症状评分少于对照组,差异有统计学意义(P<0.05)。治疗6个月后,2组血清Hcy与hs-CRP水平分别与治疗前比较均降低,差异均有统计学意义(P<0.05),观察组血清Hcy与hs-CRP水平均低于对照组,差异均有统计学意义(P<0.05)。临床疗效总有效率观察组87.18%,对照组64.10%,差异有统计学意义(P<0.05)。结论:参乌益肾片治疗早中期CRF脾肾气阴两虚证,能改善患者肾功能与中医证候,下调血清Hcy与hs-CRP水平。

Study of establishing disease-syndrome combined with animal model for immune thrombocytopenic purpura without additional conditions

Objective:To explore the feasibility of establishing the disease-syndrome combined animal model for immune thrombocytopenic purpura(ITP)without additional conditions.Methods:Three batches of data related to the ITP model mice obtained by replication at different time were analyzed,and whether the APS-injected model mice replicated through the passive immune modeling method could simulate the pathogenesis and clinical characteristics of human ITP was evaluated according to the differentiation criteria for diseasesyndrome combined model.Results:The APS-injected replicated ITP model mice possessed the following traits:(1)Compared with the normal group,the platelet count was significantly decreased,and coagulation time was significantly increased in the model group(P<.01).(2)Compared with the normal group,the medullary thrombocytogenous megakaryocytes were significantly decreased(P<.05,.01,.001).(3)The APS-injected sites and other parts of the model mice had spontaneous hemorrhage.(4)Behavioral changing signs were observed 1 week after the modeling(i.e.low activity,delayed activity,poor appetite,skin petechia/hemorrhage and spontaneous hemorrhage at the injected sites or other parts),and were getting more and more severe.Conclusion:According to the syndrome differentiation criteria for disease-syndrome combined model of ITP,the APS-injected animal model of ITP replicated through the passive immune modeling method without additional conditions possesses the characteristics of disease-syndrome combined model.It provides an ideal tool for the development of traditional Chinese medicine pharmacology experiment.

CLINICAL RESEARCH ON TREATMENT OF CHRONIC PROSTATITIS WITH ACUPUNCTURE

In the present study, the authors put forward that Zhibian(BL 54) and Sanyin-jiao(SP 6) are the effective acupoints for treatment of chronic prostatitis and possess an unique cura-tive effect in treatment of this disease with the type of deficiency of both the spleen and the kidney. Atotal effective rate was 92% in group of 1OO cases treated with acupuncture and comparison betweenpre- and post-treatment in examinations of prostatic fluid and other 6 items showed, significantly bet-ter than that of oral compound Sinohan(P【0. 01 ).

中西医结合治疗慢性肾功能衰竭失代偿期41例临床观察

目的:观察中西医结合治疗脾虚湿浊血瘀证CRF失代偿期41例临床效果。方法:按照随机数字表法将淮安市楚州中医院收治的81例CRF失代偿期患者分为对照组和观察组,对照组40例予以基础治疗;观察组41例在前者基础上予以补肾健脾化浊汤治疗,观察两组肾功能、肾纤维化、不良反应及临床疗效。结果:治疗90 d后,观察组Scr、BUN、FN、TGF-β1水平低于对照组,观察组BMP-7水平高于对照组(P<0.05);观察组不良反应总发生率与对照组对比差异无统计学意义(P>0.05);观察组总有效率为92.68%,高于对照组(P<0.05)。结论:脾虚湿浊血瘀证CRF失代偿期患者使用补肾健脾化浊汤辅助治疗可以改善肾功能,抑制肾纤维化,提高临床疗效,且不增加不良反应发生率。

解毒泄浊方联合血液透析治疗慢性肾功能衰竭患者疗效及对钙磷代谢的影响

目的研究解毒泄浊方联合血液透析治疗慢性肾功能衰竭(chronic renal failure,CRF)脾肾亏虚夹湿浊证患者疗效及对肾功能和钙磷代谢水平的影响。方法选取2020年7月—2022年3月来院就诊的终末期CRF患者62例为样本进行前瞻性随机对照实验,将患者按照入组顺序进行编号并采用随机数字表法均分为观察组和对照组,每组31例,两组均进行血液透析和对症支持治疗,观察组在此基础上给予中药解毒泄浊方辅助治疗,比较两组治疗8周时疗效、中医症状积分、肾功能和钙磷代谢水平。结果观察组和对照组有效率分别为90.32%(28/31)和67.74%(21/31),两组比较差异有统计学意义(χ^(2)=4.769,P=0.029);治疗8周时观察组倦怠乏力、气短懒言、腰膝酸软和食少纳呆等主要症状评分均低于对照组(t=4.508、4.236、3.265、4.293,P<0.05);治疗8周时观察组血肌酐(Scr)、尿素氮(BUN)、β_(2)微球蛋白(β_(2)-MG)、磷离子和全段甲状旁腺激素(iPTH)均低于对照组(t=4.757、4.240、3.979、2.022、2.956,P<0.05),血清钙离子水平高于对照组(t=2.793,P<0.05);治疗8周时两组iPTH达标率分别为67.74%(21/31)和41.94%(13/31),差异有统计学意义(χ^(2)=4.769,P<0.05)。结论CRF脾肾亏虚夹湿浊证患者在血液透析基础上应用中药解毒泄浊方进行辅助治疗有利于缓解患者症状,改善肾功能和钙磷代谢,提升治疗效果。

从虚、毒、瘀探析慢性肾衰竭的中医辨治

慢性肾衰竭作为目前临床上的一种常见病,受到国内外学者广泛关注。西医治疗慢性肾衰竭尚未有成熟完备的诊疗方案。通过中医理论研究及临床经验总结,将慢性肾衰竭的病因病机归纳为正虚邪实,脾肾亏虚,浊毒、瘀血内生。分别从虚、毒、瘀三方面,深入阐述慢性肾衰竭的发生发展及变化规律,希望能为中医临床用药,降低患者肾损害,提供新的思路。

益肾活血降浊汤灌肠治疗慢性肾衰竭脾虚湿浊证

目的探讨益肾活血降浊汤灌肠治疗慢性肾衰竭脾虚湿浊证患者临床效果及对患者肾功能、钙磷代谢指标的影响。方法纳入脾虚湿浊证慢性肾衰竭72例,随机数表法分为对照组与观察组,各36例。对照组予常规西医治疗,观察组在对照组基础上予益肾活血降浊汤灌肠治疗,2组均治疗14 d。比较2组治疗前后中医证候积分、肾功能血尿素氮(BUN)、血肌酐(Scr)、24 h尿蛋白定量、钙磷代谢血磷、血钙、甲状旁腺激素(PTH)及临床疗效。结果治疗后,2组中医证候积分均低于治疗前,观察组低于对照组(P<0.05);观察组治疗后BUN、Scr、24 h尿蛋白定量、血磷、PTH指标水平低于对照组(P<0.05);2组治疗后血钙值均提高,观察组高于对照组(P<0.05);观察总组有效率(91.67%,33/36)高于对照组(69.44%,25/36)(P<0.05)。结论益肾活血降浊汤灌肠治疗慢性肾衰竭脾虚湿浊证效果满意,可改善患者肾功能及钙磷代谢水平,值得临床推广应用。