CAJ | 학술논문

目的：：探究观察肾经、膀胱经开合时间与中医治疗肾病综合征疗效的关系,为中医药物治疗肾病综合征选择最优的用药时间提供理论基础。方法：选择原发性肾病综合征患者90例,随机分为观察组和对照组,每组各45例。两组均给予西医常规治疗,对照组加用真武汤合五苓散汤剂,分早晚餐前口服；观察组加用真武汤合五苓散汤剂,下午3点顿服,疗程为3周。随访1月,观察两组治疗前后治疗有效率,临床症状评分,SCr、 ALB、24 h尿蛋白定量、血脂等生化指标。结果：观察组总有效率(91.1%)高于对照组(86.7%),差异无统计学意义(P=0.502)；观察组和对照组治疗后血肌酐、总胆固醇、甘油三酯和24 h尿蛋白定量均明显下降,血清白蛋白明显上升,差异具有统计学意义(P<0.001)；但观察组血肌酐、总胆固醇、甘油三酯和24 h尿蛋白定量治疗后降低值明显高于对照组,血清白蛋白升高值明显高于对照组,且具有统计学差异(P<0.001)。观察组全身水肿消退时间(8.7±2.4)d小于对照组(10.3±2.8)d,差异具有统计学意义(P<0.01)；观察组和对照组治疗后临床症状评分均有明显降低,差异具有统计学意义(P<0.05)。观察组治疗前后的临床症状评分降低值明显高于对照组,且差异具有统计学意义(P<0.001)。结论：肾、膀胱经开时(下午3点)服用真武汤合五苓散汤剂治疗肾病综合征疗效优于传统服药时间,肾、膀胱经开时时间是真武汤合五苓散合剂治疗肾病综合征疗效最佳时间。
목적：：탐구관찰신경、방광경개합시간여중의치료신병종합정료효적관계,위중의약물치료신병종합정선택최우적용약시간제공이론기출。방법：선택원발성신병종합정환자90례,수궤분위관찰조화대조조,매조각45례。량조균급여서의상규치료,대조조가용진무탕합오령산탕제,분조만찬전구복；관찰조가용진무탕합오령산탕제,하오3점돈복,료정위3주。수방1월,관찰량조치료전후치료유효솔,림상증상평분,SCr、 ALB、24 h뇨단백정량、혈지등생화지표。결과：관찰조총유효솔(91.1%)고우대조조(86.7%),차이무통계학의의(P=0.502)；관찰조화대조조치료후혈기항、총담고순、감유삼지화24 h뇨단백정량균명현하강,혈청백단백명현상승,차이구유통계학의의(P<0.001)；단관찰조혈기항、총담고순、감유삼지화24 h뇨단백정량치료후강저치명현고우대조조,혈청백단백승고치명현고우대조조,차구유통계학차이(P<0.001)。관찰조전신수종소퇴시간(8.7±2.4)d소우대조조(10.3±2.8)d,차이구유통계학의의(P<0.01)；관찰조화대조조치료후림상증상평분균유명현강저,차이구유통계학의의(P<0.05)。관찰조치료전후적림상증상평분강저치명현고우대조조,차차이구유통계학의의(P<0.001)。결론：신、방광경개시(하오3점)복용진무탕합오령산탕제치료신병종합정료효우우전통복약시간,신、방광경개시시간시진무탕합오령산합제치료신병종합정료효최가시간。
Objective: To investigate the effect of TCM treatment on nephrotic syndrome at the time of opening-closing of Shaoyin kidney and Taiyang bladder meridian, and to provide theoretical basis for optimal medication timing for TCM treatment against nephrotic syndrome. Methods: 90 patients with primary nephrotic syndrome were randomly divided into observation group(Group A) and control group (Group B), with 45 cases in each group. Two groups were given conventional western medicine treatment. The group B additionally took Zhenwu decoction and Wuling powder before breakfast and dinner each day for three weeks, and the group A additionally took Zhenwu decoction and Wuling powder at 15 o'clock each day for three weeks. With one month follow-up, treatment efficacy, clinical symptom scores, SCr, ALB, 24 h urine protein, blood lipids and other quantitative biochemical indicators of the two groups were observed before and after of the treatment. Results:The treatment efficacy rate of group A(91.1%) is higher than that of control group B (86.7%), (P= 0.502). After treatment, serum creatinine, total cholesterol, triglycerides, and 24 h urine protein of the two groups were significantly decreased, and quantitative serum albumin was significantly increased (P < 0.001); both the two changes were more significant in group A than in group B (P< 0.001). Anasarca fade time of the group A was shorter than that of the group B (P< 0.01). The clinical symptom scores of the two groups decreased significantly after treatment (P< 0.05) and the decrease value of group A was significantly higher than that of group B (P <0.001). Conclusion: The time when the Shaoyin kidney and Taiyang bladder meridian are open (3 pm), is the optimal medication timing for TCM treatment of nephrotic syndrome.