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应勤丽,余雪飞,王洪白,郑琼飞.隔药饼灸联合防己茯苓汤治疗重症感染所致急性肾损伤的疗效观察[J].湖南中医药大学学报,2021,41(11):1772-1776[点击复制] |
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| 隔药饼灸联合防己茯苓汤治疗重症感染所致急性肾损伤的疗效观察 |
| 应勤丽,余雪飞,王洪白,郑琼飞 |
| (重庆市黔江中心医院, 重庆 409000) |
| 摘要: |
| 目的 探讨隔药饼灸联合防己茯苓汤治疗重症感染所致急性肾损伤（acute kidney injury，AKI）的疗效。方法 选择2018年2月至2020年9月我院收治的60例重症感染所致AKI患者，随机数字表法分为对照组和观察组，各30例。对照组采用抗感染、血液净化和维持电解质平衡等基础治疗以及防己茯苓汤中药治疗28 d；观察组在对照组基础上给予隔药饼灸治疗28 d。观察比较两组的疗效、不良反应和病死率以及治疗前、后中医症候积分、肾功能、炎性因子差异。结果 观察组治疗有效率高于对照组（P<0.05）；两组治疗后恶心呕吐、食少纳呆、身重困倦、脘腹胀满、小便不利中医症候积分，血尿素氮（blood urea nitrogen，BUN）、血肌酐（serum creatinine，SCr）、肾损伤分子-1（kidney injury molecule-1，KIM-1）、中性粒细胞明胶酶相关脂质运载蛋白（neutrophil gelatinase-associated lipid carrier protein，NGAL）、肿瘤坏死因子-α（tumor necrosis factor-α，TNF-α）、白介素-1β（interleukin 1 β，IL-1β）、白介素-6（Interleukin-6，IL-6）、C反应蛋白（C-reactive protein，CRP），尿白蛋白排泄率（urine albumer excretion rate，UAER）水平均较治疗前降低（P<0.05），观察组治疗后恶心呕吐、食少纳呆、身重困倦、脘腹胀满、小便不利中医症候积分，BUN、SCr、KIM-1、NGAL、TNF-α、IL-1β、IL-6、CRP，UAER水平低于对照组（P<0.05）。观察组病原菌清除率高于对照组（P<0.05），病死率低于对照组（P<0.05），两组不良反应发生率比较，差异无统计学意义（P>0.05）。结论 隔药饼灸联合防己茯苓汤可有效地降低重症感染所致AKI患者炎性反应水平，改善肾功能和临床症状，提高临床治疗效果。 |
| 关键词: 急性肾损伤 隔药饼灸 防己茯苓汤 感染 肾功能 炎性因子 |
| DOI：10.3969/j.issn.1674-070X.2021.11.021 |
| 投稿时间：2021-06-17 |
| 基金项目:重庆市科卫联合中医药技术创新与应用发展项目（2020ZY023694）。 |
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| Observation on the Curative Effect of Medicine Cake Moxibustion Combined with Fangji Fuling Decoction in the Treatment of Acute Kidney Injury Caused by Severe Infection |
| YING Qinli,YU Xuefei,WANG Hongbai,ZHENG Qiongfei |
| (Chongqing Qijiang Central Hospital, Chongqing 409000) |
| Abstract: |
| Objective To explore the curative effect of medicine cake moxibustion combined with Fangji Fuling Decoction in the treatment of acute kidney injury (AKI) caused by severe infection. Methods A total of 60 AKI patients with severe infection admitted to our hospital from February 2018 to September 2020 were selected and divided into two groups by random number table method. The control group (30 cases) was treated 28 days with anti-infection, blood purification, maintaining electrolyte balance and Fangji Fuling Decoction, the observation group (30 cases) was treated 28 days with medicine cake moxibustion on the basis of the control group. Therapeutic effect adverse reactions and mortality of two groups were observed and compared, TCM syndrome score, renal function, inflammatory factors were compared between the two groups. Results The effective rate of the observation group was higher than that of the control group (P<0.05). After treatment, TCM syndrome score (nausea and vomiting, indigestion and loss of appetite, heavy body and drowsiness, abdominal distension, adverse urination), serum blood urea nitrogen (BUN), serum creatinine (SCr), kidney injury molecule-1 (KIM-1), neutrophil gelatinase-associated lipid carrier protein (NGAL), tumor necrosis factor-α (TNF-α), interleukin 1β (IL-1β), interleukin-6 (IL-6), C-reactive protein (CRP), and urine albumer excretion rate (UAER) levels decreased than those of before treatment (P<0.05). After treatment, TCM syndrome score (nausea and vomiting, indigestion and loss of appetite, heavy body and drowsiness, abdominal distension, adverse urination) and BUN, SCr, KIM-1, NGAL, TNF-α, IL-1β, IL-6, CRP, and UAER levels of observation group were lower than those of the control group (P<0.05). The clearance rate of pathogen in observation group was higher than that in control group (P<0.05), the fatality rate of the observation group was lower than that of the control group (P<0.05), and there was no significant difference in the adverse reaction rate between the two groups (P>0.05). Conclusion The combination of medicine cake moxibustion combined with Fangji Fuling Decoction can effectively inhibit the level of inflammatory response in AKI patients with severe infection, improve renal function and clinical symptoms, and improve the clinical treatment effect. |
| Key words: acute kidney injury medicine cake moxibustion Fangji Fuling Decoction infection renal function inflammatory factor |
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