补肾泄毒颗粒治疗慢性肾衰的疗效观察及对血清PTH、EPO的影响
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摘要
慢性肾功能衰竭是多种肾脏疾病发展的最终结局,是临床常见的疑难病。研究包括中医药治疗在内的慢性肾衰非透析疗法以延缓病情发展具有十分重要的意义。
本论文主要包括文献研究、经验继承和临床研究三部分。
文献研究部分有二篇。第一篇“慢性肾衰的中医研究进展”主要介绍中医对慢性肾衰的认识、中医临床治疗慢性肾衰现状和有关中药作用机理研究的进展。中医学无“慢性肾功能衰竭”的名词,但古代文献中的“癃闭”、“肾风”、“关格”所描述的病症,与慢性肾衰患者的临床表现是很相似的。中医认为本病进展有内外两方面的因素:内因主要为肾气不足,外因多为外感六淫之邪、皮肤疮毒、肾毒性药物侵犯肾脏。肾病既久,失治误治,导致肾阳衰微,真阴亏耗,致使肾脏本身功能日益衰退,气血阴阳虚惫,肺脾心肝为之虚损,属本虚标实、虚实夹杂之证。其治疗主要包括中医辨证论治,基本方基础上随症加减,单味药及有效成分(主要为大黄和冬虫夏草),其它疗法如灌肠疗法、中药结肠透析、药浴及泡足疗法、中药穴位外敷法、隔药灸疗、超声激光疗法等。中医药治疗慢性肾衰的作用机理主要集中在抑制肾小球系膜细胞的异常增殖及细胞外基质的过度积聚、调控细胞凋亡、调节血管活性物质、影响细胞因子、改善肾小球血液动力学、清除氧自由基等几个方面。
第二篇“慢性肾衰的现代医学认识及相关研究进展”主要介绍了现代医学对慢性肾衰的有关认识,尤其是慢性肾衰非透析治疗的临床现状。慢性肾衰病因分原发性和继发性肾脏病两大类,原发性肾脏病主要有慢性肾小球肾炎、慢性肾盂肾炎、慢性间质性肾炎等,继发性肾脏病主要有代谢异常所致的肾脏损害、血管性病变、遗传性肾病、中毒性肾病及梗阻性肾病等。其发病机理主要包括健存肾单位学说、矫枉失衡学说、肾小球高滤过学说、肾小管高代谢学说、脂代谢紊乱学说、尿毒症毒素学说等,近年来则认为细胞因子和生长因子在慢性肾衰进展中也扮演着重要的角色。其治疗主要为慢性肾衰的一体化治疗,主要包括饮食控制与营养疗法、全身及肾小球局部高压的控制、抗凝和抗血小板治疗、降脂治疗等。
经验继承部分,题为“导师聂莉芳教授治疗慢性肾衰的临床经验”。主要从慢性肾衰的中医病名分期、病因病机、治疗方法等方面总结整理导师聂莉芳教授治疗慢性肾衰的临床经验。导师通过病名的整理研究,认为慢性肾衰的中医病名以关格较为恰当,因为它集中地突出了慢性肾衰终末期,由于正虚至极,枢机不利,气机升降失司,三焦壅塞这一病理机转所反映的临床特点。同时关格一病,历代医家向来认为是疑难重症,这对于判断预后是有一定意义的。导师认为慢性肾衰的病因有主因与诱因之分。主因多系脾肾虚损,与先天不足、饮食失常、七情内伤、久病失治、房劳过度等多种因素耗伤正气有关,其中尤以肾气衰惫,分清泌浊失职,致使湿浊内停为主;诱因则责之外邪与过劳。导师将慢性肾衰的中医病机概括为本虚标实、寒热错杂、病位广泛,其中本虚标实、正虚邪实为本病的病机中心。鉴于慢性肾衰在病程中有虚实主次及标本缓急之异,导师于1984年在国内率先提出了对关格病中医临床分期的学术观点,将关格病(慢性肾衰)分为虚损期、关格期两期。导师认为分期对临床具有重要的指导意义:①对其病机、临床表现特点及发展变化的规律等方面的认识具有整体观念,从而对论治具有整体性的指导意义;②有利于关格病辨证论治的规范化研究及治疗方案的优化;③有利于对预后的判断。导师临床治疗本病的思路是:首辨病期,然后细细辨证,将辨病期与辨证有机地结合起来,继之选择治法与相应的方药。而且还强调病期与证型可分而不可定,应同时注意其动态变化的情况。导师强调气阴两虚在慢性肾衰虚损期中最为多见,在此基础上,同时要细辨究竟是心肾气阴两虚、肺肾气阴两虚、脾肾气阴两虚、肾气阴两虚、肝肾气阴两虚其中的哪一种类型,同时在气阴两虚的程度方面又细分为气阴两虚偏于气虚、气阴两虚偏于阴虚、气阴两虚并重三种情况。之后,在临床上根据患者的实际情况予以恰如其分的治疗。导师认为关格期是慢性肾衰的终末期阶段,患者的临床表现具有典型的下关上格的关格病特征,病机特点以湿浊、湿热中阻为主,治法则当以救治脾胃为主。导师强调针对上格,调理脾胃法疗效可靠,常可转危为安。
临床研究部分,题为“补肾泄毒颗粒治疗慢性肾衰的疗效观察及对血清EP0和PTH的影响”。目的:观察补肾泄毒颗粒(导师经验方)治疗慢性肾衰的临床疗效及对血清EPO和PTH的影响。方法:纳入60例慢性肾衰患者,按照2:1比例,随机分为治疗组(40例)和对照组(20例),治疗组给予补肾泄毒颗粒,对照组给予尿毒清冲剂,两组患者均予基础治疗(包括饮食及对症治疗)。1个月为1个疗程,共治疗2个疗程。观测临床症状、肾功能、血红蛋白(Hb)和红细胞压积(HCT)变化,并观察补肾泄毒颗粒治疗43例患者治疗前后血清甲状旁腺激素(PTH)和促红细胞生成素(EPO)的变化。结果:在疾病疗效方面,治疗组总有效率为80.75%,对照组为65.00%,两组之间有显著性差异,P＜0.05,提示在疾病疗效方面,治疗组显著优于对照组。在中医证候疗效方面,治疗组总有效率为87.50%,高于对照组55.00%,有显著性差异,p＜0.05。两组病人经治疗后,血红蛋白水平和红细胞压积显著提高,血肌酐、血尿素氮水平显著降低,且治疗组作用优于对照组,有显著性差异,p＜0.05,p＜0.01。经补肾泄毒颗粒治疗后,43例慢性肾衰伴有肾性贫血的患者的血清EPO水平明显升高,与治疗前比较有显著性差异,P＜0.01,治疗后血清PTH、P均有明显下降,而Ca升高,与治疗前比较有显著性差异,P＜0.01。结论:补肾泄毒颗粒不仅能够显著改善慢性肾衰患者的临床症状和体征,改善肾功能,纠正肾性贫血和升高血清EPO水平,并具有抑制慢性肾衰患者高PTH血症,调节钙磷代谢失调的作用,延缓慢性肾衰的病程进展。
Chronic renal failure, being a common obstinate disease clinically, is the ultimate outcome of multiple renal diseases. The study of non-dialysis therapy for chronic renal failure, including the application of traditional Chinese medicine, has significant meaning in delay the development of disease progress.
This study consists three main part including reference research, experience inheriting and clinical research.
In the reference research part, there were two major references. The first one, "The study development of therapy approach for chronic renal failure using Traditional Chinese Medicine", mainly introduced the opinion of Traditional Chinese Medicine for chronic renal failure, the current situation of chronic renal failure therapy using TCM clinically and the development of mechanism for Chinese herbal medicine functioning. The second reference, "the related research development of opinion in modern medicine for chronic renal failure", mainly discussed the opinions for chronic renal failure in the angle of modern medicine, and especially highlighted the current clinical situation of non-dialysis therapy for chronic renal failure.
In the experience inheriting part, named after "Clinical experience in chronic renal failure therapy of Prof. Lifang Nie". In this part, we discussed the disease name and stage in Traditional Chinese Medicine, etiology and pathogenesis, therapy method for chronic renal failure, and summarized the clinical experience of Professor Lifang Nie in treatment of chronic renal failure. My tutor thinks that it is more appropriate to name chronic renal failure as GuanGe in TCM through the collation of disease research.And tutor believes that the cause of chronic renal failure include primary cause and remote cause. The clinical approach of my tutor treating chronic renal failure is discrimination of the disease period at first, and then careful differentiation, combination of above both finally.
In the study part, named as "the observation on therapeutic effect and impact on serum EPO and PTH after application of Bu-shen-xie-du granule in therapy of chronic renal failure". Objective: To observe the clinical effect and impact on serum EPO and PTH in renal failure patient after using Bu-shen-xie-du granule (experience preparation of supervisor). Method, There were 60 chronic renal failure cases which was randomly divided into two groups with 2:1 proportion: therapy group (40 cases) and control group (20 cases). Bu-shen-xie-du granule was applied for the therapy group, and Niao-du-qing granule for control group. For all patients in both groups, they accepted same basic therapy (including diet and symptomatic treatment). The treatment course was 8 weeks, the changes in clinical symptom, renal function, hemoglobin (Hb) and hematocrit (HCT) were observed. We also detected the serum PTH and EPO before and after the application of Bu-shen-xie-du granule in treatment of chronic renal failure (n=43). Result: the total effective rate was 80.75% in therapy group, and 65.00% in control group, with significant difference between two groups, P<0.05, which suggested the better effect of therapy group compared with control group. In the treatment of syndrome, the overall effect rate in therapy group was 87.50%, higher than the 55.00% in control, with significant difference, P<0.05. After the treatment in both groups, the hemoglobin level and hematocrit were prominently elevated, serum creatine and BUN level were decreased obviously, but the effect in therapy group was better than control group with significant difference, P<0.05, P<0.01. After treatment with Bu-shen-xie-du granule, the chronic renal failure patients with renal anemia (n=43) has shown elevation of serum EPO level, with significant difference compared with before treatment, P<0.01. After therapy, the serum PTH was significantly decreased accompanied with the elevation of calcium level, which proved to have significant difference, P<0.01. Conclusion: Bu-shen-xie-du granule not only has the effect to improve the clinical symptom and physical sign for chronic renal failure patients, improve renal function and correct renal anemia as well as elevate EPO level, but also can inhibit the high PTH disease in chronic renal failure patients, modulate the disordered calcium-phosphate metabolism, and delay the progress of chronic renal failure.
本论文主要包括文献研究、经验继承和临床研究三部分。
文献研究部分有二篇。第一篇“慢性肾衰的中医研究进展”主要介绍中医对慢性肾衰的认识、中医临床治疗慢性肾衰现状和有关中药作用机理研究的进展。中医学无“慢性肾功能衰竭”的名词,但古代文献中的“癃闭”、“肾风”、“关格”所描述的病症,与慢性肾衰患者的临床表现是很相似的。中医认为本病进展有内外两方面的因素:内因主要为肾气不足,外因多为外感六淫之邪、皮肤疮毒、肾毒性药物侵犯肾脏。肾病既久,失治误治,导致肾阳衰微,真阴亏耗,致使肾脏本身功能日益衰退,气血阴阳虚惫,肺脾心肝为之虚损,属本虚标实、虚实夹杂之证。其治疗主要包括中医辨证论治,基本方基础上随症加减,单味药及有效成分(主要为大黄和冬虫夏草),其它疗法如灌肠疗法、中药结肠透析、药浴及泡足疗法、中药穴位外敷法、隔药灸疗、超声激光疗法等。中医药治疗慢性肾衰的作用机理主要集中在抑制肾小球系膜细胞的异常增殖及细胞外基质的过度积聚、调控细胞凋亡、调节血管活性物质、影响细胞因子、改善肾小球血液动力学、清除氧自由基等几个方面。
第二篇“慢性肾衰的现代医学认识及相关研究进展”主要介绍了现代医学对慢性肾衰的有关认识,尤其是慢性肾衰非透析治疗的临床现状。慢性肾衰病因分原发性和继发性肾脏病两大类,原发性肾脏病主要有慢性肾小球肾炎、慢性肾盂肾炎、慢性间质性肾炎等,继发性肾脏病主要有代谢异常所致的肾脏损害、血管性病变、遗传性肾病、中毒性肾病及梗阻性肾病等。其发病机理主要包括健存肾单位学说、矫枉失衡学说、肾小球高滤过学说、肾小管高代谢学说、脂代谢紊乱学说、尿毒症毒素学说等,近年来则认为细胞因子和生长因子在慢性肾衰进展中也扮演着重要的角色。其治疗主要为慢性肾衰的一体化治疗,主要包括饮食控制与营养疗法、全身及肾小球局部高压的控制、抗凝和抗血小板治疗、降脂治疗等。
经验继承部分,题为“导师聂莉芳教授治疗慢性肾衰的临床经验”。主要从慢性肾衰的中医病名分期、病因病机、治疗方法等方面总结整理导师聂莉芳教授治疗慢性肾衰的临床经验。导师通过病名的整理研究,认为慢性肾衰的中医病名以关格较为恰当,因为它集中地突出了慢性肾衰终末期,由于正虚至极,枢机不利,气机升降失司,三焦壅塞这一病理机转所反映的临床特点。同时关格一病,历代医家向来认为是疑难重症,这对于判断预后是有一定意义的。导师认为慢性肾衰的病因有主因与诱因之分。主因多系脾肾虚损,与先天不足、饮食失常、七情内伤、久病失治、房劳过度等多种因素耗伤正气有关,其中尤以肾气衰惫,分清泌浊失职,致使湿浊内停为主;诱因则责之外邪与过劳。导师将慢性肾衰的中医病机概括为本虚标实、寒热错杂、病位广泛,其中本虚标实、正虚邪实为本病的病机中心。鉴于慢性肾衰在病程中有虚实主次及标本缓急之异,导师于1984年在国内率先提出了对关格病中医临床分期的学术观点,将关格病(慢性肾衰)分为虚损期、关格期两期。导师认为分期对临床具有重要的指导意义:①对其病机、临床表现特点及发展变化的规律等方面的认识具有整体观念,从而对论治具有整体性的指导意义;②有利于关格病辨证论治的规范化研究及治疗方案的优化;③有利于对预后的判断。导师临床治疗本病的思路是:首辨病期,然后细细辨证,将辨病期与辨证有机地结合起来,继之选择治法与相应的方药。而且还强调病期与证型可分而不可定,应同时注意其动态变化的情况。导师强调气阴两虚在慢性肾衰虚损期中最为多见,在此基础上,同时要细辨究竟是心肾气阴两虚、肺肾气阴两虚、脾肾气阴两虚、肾气阴两虚、肝肾气阴两虚其中的哪一种类型,同时在气阴两虚的程度方面又细分为气阴两虚偏于气虚、气阴两虚偏于阴虚、气阴两虚并重三种情况。之后,在临床上根据患者的实际情况予以恰如其分的治疗。导师认为关格期是慢性肾衰的终末期阶段,患者的临床表现具有典型的下关上格的关格病特征,病机特点以湿浊、湿热中阻为主,治法则当以救治脾胃为主。导师强调针对上格,调理脾胃法疗效可靠,常可转危为安。
临床研究部分,题为“补肾泄毒颗粒治疗慢性肾衰的疗效观察及对血清EP0和PTH的影响”。目的:观察补肾泄毒颗粒(导师经验方)治疗慢性肾衰的临床疗效及对血清EPO和PTH的影响。方法:纳入60例慢性肾衰患者,按照2:1比例,随机分为治疗组(40例)和对照组(20例),治疗组给予补肾泄毒颗粒,对照组给予尿毒清冲剂,两组患者均予基础治疗(包括饮食及对症治疗)。1个月为1个疗程,共治疗2个疗程。观测临床症状、肾功能、血红蛋白(Hb)和红细胞压积(HCT)变化,并观察补肾泄毒颗粒治疗43例患者治疗前后血清甲状旁腺激素(PTH)和促红细胞生成素(EPO)的变化。结果:在疾病疗效方面,治疗组总有效率为80.75%,对照组为65.00%,两组之间有显著性差异,P＜0.05,提示在疾病疗效方面,治疗组显著优于对照组。在中医证候疗效方面,治疗组总有效率为87.50%,高于对照组55.00%,有显著性差异,p＜0.05。两组病人经治疗后,血红蛋白水平和红细胞压积显著提高,血肌酐、血尿素氮水平显著降低,且治疗组作用优于对照组,有显著性差异,p＜0.05,p＜0.01。经补肾泄毒颗粒治疗后,43例慢性肾衰伴有肾性贫血的患者的血清EPO水平明显升高,与治疗前比较有显著性差异,P＜0.01,治疗后血清PTH、P均有明显下降,而Ca升高,与治疗前比较有显著性差异,P＜0.01。结论:补肾泄毒颗粒不仅能够显著改善慢性肾衰患者的临床症状和体征,改善肾功能,纠正肾性贫血和升高血清EPO水平,并具有抑制慢性肾衰患者高PTH血症,调节钙磷代谢失调的作用,延缓慢性肾衰的病程进展。
Chronic renal failure, being a common obstinate disease clinically, is the ultimate outcome of multiple renal diseases. The study of non-dialysis therapy for chronic renal failure, including the application of traditional Chinese medicine, has significant meaning in delay the development of disease progress.
This study consists three main part including reference research, experience inheriting and clinical research.
In the reference research part, there were two major references. The first one, "The study development of therapy approach for chronic renal failure using Traditional Chinese Medicine", mainly introduced the opinion of Traditional Chinese Medicine for chronic renal failure, the current situation of chronic renal failure therapy using TCM clinically and the development of mechanism for Chinese herbal medicine functioning. The second reference, "the related research development of opinion in modern medicine for chronic renal failure", mainly discussed the opinions for chronic renal failure in the angle of modern medicine, and especially highlighted the current clinical situation of non-dialysis therapy for chronic renal failure.
In the experience inheriting part, named after "Clinical experience in chronic renal failure therapy of Prof. Lifang Nie". In this part, we discussed the disease name and stage in Traditional Chinese Medicine, etiology and pathogenesis, therapy method for chronic renal failure, and summarized the clinical experience of Professor Lifang Nie in treatment of chronic renal failure. My tutor thinks that it is more appropriate to name chronic renal failure as GuanGe in TCM through the collation of disease research.And tutor believes that the cause of chronic renal failure include primary cause and remote cause. The clinical approach of my tutor treating chronic renal failure is discrimination of the disease period at first, and then careful differentiation, combination of above both finally.
In the study part, named as "the observation on therapeutic effect and impact on serum EPO and PTH after application of Bu-shen-xie-du granule in therapy of chronic renal failure". Objective: To observe the clinical effect and impact on serum EPO and PTH in renal failure patient after using Bu-shen-xie-du granule (experience preparation of supervisor). Method, There were 60 chronic renal failure cases which was randomly divided into two groups with 2:1 proportion: therapy group (40 cases) and control group (20 cases). Bu-shen-xie-du granule was applied for the therapy group, and Niao-du-qing granule for control group. For all patients in both groups, they accepted same basic therapy (including diet and symptomatic treatment). The treatment course was 8 weeks, the changes in clinical symptom, renal function, hemoglobin (Hb) and hematocrit (HCT) were observed. We also detected the serum PTH and EPO before and after the application of Bu-shen-xie-du granule in treatment of chronic renal failure (n=43). Result: the total effective rate was 80.75% in therapy group, and 65.00% in control group, with significant difference between two groups, P<0.05, which suggested the better effect of therapy group compared with control group. In the treatment of syndrome, the overall effect rate in therapy group was 87.50%, higher than the 55.00% in control, with significant difference, P<0.05. After the treatment in both groups, the hemoglobin level and hematocrit were prominently elevated, serum creatine and BUN level were decreased obviously, but the effect in therapy group was better than control group with significant difference, P<0.05, P<0.01. After treatment with Bu-shen-xie-du granule, the chronic renal failure patients with renal anemia (n=43) has shown elevation of serum EPO level, with significant difference compared with before treatment, P<0.01. After therapy, the serum PTH was significantly decreased accompanied with the elevation of calcium level, which proved to have significant difference, P<0.01. Conclusion: Bu-shen-xie-du granule not only has the effect to improve the clinical symptom and physical sign for chronic renal failure patients, improve renal function and correct renal anemia as well as elevate EPO level, but also can inhibit the high PTH disease in chronic renal failure patients, modulate the disordered calcium-phosphate metabolism, and delay the progress of chronic renal failure.
引文
[1]庚及弟.慢性肾衰脂质肾毒性与中医浊毒病机相关性研究.中国中医药信息杂志,200,8(1):34
[2]陆晓东,郑平东.治疗慢性肾衰的经验.辽宁中医学院学报,2001,3(1):26
[3]傅文录,时振声教授辨治慢性肾衰的思维方法浅析.中医药研究,1994,(4):3
[4]张大宁主编.实用中医肾病学.中国医药科技出版社,1990,485-486
[5]刘洲,洪钦国教授辨证论治慢性肾衰经验.新中医,1996,28(1):40
[6]洪用森等.慢性肾衰的辨证分型和治疗.中华肾脏病杂志,1991,7(5):36
[7]王永钧.慢性肾衰的中医认识及对策.浙江中医杂志,1993,28(2):49
[8]王少华,张晶瑜,王彬.试论慢性肾功能衰竭正虚邪实之病机.上海中医药大学学报,2004,18(2):31-32
[9]周硕果,王自敏.王自敏教授治疗慢性肾衰竭临床经验.中国中西医结合肾病杂志,2004,5(5):251-254
[8]全国中医肾衰研讨会.慢性肾衰中医辨证分型和疗效判定信息.中医药信息,1991,(2):27
[9]傅文录,时振声教授辨治慢性肾衰的思维方法浅析.中医药研究,1994,(4):3
[10]张大宁主编.实用中医肾病学.中国医药科技出版社,1990,485-490
[11]张金玺.杜雨茂教授治疗肾病经验述略.国医论坛,1999,14(2):20
[12]候丕华.梁贻俊教授论治慢性肾衰的经验.新中医,2000,32(1):10
[13]洪用森.慢性肾衰的辨证分型和治疗.中华肾脏病杂志,1991,7(5):36
[14]许家松.方药中对慢性肾衰的理论认识和诊治经验.中医杂志,1991,22(12):11
[15]叶玉妹.叶景华治疗慢性肾功能衰竭经验.辽宁中医杂志,2006,33(3):264-265
[16]徐俊业.大黄附子汤治疗慢性肾功能不全46例.成都中医药大学学报,1999,22(2)23-24
[17]莫美霞.补肾排浊汤治疗慢性肾功能衰竭30例观察.湖南中医学院学报,1999,19(2):36-37
[18]王振岗.化湿降浊解毒汤治疗慢性肾功能衰竭40例.陕西中医,2005,26(12):31
[19]陈东河.补血生髓丸治疗肾性贫血56例.天津中医,2000,17(3):封四
[20]李深,饶向荣,戴希文.益肾缓衰方治疗慢性肾功能衰竭35例远期疗效观察.中医杂志,2001,42(3):164-166
[21]管竞环.大黄静脉注射治疗慢性肾功能不全23例临床疗效观察临床内科杂志.1985,(1):38
[22]王锋,闫忠华,翟秋根.卡托普利和大黄治疗慢性肾功能衰竭23例临床观察.中西医结合实用临床急救 1999,6(4):182
[23]管益君.冬虫夏草对慢性肾功能衰竭患者 T 细胞亚群的影响.中国中西医结合杂志,1992,12(6):338-339
[24]井芝春,张惠莉.人工培养冬虫夏草对慢性肾衰患者蛋白质代谢的改善,青海医药杂志,2000,30(5):13-144.
[25]魏明刚.冬虫夏草治疗肾性贫血的临床研究.中华实用中西医杂志,2004,(11):796-797.
[26]刘爱珍,陈荣鸾.黄芪注射液治疗慢性肾衰竭的临床观察.中国中西医结合肾病杂志,2002,3(3):172。
[27]吴会玉,黄雪霞,史伟田.七注射液治疗慢性肾功能衰竭疗效观察.辽宁中医杂志,2005,32(12):1228-1229.
[28]项红秀,王学玉,胡海云,等.灯盏细辛注射液治疗慢性肾功能衰竭疗效观察.河北医药,2006,28(3):733
[29]卞华.李学铭教授治疗慢性肾衰的经验.国医论坛,2002,17(4):14
[30]李海聪.内服中药加灌肠治疗慢性肾衰疗效观察.北京中医药大学学报,1998,21(5):45-47
[31]陶筱娟.泄浊排钾方高位结肠灌肠抢救慢性肾衰高血钾症.中国中医药信息杂志,1998,5(12):38
[32]戴西湖.治疗慢性肾衰的方药分析.中医杂志,1986,27(5):64
[33]吉勤,张春艳,王清.中药结肠透析对慢性肾衰竭的影响.中国中西医结合肾病杂志,2007,8(12):726-728
[34]孙建实.中药药浴治疗尿毒症20例疗效观察.浙江中医杂志,1994,29(3):134
[35]卢守谦.中医”浴汗法”治疗慢性肾衰.中国医药学报,1989(3):45-46
[36]李汉友.尿毒膏外治慢性肾衰24例疗效观察.中医外治杂志,1996,(2):7
[37]王红,仝小林.肾区中药热熨治疗慢性肾衰90例.中医外治杂志,1996,(3):64
[38]夏滨祥.外敷降压膏治疗慢性肾衰高血压]8例.黑龙江中医药,1991,(5):43-44
[39]王志萍.隔药灸结合血透治疗慢性肾功能衰竭疗效观察.中国针灸,2000,20(3):136
[40]彭敏球.黄芪注射液低能量氦氖激光血管内照射术二联疗法治疗慢性肾衰临床疗效观察.第五届全国中西医结合肾脏病学术交流会论文集,1999,226-227
[41]王海燕.肾脏病学.北京:人民卫生出版社,1996,475-476
[42]王景明,孙奕,叶传惠.中药肾衰宁对体外培养人肾小球系膜细胞增殖及产生白介素-8的影响.中国中西医结合急救杂志,2000,7(4):197-199
[43]徐大基,杨霓芝,雷娓娓.尿毒康治疗慢性肾功能衰竭动物模型的肾脏病理形态学观察.福建中医药,1999,30(6):37-38
[44]徐晓利,马润家.医学生物化学.北京:人民卫生出版社,1998,852-874
[45]何立群,高建东,郑平东.肾衰冲剂缓解5/6肾切除大鼠肾小球硬化的实验研究.中国中医药信息杂志,2002,9(2):22-23
[46]Shimizu A,Kitamura S,Masuda Y et al.Apotosis in the repair processes of experimental proliferation glomerulonephritis.Kidney Int.1995,47:121-123
[47]揣冰,丁樱,吴力群.肾必宁对大鼠系膜增生性肾小球肾炎肾小球细胞凋亡及bax,bcl-2表达的影响.中国中西医结合肾病杂志,2003,4(6):316-318
[48]李海涛,李晓冬,朱荃,等.紫草素对人胎肾系细胞凋亡的影响.药学进展,2001,25(6):367-369
[49]余学清,李惠群,叶任高,等.慢性肾脏疾病患者尿中内皮素变化及其临床意义.中华肾脏病杂志,1995,11(2):91-93
[50]孙万森,乔成林,程伟,等.绞股蓝总皂甙对慢性肾功不全大鼠血浆内皮素含量和肾功能的影响.中国危重病急救医学,1998,10(5):268-269
[51]马建伟,刘占民,徐丽梅,等.滋肾活血解毒方对慢性肾功衰竭大鼠 TGF-β、ET-1mRNA 的影响.北京中医,2001,20(3):45-47
[52]陈朝红,刘志红,王庆文,等.血管紧张素转化酶基因多态性在终末期肾功能衰竭患者中的分布及其意义.中华肾脏病杂志,1997,13(1):22
[53]王怡,何立群,郑平东.抗纤灵冲剂改善慢性肾衰实验兔血液动力学及肾小球硬化的研究.上海中医药大学学报,2000,14(2):47-49
[54]钟慈声.一氧化氮的生物医学.上海:上海医科大学出版社,1997.257
[55]黄怀鹏,陈志强,王虹.雷公藤对肾小球系膜细胞增殖及其分泌 NO、NOS 影响的实验研究.山东中医药大学学报,2001,25(3):222-223
[56]湛冯岚.TGF-β与肾脏病的研究新进展.国外医学·泌尿分册,1999,19(6):280
[57]刘志红.转化生长因子及大黄酸对肾小球系膜细胞葡萄糖转运蛋白功能的影响.中华医学杂志,1999,79(10):780-783
[58]赖雁妮,俞茂华,朱秋毓,等.黄芪多糖对糖尿病大鼠肾组织转化生长因子β_1的影响.复旦学报(医学版),2002,29(4):255-257
[59]Baud L,Ardaillou R.Tumor necrosis factor alpha in glomerular injury.Kidney Int.1994,45(5):32-26
[60]易明娟,章崇立,谢子清,等.复方大黄注射液对肾小球系膜细胞增殖及产生细胞因子的影响.中药药理与临床,1993,13(4):33-34
[61]刘云海.川芎嗪对慢性肾衰患者肾血流量及肌酐清除率的影响.中国中西医结合杂志,1993,13(2):107
[62]王海燕,郑法雷,刘玉春,等.原发性肾小球疾病分型与治疗及诊断标准.中华内科杂志,1993,32(1):131-134
[63]朱辟疆,周逊,韦先进.保元强肾Ⅱ号对慢性肾功能衰竭血浆及尿 SOD、MDA 的影响.中华肾脏病杂志,1997,17(11):649-651
[64]袁发焕,廖立生.慢性肾衰大鼠组织内炎性细胞浸润机理探讨.四川医学,1993,(10):599-600
[1]Fouque D,Wang P,Laville M,et al.Low protein diets for chronic renal failure in non diabetic adults.Cochrane Database Syst Rev,2001,(2):CD001892
[2]Ideura T,Shimazui M,Higuehi K,et al.Effect of nonsupplemented low-protein diet on very late stage CRF.Am J Kidney Dis,2003,41(3):31-34
[J].Prakash S,Pande DP,Sharma S,et al.Randomized,double-blind,placebo-controlled thai to evaluate efficacy of keto diet in prediaiyfic chronic renal failure.J Ren Nutr,2004,14(2):89-96
[4]Fair DE,Ogborn MR,Weiler HA,et al.Dietary soy protein attenuates renal disease progression after I and 3 weeks in Han:SPRD-cy weanlingmts.Nutr,2004,134,1500-1507
[5]WolfS,Rifler T.Are all antihypertensive drugs renprotective ? Ffetz,2004,29(3):248-54
[6]Kanazawa M,Kohzuki M,Yoshida K,et al.Combination therapy with an angiotensin-converting enzyme(ACE)inhibitor and a calcium antago-nist:beyond the renoprotective effects of ACE inhibitor rmonotherapy in a spontaneous hypertensive rat with renal ablation.Hypertens Res,2002,25(3):447-53
[7]Cook ED,Preddie DC.Relative effects of angiotensin converting enzyme inhibitors and calcium antagonists in advanced diabetic nephropathy.Ethn Dis,2004,14(1):87-93
[8]Atria DM,Ni ZN,Boer P,et al.Proteinuria is preceded by decreased nitric oxide synthesis and prevented by a NO donor in cholesterol-fed rats.Kidney Int,2002,61(5):1776—1787
[9]Fried LF,Orchard IJ,Kasiske BL.Effect of lipid reduction on the progression of renal disease:a meta-analysis.Kidney Int,2001,59(1):260-269
[10]Okada M,Yanagida H,Kuwajima H,et al.Antiproliferative effect of fluvastatin and thiazolidinedione in mesangial cells of diabetic rats.Pediatr Nephrol,2004,19(1):26-32
[11]Hatmno K,Iwano M,Akai Y,et al.Expression of glomemlar plasminogenactivator inhibitor type I in glomerulonephritis.AmJ kidney Dis,2002,39(4):695-705
[12]Ceol M,Vianello D,Schleicher E,et al.Heparin reduces glomerular infiltration and TGF-beta protein expression by mecrophages inpuromycin glomerulosclerosis.J Nephrol,2003,16(2):210-218
[13]Zhang BL,Li 25,Song LY,et al.Experimental study on prevention and treatment of focal segmental glomerulosclerosis with heparin.Zhongguo Wei zhong BingJi Jiu Yi Xue,2000,16(1):26-28
[1]郑筱萸.《中药新药临床研究指导原则》(试行).北京:中国医药科技出版社,2002年,89
[2]王钢.肾功能衰竭中医治疗.南京:江苏科学技术出版,2002年,71
[3]沈庆法.慢性肾功能衰竭的中医认识和临床研究.上海中医药杂志,2000,(3):42-44
[4]阳晓,朱文锋,胡学军,等.681例慢性肾功能衰竭正虚证候分布特点调查分析.中医杂志,1999,40(2):112-114
[5]李智军,魏连波,贺丰,等。黄芪多糖治疗大鼠系膜细胞增生性肾炎的实中国中西医结合肾病杂志 2000,1(4):206
[6]刘福君,赵修南,聂伟,等.地黄低聚糖增强小鼠免疫功能的作用.中国药理学通报.1998,14(1):90
[7]刘福君,赵修南,聂伟,等.地黄低聚糖对老年小鼠免疫功能的作用.中国药理血会通讯.1995,12(3):94
[8]于震,王军,李更生,等.地黄甙 D 滋阴补血和降血糖作用的实验研究.辽宁中医杂志,2001,28(4):240-241
[9]宁英远,等.大黄素对人肾成纤维细胞增殖的影响.中国中西医结合杂志,2000,20(2):105-106
[10]刘冠贤,等.大黄素对狼疮性肾炎成纤维细胞生物血行为的影响.中国中西医结合杂志,2000,20(3):196-198
[11]柯凌.大黄的药理及其在肾脏病中的运用.中国中西医结合肾病杂志.2001,2(2):347-348
[12]刘慰华,黄河清,邓艳辉,等.黄连素对糖尿病肾损伤大鼠肾功能、氧化应激、肾脏醛糖还原酶的影响.中国药理学通报,2008,24(7):955-959
[13]Jelkman W.Molecular biology of erythropoietin Intern Med,2004,43(8):649-659
[14]周金立,马红雨,王洪波.C 反应蛋白对慢性肾功能衰竭贫血患者促红细胞生成素生成的影响.中国医师杂志,2003,5(6):763-764
[15]郑法雷,章友康,陈香梅等主编.肾脏并临床与进展.人民卫生出版社,2005,288
[16]王美云,景分清.腹膜透析和血液透析患者贫血程度及血清EP0水平比较.镇江医学院学报,2000,10(1):26-27
[17]Merrrms DE,Williams T,Eastwood JB,et al.'Ihe role Ofparathy-midectomy in the management Of hypenparathyroidism in patients on main-tenance hemodialysis and after renal transplantation.Nephron,1982,30:143-148.
[18]梅长林.慢性肾功能衰竭继发性甲状旁腺功能亢进的发病机理及治疗现状.中华医学信息导报,2000,015(004):15
[19]Bonjour JP.1,25-dihydroxy vitamin D and phosphate Homeostasis in Eariy chron;c Failure:The Trade off Hypothesis Revisited.In:Davison Am.Nephrology.Bajlliere Tindall.Cambridgge Vniversity Press,1988,1059-1066.
[20]王海燕.慢性肾功能衰竭.肾脏病学,第2版.北京:人民卫生出版社,1996,1392.
[21]Reighel H,koeffler Hp.The role of the vitamin D endocrine system in health and disease.N Engl J med,1989,320:980.
[22]Lacus PA,Brown re.1,25-dihydroxycholeccel ciferol and parathyroid homonein advanced chronic renal failure:effect of simulataneous protein and phosphates restriction.clinNephrol,1986,25:7.
[23]Coburn Gw,Hurtenbower Dl.Intestinal absorption of calcium and the effect of renal insufficiency.Kidney Int,1973,4:96.
[24]钱宇锋,蔡卫民.甲状旁腺激素测定在慢性肾功能衰竭中的临床意义.医学研究生报,2003,7(16):536-542.
[25]Denda M,Finch J,Slatopolsdy E.Phosphorus accelerates the develOp-merit Of parathyroid hyperplasia and secondary hypelparathyroidism inrats with renal failure.AMJ of Kidney,1996,28(4):596-602
[26]王小兵,王笑云.磷与继发性甲状旁腺功能亢进研究新进展.中国血液净化杂志,2003,2(6):333-336
[27]Eric P Cohen,John E.Parathyroidectomy in chronic renal failure:Hasmedical care reduced the need for surgery?Nephron Basel,2000,89(3):271-274.
[2]陆晓东,郑平东.治疗慢性肾衰的经验.辽宁中医学院学报,2001,3(1):26
[3]傅文录,时振声教授辨治慢性肾衰的思维方法浅析.中医药研究,1994,(4):3
[4]张大宁主编.实用中医肾病学.中国医药科技出版社,1990,485-486
[5]刘洲,洪钦国教授辨证论治慢性肾衰经验.新中医,1996,28(1):40
[6]洪用森等.慢性肾衰的辨证分型和治疗.中华肾脏病杂志,1991,7(5):36
[7]王永钧.慢性肾衰的中医认识及对策.浙江中医杂志,1993,28(2):49
[8]王少华,张晶瑜,王彬.试论慢性肾功能衰竭正虚邪实之病机.上海中医药大学学报,2004,18(2):31-32
[9]周硕果,王自敏.王自敏教授治疗慢性肾衰竭临床经验.中国中西医结合肾病杂志,2004,5(5):251-254
[8]全国中医肾衰研讨会.慢性肾衰中医辨证分型和疗效判定信息.中医药信息,1991,(2):27
[9]傅文录,时振声教授辨治慢性肾衰的思维方法浅析.中医药研究,1994,(4):3
[10]张大宁主编.实用中医肾病学.中国医药科技出版社,1990,485-490
[11]张金玺.杜雨茂教授治疗肾病经验述略.国医论坛,1999,14(2):20
[12]候丕华.梁贻俊教授论治慢性肾衰的经验.新中医,2000,32(1):10
[13]洪用森.慢性肾衰的辨证分型和治疗.中华肾脏病杂志,1991,7(5):36
[14]许家松.方药中对慢性肾衰的理论认识和诊治经验.中医杂志,1991,22(12):11
[15]叶玉妹.叶景华治疗慢性肾功能衰竭经验.辽宁中医杂志,2006,33(3):264-265
[16]徐俊业.大黄附子汤治疗慢性肾功能不全46例.成都中医药大学学报,1999,22(2)23-24
[17]莫美霞.补肾排浊汤治疗慢性肾功能衰竭30例观察.湖南中医学院学报,1999,19(2):36-37
[18]王振岗.化湿降浊解毒汤治疗慢性肾功能衰竭40例.陕西中医,2005,26(12):31
[19]陈东河.补血生髓丸治疗肾性贫血56例.天津中医,2000,17(3):封四
[20]李深,饶向荣,戴希文.益肾缓衰方治疗慢性肾功能衰竭35例远期疗效观察.中医杂志,2001,42(3):164-166
[21]管竞环.大黄静脉注射治疗慢性肾功能不全23例临床疗效观察临床内科杂志.1985,(1):38
[22]王锋,闫忠华,翟秋根.卡托普利和大黄治疗慢性肾功能衰竭23例临床观察.中西医结合实用临床急救 1999,6(4):182
[23]管益君.冬虫夏草对慢性肾功能衰竭患者 T 细胞亚群的影响.中国中西医结合杂志,1992,12(6):338-339
[24]井芝春,张惠莉.人工培养冬虫夏草对慢性肾衰患者蛋白质代谢的改善,青海医药杂志,2000,30(5):13-144.
[25]魏明刚.冬虫夏草治疗肾性贫血的临床研究.中华实用中西医杂志,2004,(11):796-797.
[26]刘爱珍,陈荣鸾.黄芪注射液治疗慢性肾衰竭的临床观察.中国中西医结合肾病杂志,2002,3(3):172。
[27]吴会玉,黄雪霞,史伟田.七注射液治疗慢性肾功能衰竭疗效观察.辽宁中医杂志,2005,32(12):1228-1229.
[28]项红秀,王学玉,胡海云,等.灯盏细辛注射液治疗慢性肾功能衰竭疗效观察.河北医药,2006,28(3):733
[29]卞华.李学铭教授治疗慢性肾衰的经验.国医论坛,2002,17(4):14
[30]李海聪.内服中药加灌肠治疗慢性肾衰疗效观察.北京中医药大学学报,1998,21(5):45-47
[31]陶筱娟.泄浊排钾方高位结肠灌肠抢救慢性肾衰高血钾症.中国中医药信息杂志,1998,5(12):38
[32]戴西湖.治疗慢性肾衰的方药分析.中医杂志,1986,27(5):64
[33]吉勤,张春艳,王清.中药结肠透析对慢性肾衰竭的影响.中国中西医结合肾病杂志,2007,8(12):726-728
[34]孙建实.中药药浴治疗尿毒症20例疗效观察.浙江中医杂志,1994,29(3):134
[35]卢守谦.中医”浴汗法”治疗慢性肾衰.中国医药学报,1989(3):45-46
[36]李汉友.尿毒膏外治慢性肾衰24例疗效观察.中医外治杂志,1996,(2):7
[37]王红,仝小林.肾区中药热熨治疗慢性肾衰90例.中医外治杂志,1996,(3):64
[38]夏滨祥.外敷降压膏治疗慢性肾衰高血压]8例.黑龙江中医药,1991,(5):43-44
[39]王志萍.隔药灸结合血透治疗慢性肾功能衰竭疗效观察.中国针灸,2000,20(3):136
[40]彭敏球.黄芪注射液低能量氦氖激光血管内照射术二联疗法治疗慢性肾衰临床疗效观察.第五届全国中西医结合肾脏病学术交流会论文集,1999,226-227
[41]王海燕.肾脏病学.北京:人民卫生出版社,1996,475-476
[42]王景明,孙奕,叶传惠.中药肾衰宁对体外培养人肾小球系膜细胞增殖及产生白介素-8的影响.中国中西医结合急救杂志,2000,7(4):197-199
[43]徐大基,杨霓芝,雷娓娓.尿毒康治疗慢性肾功能衰竭动物模型的肾脏病理形态学观察.福建中医药,1999,30(6):37-38
[44]徐晓利,马润家.医学生物化学.北京:人民卫生出版社,1998,852-874
[45]何立群,高建东,郑平东.肾衰冲剂缓解5/6肾切除大鼠肾小球硬化的实验研究.中国中医药信息杂志,2002,9(2):22-23
[46]Shimizu A,Kitamura S,Masuda Y et al.Apotosis in the repair processes of experimental proliferation glomerulonephritis.Kidney Int.1995,47:121-123
[47]揣冰,丁樱,吴力群.肾必宁对大鼠系膜增生性肾小球肾炎肾小球细胞凋亡及bax,bcl-2表达的影响.中国中西医结合肾病杂志,2003,4(6):316-318
[48]李海涛,李晓冬,朱荃,等.紫草素对人胎肾系细胞凋亡的影响.药学进展,2001,25(6):367-369
[49]余学清,李惠群,叶任高,等.慢性肾脏疾病患者尿中内皮素变化及其临床意义.中华肾脏病杂志,1995,11(2):91-93
[50]孙万森,乔成林,程伟,等.绞股蓝总皂甙对慢性肾功不全大鼠血浆内皮素含量和肾功能的影响.中国危重病急救医学,1998,10(5):268-269
[51]马建伟,刘占民,徐丽梅,等.滋肾活血解毒方对慢性肾功衰竭大鼠 TGF-β、ET-1mRNA 的影响.北京中医,2001,20(3):45-47
[52]陈朝红,刘志红,王庆文,等.血管紧张素转化酶基因多态性在终末期肾功能衰竭患者中的分布及其意义.中华肾脏病杂志,1997,13(1):22
[53]王怡,何立群,郑平东.抗纤灵冲剂改善慢性肾衰实验兔血液动力学及肾小球硬化的研究.上海中医药大学学报,2000,14(2):47-49
[54]钟慈声.一氧化氮的生物医学.上海:上海医科大学出版社,1997.257
[55]黄怀鹏,陈志强,王虹.雷公藤对肾小球系膜细胞增殖及其分泌 NO、NOS 影响的实验研究.山东中医药大学学报,2001,25(3):222-223
[56]湛冯岚.TGF-β与肾脏病的研究新进展.国外医学·泌尿分册,1999,19(6):280
[57]刘志红.转化生长因子及大黄酸对肾小球系膜细胞葡萄糖转运蛋白功能的影响.中华医学杂志,1999,79(10):780-783
[58]赖雁妮,俞茂华,朱秋毓,等.黄芪多糖对糖尿病大鼠肾组织转化生长因子β_1的影响.复旦学报(医学版),2002,29(4):255-257
[59]Baud L,Ardaillou R.Tumor necrosis factor alpha in glomerular injury.Kidney Int.1994,45(5):32-26
[60]易明娟,章崇立,谢子清,等.复方大黄注射液对肾小球系膜细胞增殖及产生细胞因子的影响.中药药理与临床,1993,13(4):33-34
[61]刘云海.川芎嗪对慢性肾衰患者肾血流量及肌酐清除率的影响.中国中西医结合杂志,1993,13(2):107
[62]王海燕,郑法雷,刘玉春,等.原发性肾小球疾病分型与治疗及诊断标准.中华内科杂志,1993,32(1):131-134
[63]朱辟疆,周逊,韦先进.保元强肾Ⅱ号对慢性肾功能衰竭血浆及尿 SOD、MDA 的影响.中华肾脏病杂志,1997,17(11):649-651
[64]袁发焕,廖立生.慢性肾衰大鼠组织内炎性细胞浸润机理探讨.四川医学,1993,(10):599-600
[1]Fouque D,Wang P,Laville M,et al.Low protein diets for chronic renal failure in non diabetic adults.Cochrane Database Syst Rev,2001,(2):CD001892
[2]Ideura T,Shimazui M,Higuehi K,et al.Effect of nonsupplemented low-protein diet on very late stage CRF.Am J Kidney Dis,2003,41(3):31-34
[J].Prakash S,Pande DP,Sharma S,et al.Randomized,double-blind,placebo-controlled thai to evaluate efficacy of keto diet in prediaiyfic chronic renal failure.J Ren Nutr,2004,14(2):89-96
[4]Fair DE,Ogborn MR,Weiler HA,et al.Dietary soy protein attenuates renal disease progression after I and 3 weeks in Han:SPRD-cy weanlingmts.Nutr,2004,134,1500-1507
[5]WolfS,Rifler T.Are all antihypertensive drugs renprotective ? Ffetz,2004,29(3):248-54
[6]Kanazawa M,Kohzuki M,Yoshida K,et al.Combination therapy with an angiotensin-converting enzyme(ACE)inhibitor and a calcium antago-nist:beyond the renoprotective effects of ACE inhibitor rmonotherapy in a spontaneous hypertensive rat with renal ablation.Hypertens Res,2002,25(3):447-53
[7]Cook ED,Preddie DC.Relative effects of angiotensin converting enzyme inhibitors and calcium antagonists in advanced diabetic nephropathy.Ethn Dis,2004,14(1):87-93
[8]Atria DM,Ni ZN,Boer P,et al.Proteinuria is preceded by decreased nitric oxide synthesis and prevented by a NO donor in cholesterol-fed rats.Kidney Int,2002,61(5):1776—1787
[9]Fried LF,Orchard IJ,Kasiske BL.Effect of lipid reduction on the progression of renal disease:a meta-analysis.Kidney Int,2001,59(1):260-269
[10]Okada M,Yanagida H,Kuwajima H,et al.Antiproliferative effect of fluvastatin and thiazolidinedione in mesangial cells of diabetic rats.Pediatr Nephrol,2004,19(1):26-32
[11]Hatmno K,Iwano M,Akai Y,et al.Expression of glomemlar plasminogenactivator inhibitor type I in glomerulonephritis.AmJ kidney Dis,2002,39(4):695-705
[12]Ceol M,Vianello D,Schleicher E,et al.Heparin reduces glomerular infiltration and TGF-beta protein expression by mecrophages inpuromycin glomerulosclerosis.J Nephrol,2003,16(2):210-218
[13]Zhang BL,Li 25,Song LY,et al.Experimental study on prevention and treatment of focal segmental glomerulosclerosis with heparin.Zhongguo Wei zhong BingJi Jiu Yi Xue,2000,16(1):26-28
[1]郑筱萸.《中药新药临床研究指导原则》(试行).北京:中国医药科技出版社,2002年,89
[2]王钢.肾功能衰竭中医治疗.南京:江苏科学技术出版,2002年,71
[3]沈庆法.慢性肾功能衰竭的中医认识和临床研究.上海中医药杂志,2000,(3):42-44
[4]阳晓,朱文锋,胡学军,等.681例慢性肾功能衰竭正虚证候分布特点调查分析.中医杂志,1999,40(2):112-114
[5]李智军,魏连波,贺丰,等。黄芪多糖治疗大鼠系膜细胞增生性肾炎的实中国中西医结合肾病杂志 2000,1(4):206
[6]刘福君,赵修南,聂伟,等.地黄低聚糖增强小鼠免疫功能的作用.中国药理学通报.1998,14(1):90
[7]刘福君,赵修南,聂伟,等.地黄低聚糖对老年小鼠免疫功能的作用.中国药理血会通讯.1995,12(3):94
[8]于震,王军,李更生,等.地黄甙 D 滋阴补血和降血糖作用的实验研究.辽宁中医杂志,2001,28(4):240-241
[9]宁英远,等.大黄素对人肾成纤维细胞增殖的影响.中国中西医结合杂志,2000,20(2):105-106
[10]刘冠贤,等.大黄素对狼疮性肾炎成纤维细胞生物血行为的影响.中国中西医结合杂志,2000,20(3):196-198
[11]柯凌.大黄的药理及其在肾脏病中的运用.中国中西医结合肾病杂志.2001,2(2):347-348
[12]刘慰华,黄河清,邓艳辉,等.黄连素对糖尿病肾损伤大鼠肾功能、氧化应激、肾脏醛糖还原酶的影响.中国药理学通报,2008,24(7):955-959
[13]Jelkman W.Molecular biology of erythropoietin Intern Med,2004,43(8):649-659
[14]周金立,马红雨,王洪波.C 反应蛋白对慢性肾功能衰竭贫血患者促红细胞生成素生成的影响.中国医师杂志,2003,5(6):763-764
[15]郑法雷,章友康,陈香梅等主编.肾脏并临床与进展.人民卫生出版社,2005,288
[16]王美云,景分清.腹膜透析和血液透析患者贫血程度及血清EP0水平比较.镇江医学院学报,2000,10(1):26-27
[17]Merrrms DE,Williams T,Eastwood JB,et al.'Ihe role Ofparathy-midectomy in the management Of hypenparathyroidism in patients on main-tenance hemodialysis and after renal transplantation.Nephron,1982,30:143-148.
[18]梅长林.慢性肾功能衰竭继发性甲状旁腺功能亢进的发病机理及治疗现状.中华医学信息导报,2000,015(004):15
[19]Bonjour JP.1,25-dihydroxy vitamin D and phosphate Homeostasis in Eariy chron;c Failure:The Trade off Hypothesis Revisited.In:Davison Am.Nephrology.Bajlliere Tindall.Cambridgge Vniversity Press,1988,1059-1066.
[20]王海燕.慢性肾功能衰竭.肾脏病学,第2版.北京:人民卫生出版社,1996,1392.
[21]Reighel H,koeffler Hp.The role of the vitamin D endocrine system in health and disease.N Engl J med,1989,320:980.
[22]Lacus PA,Brown re.1,25-dihydroxycholeccel ciferol and parathyroid homonein advanced chronic renal failure:effect of simulataneous protein and phosphates restriction.clinNephrol,1986,25:7.
[23]Coburn Gw,Hurtenbower Dl.Intestinal absorption of calcium and the effect of renal insufficiency.Kidney Int,1973,4:96.
[24]钱宇锋,蔡卫民.甲状旁腺激素测定在慢性肾功能衰竭中的临床意义.医学研究生报,2003,7(16):536-542.
[25]Denda M,Finch J,Slatopolsdy E.Phosphorus accelerates the develOp-merit Of parathyroid hyperplasia and secondary hypelparathyroidism inrats with renal failure.AMJ of Kidney,1996,28(4):596-602
[26]王小兵,王笑云.磷与继发性甲状旁腺功能亢进研究新进展.中国血液净化杂志,2003,2(6):333-336
[27]Eric P Cohen,John E.Parathyroidectomy in chronic renal failure:Hasmedical care reduced the need for surgery?Nephron Basel,2000,89(3):271-274.
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