減輕慢性腎衰竭患者尿毒症狀之中醫藥治療案例

Reducing Uremic Symptoms in Patients with Chronic Renal Failure by Traditional Chinese Medicine - A Case Report

王宏銘(Hung-Ming Wang) ； 徐培倩(Pei-Chien Hsu) ； 游榮聖(Jung-Sheng Yu)

《中西整合醫學雜誌》 18卷1期 (2016/03) Pp. 7-16

摘要

慢性腎臟病（CKD）是一個重大的公共衛生問題，為腎功能在數月或數年間逐漸喪失的一種疾病。CKD定義為有腎臟實質傷害證據且病程達3個月以上，或不論任何原因，腎絲球過濾率GFR ＜ 60 ml/min/1.73m2超過三個月以上。慢性腎臟疾病可發展為末期腎功能衰竭，此時人體維持代謝和體液及電解質平衡功能出現一漸進且不可逆的惡化，從而導致尿毒症。尿毒症會影響身體的許多部位。包括胃腸系統，心血管系統，神經系統，皮膚系統和免疫系統等。目前尿毒症治療以透析治療為主，換腎療法因捐腎的供不應求而僅佔少數。因此，如何延緩CKD患者進入透析治療是一個非常重要的問題。許多病人因而紛紛轉向中醫，以尋求幫助。本病例為一名59歲的女性患者因ESRD而尋求中醫協助。在服用中藥四個月後包括症狀、血清尿素氮、肌酸酐都獲得了明顯改善。可提供末期腎衰患者一個有效的替代治療方式。

關鍵字

末期腎衰竭 ； 血清尿素氮 ； 慢性腎臟病 ； 傳統中醫藥

並列摘要

Chronic kidney disease(CKD), a major public health problem, is a progressive loss in kidney function over a period of months or years. CKD is defined as the presence of kidney damage or decreased kidney function (eGFR ＜60 mL/min/1.73 m2) for three or more months, irrespective of the cause. Chronic kidney disease can progress to end-stage kidney failure, which is a progressive, irreversible deterioration in renal function in which the body's ability to maintain metabolic and fluid and electrolyte balance fails, resulting in uremia. Uremia may affect any part of the body. Including gastrointestinal system, cardiovascular system, neurologic system, integument system, and immune system. Treatment of uremia is now dominated by dialysis. Thus, how to delay dialysis initiation in CKD predialysis patients is a important issue. We report a case of a 59-year-old female patient with ESRD seeking TCM advice. The symptoms, serum creatinine and blood urea nitrogen(BUN) was improved after taking Chinese herbal formulae within 4 months. This approach seems to offer a effective alternative treatment for ESRD patients.

並列關鍵字

ESRD ； BUN ； chronic renal disease ； traditional chinese medicine

參考文獻

National Kidney Foundation: K/DOQI clinical practice guidelines for chronic kidney disease: evaluation, classification, and stratification. Am J Kidney Dis 2002; 39(2Suppl 1): S1-266.

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