中医药学报

肾病综合征水肿患者内服柴苓汤与外敷芒硝的疗效及安全性分析

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李静, 王玉婷, 张城浩, 田丹丹, 乔志辉

中医药学报 | 临床研究 2026,54(3): 68-73

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中医药学报 |临床研究 2026 , 54 (3) : 68 -73

肾病综合征水肿患者内服柴苓汤与外敷芒硝的疗效及安全性分析

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李静, 王玉婷, 张城浩, 田丹丹, 乔志辉

作者信息

通讯作者:

* 乔志辉（1988-），男，主治医师，主要从事中医治疗肝肾疾病的研究。

作者简介:

李静（1986-），女，主治医师，主要从事中医治疗肾病、消化疾病的研究。

Analysis of the Efficacy and Safety of Oral Chailing Decoction Combined with External Mirabilite Application in Patients with Nephrotic Syndrome Edema

LI Jing, WANG Yuting, ZHANG Chenghao, TIAN Dandan, QIAO Zhihui

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doi: 10.19664/j.cnki.1002-2392.260058

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目的： 观察柴苓汤内服联合芒硝外敷方案应用于肾病综合征水肿患者的临床疗效及安全性。方法： 选取河北省中医药大学第二附属医院2023年1月—2024年12月收治的80例肾病综合征水肿患者，按入院顺序奇偶性分为对照组和治疗组，每组40例。对照组给予常规基础治疗与芒硝外敷，治疗组在对照组治疗基础上加用柴苓汤，对比两组临床疗效、生理指标、中医证候积分、肝肾功能指标及安全性。结果： 治疗组患者水肿治疗总有效率高于对照组，差异有统计学意义（P < 0.05）。两组治疗前生理指标及实验室指标比较，差异无统计学意义（P > 0.05）；治疗后治疗组空腹体质量、下肢小腿周径均低于对照组（P < 0.01），其24 h尿量显著高于对照组（P < 0.01）。两组治疗前中医证候各项积分比较，差异无统计学意义（P > 0.05）；治疗后治疗组水肿、便溏、乏力、纳差等中医证候积分均低于对照组（P <0.01）。两组治疗前肝肾功能指标比较，差异无统计学意义（P > 0.05）；治疗后治疗组丙氨酸氨基转移酶与对照组比较，差异无统计学意义（P > 0.05），治疗后治疗组24 h尿蛋白定量、血清胱抑素C及尿素氮水平均低于对照组（P < 0.01）。治疗组与对照组不良反应发生率比较，差异无统计学意义（P >0.05）。结论： 柴苓汤内服联合芒硝外敷治疗，能够显著提升肾病综合征水肿患者临床疗效，改善其生理指标及实验室指标，并降低患者中医证候积分，且不会增加不良反应、安全性高。

关键词

水肿疗效观测表 / 不良反应 / 肾病综合征水肿 / 柴苓汤 / 芒硝外敷

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Objective: To evaluate the clinical efficacy and safety of oral administration of Chailing Decoction combined with external mirabilite application in patients with nephrotic syndrome edema.Methods: Eighty patients with nephrotic syndrome edema admitted to the Second Affiliated Hospital of Hebei University of Chinese Medicine from January 2023 to December 2024 were enrolled. Patients were divided into a control group and a treatment group based on admission sequence (odd and even numbers), with 40 patients in each group. The control group received conventional basic treatment plus external application of magnesium sulfate. The treatment group added Chailing Decoction to the control group's regimen. The two groups were compared in terms of edema treatment efficacy, physiological indicators, traditional Chinese medicine syndrome scores, liver and kidney function indicators, and safety.Results: The total effective rate for edema treatment was significantly higher in the treatment group than in the control group (P <0.05). Pre - treatment physiological and laboratory parameters showed no statistically significant differences between groups(P > 0.05). Post - treatment, the treatment group exhibited significantly lower fasting body weight and lower calf circumference than the control group (P <0.01), while demonstrating significantly higher 24 - hour urine output (P <0.01). Pre - treatment scores for TCM syndromes showed no statistically significant difference between groups (P >0.05). Post - treatment scores for edema, loose stools, fatigue, and poor appetite were significantly lower in the treatment group than the control group (P < 0.01). Pre - treatment liver and kidney function indicators showed no statistically significant difference between groups (P > 0.05). After treatment, alanine aminotransferase levels in the treatment group showed no statistically significant difference compared to the control group (P >0.05). However, 24- hour urinary protein levels, serum cystatin C, and blood urea nitrogen levels were significantly lower in the treatment group than in the control group (P < 0.01). The incidence of adverse reactions between the two groups showed no statistically significant difference (P > 0.05).Conclusion: The combination therapy of oral administration of Chailing Decoction combined with external mirabilite application significantly improved clinical efficacy in patients with nephrotic syndrome edema, enhanced physiological and laboratory parameters, and reduced traditional Chinese medicine syndrome scores. This regimen did not increase adverse reactions and demonstrated high safety.

Key words

Oedema efficacy observation table / Adverse reactions / Nephrotic syndrome oedema / Chailing Decoction / External mirabilite application

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李静, 王玉婷, 张城浩, 田丹丹, 乔志辉. 肾病综合征水肿患者内服柴苓汤与外敷芒硝的疗效及安全性分析. 中医药学报, 2026 , 54 (3) : 68 -73 . DOI: 10.19664/j.cnki.1002-2392.260058

LI Jing, WANG Yuting, ZHANG Chenghao, TIAN Dandan, QIAO Zhihui. Analysis of the Efficacy and Safety of Oral Chailing Decoction Combined with External Mirabilite Application in Patients with Nephrotic Syndrome Edema[J]. Acta Chinese Medicine and Pharmacology, 2026 , 54 (3) : 68 -73 . DOI: 10.19664/j.cnki.1002-2392.260058

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河北省中医药管理局科研计划项目 (2024056)

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2026年第54卷第3期

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doi: 10.19664/j.cnki.1002-2392.260058

接收时间：2025-04-16
首发时间：2026-09-07

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收稿日期：2025-04-16

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2种不同金属材料的力学参数

科 Family	属数 Number of genus	种数 Number of species	占总种数比例 Percentage of total species (%)	属 Genus	种数 Number of species	占总种数比例 Percentage of total species (%)
鹅膏菌科Amanitaceae	2	11	5.26	鹅膏菌属 Amanita	10	4.78
小菇科 Mycenaceae	2	12	5.74	丝盖伞属 Inocybe	5	2.39
多孔菌科 Polyporaceae	8	14	6.70	蜡蘑属 Laccaria	5	2.39
红菇科 Russulaceae	3	23	11.00	小皮伞属 Marasmius	6	2.87
				小菇属 Mycena	11	5.26
				光柄菇属 Pluteus	5	2.39
				红菇属 Russula	17	8.13
				栓菌属 Trametes	5	2.39

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