中医药研究论丛

211.15 慢性肾脏病中医药治疗病例报告
TJ TCM.21(1) : 191-202, 2018
慢性肾脏病中医药治疗病例报告
A Case Report on Treatment of Chronic Kidney Disease with Traditional Chinese Medicine
林博彦1* 林晓华1
1 卫生福利部屏东医院,屏东,台湾
【摘要】
台湾慢性肾脏病(chronic kidney disease, CKD) 盛行率约11.9%(1),依国民健康局估计,国内20 岁以上成人每10 位就有一位患有慢性肾脏病(2)。慢性肾脏病常渐进性发展为慢性肾衰竭(ESRD),台湾於2010 年底末期肾脏疾病(End Stage Renal Disease, ESRD) 的盛行率(2584/ 每百万人口)为世界第一,每年耗用超过三百亿台币的透析医疗费用,占所有重大伤病门诊申报费用近五成(3)。预防肾脏病的发生,治疗且延缓肾脏病人进展至末期,是目前国家健康政策的首要任务(1)。肾脏病早期症状不明显,长期出现蛋白尿,尿中有泡沫,是肾功能异常的标记之一,蛋白尿的治愈与否,关系着慢性肾脏病的愈後。本文中介绍病患叶女士检查出蛋白尿已3 年多,西医肾脏科治疗三年多未见改善,尿液检查尿蛋白仍是3+eGFR47,改服用中药治疗约3个月,再验生化及尿液常规检验已无蛋白尿,eGFR 上升至73.5,听从西医肾脏科服用西药保养治疗慢性肾炎,一年多後生化尿液检查又见异常,肾脏科医师治疗半年未改善,改服中药一个月再验生化尿液检验,已无蛋白尿,追踪至今无再恶化复发,GFR 维持在低风险G2
【关键词】慢性肾脏病、蛋白尿、中药
Bo-Yen Lin1* Hsiao-Hua Lin1  
1Pingtung General Hospital, Ministry of Health and Welfare, Pingtung, Taiwan
【Summary】
Taiwan’s prevalence of chronic kidney disease (CKD) is roughly 11.9%(1), and according to the Health Promotion Administration, Ministry of Health and Welfare, approximately one in every 10 adults over 20 years of age in Taiwan suffers from CKD(2). CKD often progresses to chronic renal failure (CRF). By the end of 2010, Taiwan’s end-stage renal disease (ESRD) prevalence rate (2584 per million people) ranked first in the world, with NTD30 billion spent on dialysis, accounting for nearly 50% of the reported outpatient expenditure on major injuries (3). It is the primary task of the national health policy to prevent and treat kidney disease, and to delay its progress towards the terminal stage(1). Early symptoms of kidney disease are not obvious, and sustained proteinuria and foam in urine is one of the signals of renal dysfunction, and curing proteinuria determines the recovery from CKD. The patient in this paper, Mrs. Yeh, was diagnosed with proteinuria three years ago, and has undergone Western medicine treatment in the nephrology department since then, with no improvement seen and urine protein of 3+, eGFR47. However, after receiving traditional Chinese medicine (TCM) treatments for about three months, biochemical and urine routine examination results showed no proteinuria, with eGFR rising to 73.5. Then, following the Western-style doctors’ advice, she returned to Western medicine treatments for chronic nephritis.
After more than a year, the biochemical and urine routine test results indicated abnormality, and no improvement was made for another six months. After taking TCM for a month, no proteinuria was identified in biochemical or urine examination results, to date, no deterioration or recurrence has been reported from follow-up feedback, and her GFR is maintained at low-risk G2.
Keywordschronic kidney disease, proteinuria, Chinese medicine