|
台灣慢性腎臟病(chronic kidney disease, CKD) 盛行率約11.9%(1)，依國民健康局估計，國內20 歲以上成人每10 位就有一位患有慢性腎臟病(2)。慢性腎臟病常漸進性發展為慢性腎衰竭(ESRD)，臺灣於2010 年底末期腎臟疾病(End Stage Renal Disease, ESRD) 的盛行率（2584/ 每百萬人口）為世界第一，每年耗用超過三百億臺幣的透析醫療費用，占所有重大傷病門診申報費用近五成(3)。預防腎臟病的發生，治療且延緩腎臟病人進展至末期，是目前國家健康政策的首要任務(1)。腎臟病早期症狀不明顯，長期出現蛋白尿，尿中有泡沫，是腎功能異常的標記之一，蛋白尿的治癒與否，關係著慢性腎臟病的癒後。本文中介紹病患葉女士檢查出蛋白尿已3 年多，西醫腎臟科治療三年多未見改善，尿液檢查尿蛋白仍是3+，eGFR47，改服用中藥治療約3個月，再驗生化及尿液常規檢驗已無蛋白尿，eGFR 上升至73.5，聽從西醫腎臟科服用西藥保養治療慢性腎炎，一年多後生化尿液檢查又見異常，腎臟科醫師治療半年未改善，改服中藥一個月再驗生化尿液檢驗，已無蛋白尿，追蹤至今無再惡化復發，GFR 維持在低風險G2。
|
|
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.
Keywords：chronic kidney disease, proteinuria, Chinese medicine
|
211.15 慢性腎臟病中醫藥治療病例報告
