参蛭活血汤辅助治疗原发性膜性肾病Ⅰ-Ⅱ期气虚血瘀型的疗效观察

Curative Effect ObservationUsing Shenzhi Huoxue Decoction in the Adjuvant Treatment of Stage Ⅰ-Ⅱ Primary Membranous Nephropathy of Qi Deficiency and Blood Stasis Type

目的:探究参蛭活血汤辅助治疗原发性膜性肾病(PMN)Ⅰ-Ⅱ期气虚血瘀型的效果。方法:选取2020年7月~2021年7月于我院收治的90例Ⅰ-Ⅱ期气虚血瘀型PMN患者为研究对象,遵循随机分组的原则,分为观察组(n=45)和对照组(n=45),对照组予西医常规治疗,观察组在对照组的基础上使用参蛭活血汤辅助治疗。比较两组患者治疗后临床疗效差异,评估两组患者治疗前后中医证侯积分、肾功能[24h尿蛋白定量(24hUTP)、血尿素氮(BUN)、血肌酐(Scr)]变化,分析两组患者治疗期间药物不良反应差异。结果:治疗6个月后,两组患者总体疗效差异有统计学意义,观察组患者总有效率高于对照组(P<0.05);治疗6个月后,两组患者腰膝酸软、倦怠乏力、肢体浮肿、少食纳呆、头晕、胃脘胀满得分较治疗前降低,且观察组低于同期对照组(P<0.05);治疗6个月后,两组患者24hUTP均较治疗前下降,且观察组低于同期对照组(P<0.05),两组患者BUN、Scr均较治疗前上升,两组患者组间比较,差异无统计学意义(P>0.05);两组患者不良反应发生率比较,差异无统计学意义(P>0.05)。结论:参蛭活血汤辅助治疗Ⅰ-Ⅱ期气虚血瘀型PMN患者可提升疗效,改善临床症状,能有效降低24h尿蛋白水平,安全性较好。

Objective:To explore the effect of using Shenzhi Huoxue decoction in the adjuvant treatment of stage I-II primary membranous nephropathy(PMN)of Qi deficiency and blood stasis type.Methods:90 patients with stage I-II PMN of Qi deficiency and blood stasis type who were treated in the hospital between July 2020 and July 2021 were selected as the research subjects,and they were divided into an observation group(n=45)and a controlled group(n=45)according to the principle of random grouping.The controlled group was given conventional western medicine treatment,while the observation group adopted Shenzhi Huoxue Decoction adjuvant therapy on the basis of the controlled group.The clinical efficacy between the two groups of patients was compared after treatment,and the changes in TCM syndromes scores and renal function[24 h urine total protein(24 hUTP),blood urea nitrogen(BUN),serum creatinine(Scr)]were evaluated in the two groups before and after treatment,and the differences in adverse drug reactions were analyzed during treatment.Results:After 6 months of treatment,there was a statistically significant difference in the overall efficacy between the two groups,and the total effective rate in the observation group was higher than that in the controlled group(P<0.05).The scores of soreness and weakness of waist and knees,fatigue,limb edema,poor appetite and anorexia,dizziness and epigastric fullness in the two groups after 6 months of treatment were reduced compared with those before treatment,and the scores in the observation group were lower than those in the controlled group(P<0.05).After 6 months of treatment,the 24 hUTP in both groups was lower than that before treatment,and the 24 hUTP in the observation group was lower than that in the controlled group at the same period(P<0.05),and the BUN and Scr of the two groups were increased compared with those before treatment,and there were no statistical differences between the two groups(P>0.05).There was no statistical significance in the incidence rate of adverse reactions between the two groups(P>0.05).Conclusion:Shenzhi Huoxue Decoction adjuvant therapy can enhance the efficacy,improve the clinical symptoms,and effectively reduce the 24 h urine protein level in patients with stage I-II PMN of Qi deficiency and blood stasis type,with good safety.