参芪地黄汤治疗慢性肾小球肾炎气阴两虚证临床疗效及对免疫功能影响

Clinical Effect of Shenqi Dihuang Decoction(参芪地黄汤)in the Treatment of Chronic Glomerulonephritis with Syndrome of Deficiency of Both Qi and Yin and Influence on Immune Function

目的观察参芪地黄汤治疗慢性肾小球肾炎(CGN)气阴两虚证患者临床疗效及对免疫功能的影响。方法选取2019年1月—2019年12月于阜新市中医医院肾内科就诊的120例CGN气阴两虚证患者,按照随机数字表法将120例CGN气阴两虚证患者分为中医综合治疗组和西药常规对照组,每组各60例,其中西药常规对照组采用缬沙坦胶囊80 mg日1次口服、黄葵胶囊5粒日3次口服等常规西药治疗,中医综合治疗组则在西药常规对照组基础上联合参芪地黄汤治疗,两组患者均连续治疗8周。分析两组患者治疗前后中医证候积分、24 h尿蛋白定量(24 h-UPQ)、肾功能指标[尿素氮(BUN)、血肌酐(Scr)]、体液免疫指标[免疫球蛋白A(Ig A)、免疫球蛋白G(Ig G)、免疫球蛋白M(Ig M)、补体C_(3)]、细胞免疫指标(CD_(4)^(+)、CD_(8)^(+)、CD_(4)^(+)/CD_(8)^(+))水平变化情况。结果中医综合治疗组临床有效率(88.33%)显著高于西药常规对照组(58.33%),两组比较差异具有统计学意义(P<0.05);治疗结束后,中医综合治疗组BUN、Scr、24 h-UPQ水平显著低于西药常规对照组(P<0.05),中医证候积分显著低于西药常规对照组(P<0.05),血清Ig G、Ig M、补体C_(3)、CD_(4)^(+)、CD_(4)^(+)/CD_(8)^(+)水平显著高于西药常规对照组(P<0.05),血清Ig A、CD_(8)^(+)水平显著低于西药常规对照组(P<0.05)。结论参芪地黄汤联合常规西药治疗CGN气阴两虚证患者临床疗效确切,能够改善临床症状与肾功能,降低尿蛋白水平,增强细胞免疫及体液免疫功能,具有临床推广应用价值。

Objective To observe the clinical effect of Shenqi Dihuang Decoction(参芪地黄汤,SQDHT)in the treatment of chronic glomerulonephritis(CGN)with syndrome of deficiency of both Qi and Yin and influence on immune function.Methods 120 cases of CGN with syndrome of deficiency of both Qi and Yin in the nephrology department of Fuxin hospital of traditional Chinese medicine from January 2019 to December 2019 were randomly divided into the SQDHT comprehensive treatment group and the Western medicine routine control group,60 cases in each group.The Western medicine routine control group was treated with oral valsartan capsules 80 mg once daily and Huangkui Capsule(黄葵胶囊)5 tablets three times a day,and the SQDHT comprehensive treatment group was treated with SQDHT on the basis of the Western medicine routine control group.The two groups were treated for 8 weeks.TCM syndrome score,24-hour urinary protein quantity(24 h-UPQ),renal function indexes[serum creatinine(Scr),blood urea nitrogen(BUN)],humoral immunity indexes[immunoglobulin A(IgA),IgG,IgM,C3]and cellular immunity indexes(CD_(4)^(+),CD_(8)^(+),CD_(4)^(+)/CD_(8)^(+))before and after treatment were compared between two groups.Results The total effective rate of the SQDHT comprehensive treatment group was significantly higher than that of the Western medicine routine control group(P<0.05).After treatment,BUN,Scr,24 h-UPQ in the the SQDHT comprehensive treatment group were significantly lower than those of the Western medicine routine control group(P<0.05);the TCM syndrome score in the SQDHT comprehensive treatment group was significantly lower than those of the Western medicine routine control group(P<0.05);the serum IgG,IgM,C_(3),CD_(4)^(+),CD_(4)^(+)/CD_(8)^(+)in the SQDHT comprehensive treatment group were significantly higher than those of the Western medicine routine control group(P<0.05);the serum IgA and CD_(8)^(+)in the SQDHT comprehensive treatment group were significantly lower than those of the Western medicine routine control group(P<0.05).Conclusion SQDHT combined with conventional Western medicine in the treatment of CGN with syndrome of deficiency of both Qi and Yin has definite clinical effect,reduce urinary protein level,enhance cell immunity and humoral immunity and has clinical application valueof CGN patients with deficiency of Qi and Yin.