参芪地黄汤加减联合骨化三醇治疗慢性肾小球肾炎临床观察

Clinical Observation of Shenqi Dihuang Decoction(参芪地黄汤)Combined with Calcitriol in Treatment of Chronic Glomerulonephritis

目的探讨参芪地黄汤加减联合骨化三醇治疗慢性肾小球肾炎临床观察。方法将2019年1月—2020年12月在丹东市第一医院肾内科治疗的108例慢性肾小球肾炎患者随机分为两组,对照组使用常规治疗,在此基础上,观察组使用参芪地黄汤加减联合骨化三醇治疗,对比两组的临床疗效、肾功能及尿蛋白指标、中医证候积分变化、炎性因子水平变化。结果观察组治疗有效率为94.44%(51/54),明显高于对照组的77.78%(42/54)(P<0.05);观察组治疗后血肌酐(Scr)、尿素氮(BUN)、肾小球滤过率(GFR)、血清胱抑素C(Cys-C)、尿白蛋白排泄率(UAER)、24小时尿蛋白定量(24 h UTP)、β2-微球蛋白(MG-β2)水平明显低于对照组,GFR明显高于对照组(P<0.05);观察组治疗后腰膝酸软、气短乏力、脘腹胀满、肢体浮肿、纳差等中医证候积分明显低于对照组(P<0.05);观察组治疗后白细胞介素(IL-6、IL-8)、肿瘤坏死因子(TNF-α)、转化生长因子-β1(TGF-β1)水平明显低于对照组(P<0.05)。结论参芪地黄汤加减联合骨化三醇治疗慢性肾小球肾炎临床疗效显著,能有效改善肾功能,抑制蛋白尿,减轻机体炎症反应水平,缓解中医证候。

Objective To investigate the clinical effect of Shenqi Dihuang Decoction(参芪地黄汤)combined with calcitriol in the treatment of chronic glomerulonephritis.Methods A total of 108 patients with chronic glomerulonephritis treated in the hospital from January 2019 to December 2020 were randomly divided into two groups.The control group was treated with conventional treatment.On this basis,the observation group was treated with Shenqi Dihuang Decoction combined with calcitriol.The clinical efficacy,renal function,urinary protein index,TCM syndrome score and inflammatory factor levels of the two groups were compared.Results The effective rate of the observation group was 94.44%(51/54),which was significantly higher than 77.78%(42/54)of the control group(P<0.05).The levels of serum creatinine(Scr),urea nitrogen(BUN),glomerular filtration rate(GFR),serum cystatin C(Cys-C),urinary albumin excretion rate(UAER),24-hour urine protein quantification(24 h UTP)andβ2-microglobulin(MG-β2)in the observation group after treatment were significantly lower than those of the control group and GFR in the observation group was significantly higher than that of the control group(P<0.05).After treatment,the TCM syndrome scores of the observation group were significantly lower than those of the control group(P<0.05).The levels of interleukin(IL-6,IL-8),tumor necrosis factor-α(TNF-α)and transforming growth factor-β1(TGF-β1)in the observation group after treatment in the treatment group were significantly lower than those in the control group(P<0.05).Conclusion Shenqi Dihuang Decoction combined with calcitriol has a significant clinical effect in the treatment of chronic glomerulonephritis,which can effectively improve renal function,inhibit proteinuria,reduce the levels of inflammatory reaction,and relieve symptoms,which has positive clinical significance.