清下消补法治疗肝硬化合并蛋白尿30例临床观察

Clinical Observation on 30 Cases of Hepatic Cirrhosis with Proteinuria Treated with Combination of Clearing, Purging, Resolving and Tonifying Method

目的:采用回顾性研究方法观察以中医清下消补法立方所组成的清下消补方合五子衍宗汤加减治疗肝硬化合并蛋白尿的疗效。方法:肝硬化失代偿期合并蛋白尿患者60例,治疗组30例,予清下消补方合五子衍宗汤加减治疗;对照组30例,用肾肝宁胶囊。两组均以相同的西药治疗,包括护肝支持及对症治疗,检查治疗前后血中的丙氨酸转氨酶(ALT)、总蛋白(TP)、白蛋白(ALB)、总胆红素(TBIL)、直接胆红素(DBIL)、尿素氮(BUN)、肌酐(SCr)和24小时尿蛋白定量(24hu-pro),尿中的免疫球蛋白、白蛋白(IgGu、ALBu)。结果:两组治疗后组内各指标均有改善(P<0.05),两组间ALT、SCr的改善无显著性差异(P>0.05),治疗组TP、ALB、TBIL、DBIL、BUN和24hu-pro、IgGu、ALBu水平较对照组改善更明显(P<0.05)。结论:清下消补方合五子衍宗汤加减对肝硬化合并蛋白尿患者具有减轻蛋白尿、改善肾功能的疗效,为该类疾病的治疗提供了新的思路。

Objective: To observe the clinical effect of modified combined Qingxia Xiaobu Prescription and Wuzi Yanzong Decoction on hepatic cirrhosis with proteinuria. Methods: 60 cases of hepatic cirrhosis with proteinuria at compensatory phase were divided into the treatment group(n=30) treated with modified Qingxia Xiaobu Priscription and Wuzi Yanzong Decoction, and the control group treated with Shenganning Capsules. And the patients of the two groups were all treated by the same western medicine including liver-aid, supporting and expectant treatment. The changes of blood glutamic-pyruvic transminase (ALT), total protein (TP), albumin (ALB), total bilirubin (TBIL), direct bilirubin (DBIL), urea nitrogen (BUN), creatinite (SCr) and 24-h-urinary protein (24hu-pro), urinary immunoglobulin G(IgGu) and albumin (ALBu) levels before and after treatment were detected. Results: The all indexes in the two groups after treatment improved significantly (P<0. 05) and the treatment group had more significant improvement in TP, ALB, TBIL, DBIL, BUN and 24hu-pro, IgGu and ALBu levels as compared with the control group (P<0. 05). Conclusion: The modified combined Qingxia Xiaobu Description and Wuzi Yanzong Decoction can alleviate urinary protein and improve renal function in the patient of hepatic cirrhosis with proteinuria.