芪莲茅根汤治疗蛋白尿型IgA肾病临床观察与实验研究

Clinical Observation and Experimental Study on Treating Proteinuria Type of IgA Nephropathy by Qilian Maogen Decoction

[目的]观察芪莲茅根汤治疗蛋白尿型IgA肾病的临床疗效,并探讨其对实验性IgA肾病大鼠的治疗作用。[方法]治疗组94例采用中西医结合方法治疗,对照组28例采用单纯西药治疗,进行24h尿蛋白定量比较,连续观察6个月。用牛血清白蛋白(BSA)和葡萄球菌肠毒素B(SEB)诱导制作SD大鼠IgA肾病模型,治疗组予芪莲茅根汤治疗,观察其对模型大鼠蛋白尿、肾功能及血浆蛋白的影响以及对肾脏病理的改善。[结果]临床治疗组总有效率为88%,对照组为68%(P<0.05);治疗组复发率明显低于对照组(P<0.05)。24h尿蛋白定量比较,治疗组6个月后与对照组比较P<0.05,与治疗前比较P<0.01。芪莲茅根汤有明显降低尿蛋白,改善肾功能,减轻肾小球损伤,减少免疫复合物在肾小球系膜区的沉积,其改善作用优于对照组。[结论]芪莲茅根汤具有保护肾功能,减少IgA在肾小球系膜区沉积的治疗作用。

[Objective] To observe the clinical effect of Qilian Maogen Decoction in treating proteinuria type of IgA nephropathy and explore the main mechanism in treating experimental IgA nephropathy in rats. [Methods] The patients of treatment group were treated with combined TCM and Western medicine and that of control group were treated with Western medicine ordy. The 24 h urine protein quantity in patients of two groups was observed for continuous 6 months. The IgA nephropathy in SD rats was induced by using bovine serum albumin（BSA） and staphylococcal enterotoxin B（SEB）. The rats of treatment group were administrated with Qilian Maogen Decoction. The proteinuria, renal function, plasma protein and renal pathological changes were observed. [Results] The total effective rate of clinical treatment group was 88% and that of control group was 68%（P〈0.05）. The recurrence rate of clinical treatment group was obviously lower than that of control group （P〈0.05）. The Qilian Maogen Decoction may obviously decrease proteinuria, improve renal function, lessen the injury of renal glomeruli and decrease the deposition of antigen-antibody complex in the renal glomerular mesenterium. [Conclusions] The Qilian Maogen Decoction may protect renal function and decrease the IgA deposition in the glomerular mesangium of kidney.