中西医结合滋阴清化法为主治疗IgA肾病的临床研究

Clinical Study on IgA Nephropathy Treated with Method of Nourishing Yin and Eliminating Pathogens in Integrating Chinese with Western Medicine

目的:观察以滋阴清化法为主联合西药降纤酶、甲基强的松龙(或地塞米松)、盐酸氮芥治疗IgA肾病(IgAN)的临床疗效。方法:将483例住院的IgAN患者随机分为两组:即滋阴清化汤+三联组(简称治疗组)和常规疗程的泼尼松+雷公藤多苷片组(简称对照组),观察和随访两组的临床疗效。结果:(1)治疗1个月后治疗组尿蛋白明显下降,疗效优于对照组(P<0.05);(2)治疗6个月后治疗组尿蛋白继续下降,转阴率优于对照组(P<0.05);(3)12个月后治疗组尿蛋白转阴率优于对照组(P<0.05),完全缓解率达68.3%(166/243例),总有效率达96.7%(P<0.05)。结论:滋阴清化法为主联合西药降纤酶、甲基强的松龙(或地塞米松)、盐酸氮芥治疗IgAN起效快,完全缓解率和总有效率高,疗效优于常规疗程的泼尼松与雷公藤多苷片。

Objective：To observe the therapeutic effect on IgA nephropathy（IgAN） treated with the method of nourishing yin and eliminating pathogen （Chinese medical therapy） allied with western drugs as defibrase, methylprednisolone（or dexamethasone） and ehlormethine hydrochloride. Methods ：483 IgAN inpatients were randomly divided into two groups： Chinese decoction for nourishing yin and eliminating pathogens ＋ three-allied therapy group（treatment group） and prednisone of conventional treatment ＋ tripterysium glycosides group （control group）. Results： （1） After one month treatment,urine protein was decreased remarkably in treatment group,and the therapeutic effect was superior to that in control group （P〈 0.05） ; （2） After six month treatment,urine protein in treatment kept decreasing and the negative revolution proportion was superior to that in control group（P〈0.05）; （3） After 12 month treatment,the negative revolution proportion of urine protein in treatment group was superior to that in control group（P〈0.05）. The complete remission rate was 68.3%（166/243 cases） and the total effective rate was 96.7% （P〈0.05）. Conclusion：In treatment group,the effect on IgAN is achieved quickly, both complete remission rate and total effective rate are high, and the theraoeutic effect is sunerior to that in control group.