补肾活血汤治疗IgA肾病

Treatment of IgA nephritis with bushenhuoxuetang

目的探讨自拟方补肾活血汤对IgA肾病(IgAN)的疗效及其作用机制。方法经皮肾穿刺活检确诊的IgAN患者57例,A组(20例)用补肾活血汤、B组(20例)用补肾活血汤加贝那普利、C组(17例)用贝那普利治疗;均治疗8周。治疗前及治疗8周后分别检测24-h尿蛋白定量、尿红细胞计数、血肌酐、尿纤维蛋白原降解产物(FDP)及尿N-乙酰β-D氨基葡萄糖苷酶(NAG),并比较治疗前后各指标变化。结果8周后,A、B、C组蛋白尿治疗总有效率分别为75.0%、80.0%和76.5%,A、B组血尿治疗总有效率85.0%和95%,明显高于C组的47.1%(P<0.01);A、B两组尿FDP和尿NAG均明显下降(P<0.01、P<0.05)。结论补肾活血汤对IgAN具有治疗作用,尤其在治疗IgAN血尿方面,疗效明显优于贝那普利。作用机制可能与其降低尿中FDP有关。

Objective To study the therapeutic effect and mechanism of bushenhuoxuetang（BST）in IgA nephritis（IgAN）.Methods Fifty-seven patients with IgA nephritis diagnosed by renal biopsy were divided into 3 groups of treated with BST（group A,20 cases）,with BST plus benazepril（group B,20 cases）and with benazepril alone（group C,17 cases）.The changes of 24-h urinary protein（UP）,urinary red cell（URC）,serum creatinine（SCr）,urinary fibrin degradation products（UFDP）,urinary β-N-acetyglocosamidase（UNAG）before treatment and 8 weeks after treatment were observed.Results Eight weeks after treatment,total effective rates for treating UP in groups of A,B and C were 75.0%,80.0% and 76.5%,respectively.Total effective rates for treating hemuresis in groups of A and B were 85.0% and 95%,which were significantly higher than those in group C（P0.01）.UFDP and UNAG after treatment were lowered in group A and group B（P0.01 and P0.05）.Conclusion BST has therapeutic effects on IgAN,which is better than benazepril in treating IgAN.The possible mechanism is related to a decrease in urinary FDP.