肾络宁治疗IgA肾病的临床疗效及安全性评价

Clinical Research on IgA Nephrosis with the Therapy of Regulating Shaoyang Channel and Treat Both Secondary and Primary Symptoms

目的:观察疏利少阳标本兼治法之肾络宁治疗IgA肾病气阴两虚兼有湿热证的临床疗效及安全性。方法:将90例IgA肾病气阴两虚兼有湿热证患者随机分为治疗组和对照组,治疗组在基础治疗的同时,加服肾络宁;对照组在基础治疗的同时,加服肾炎康复片。治疗6个月后,观察两组患者治疗前后中医证候积分变化,以及尿常规,24 h尿蛋白定量,尿NAG、GAL,肝肾功能等实验室指标的变化。结果:(1)临床疗效比较:肾络宁组总有效率为86.67%,对照组为80%;中医证候疗效比较:肾络宁组总有效率为93.33%,对照组为86.67%。(2)对尿红细胞及尿蛋白的影响:肾络宁可明显降低患者尿中红细胞数量及减少尿蛋白,且在改善血尿方面疗效优于肾炎康复片组。(3)肾功能的影响:本研究选择的IgA肾病患者,其肾脏病理分级多在三级以下,肾功能基本正常,故未能反映出肾络宁在此方面的疗效。(4)观察期间,两组患者均未发生不良反应。结论:肾络宁治疗IgA肾病气阴两虚兼有湿热证的临床疗效肯定,安全性良好;能较好地改善患者症状,有效地减少患者血尿、尿蛋白,保护肾小管功能,且在减少血尿方面优于对照组。

Objective：Research clinical effect of Shenluoning with the therapy of regulating Shaoyang channel and treat both secondary and primary symptoms on IgA nephrosis with deficiency of qi and yin and with syndrome of dampnessheat.Methods：90 patients of IgA nephrosis with deficiency of qi and yin and with syndrome of dampnessheat are to be divided randomly into two groups,one is treatment group,the other is control group.The treatment group is to be given foundation treatment and Shenluoning,the control group is to be given foundation treatment and Shenyankangfupian.After 6 months,change of score of TCM symptoms,urine routine,24 h urine protein quantitation,urine n-acetyl-glucosaminidase（NAG）,galactosidae（GAL）,liver function,renal function are to be researched.Results：（1）Comparison of clinical effect：Total effective rate of the treatment group is 86.67%,the control group is 80%;Total effective rate of the treatment groupis 93.33%,the control group is 86.67%.（2）Effect on blood corpuscle cell and 24 h urine protein quantitation in urine：Shenluoning could reduce quantity of blood corpuscle cell and 24h urine protein quantitation in urine,and curative effect of Shenluoning on blood corpuscle cell of IgA nephrosis is better than that of Shenyankangfupian.（3）Effect on renal function：All patients of IgA nephrosis in this research,their renal function is normal and patho-renal is below tri-grade,so the curative effect of Shenluoning on renal function could not be researched.（4）During the research,no dverse reaction occured in the two groups.Conclusion：Clinic curative effect of Shenluoning on IgA nephrosis with deficiency of qi and yin and with syndrome of dampnessheat is positive and safe,Shenluoning could relieve symptoms,reduce urine RBC and 24 h urine protein quantitation,protect renal tubule function,the effect of reduce urine RBC of Shenluoning is better than that of Shenyankangfupian especially.