益气活血化湿方案治疗特发性膜性肾病的疗效观察及其相关因素分析

Clinical Therapeutic Research of Idiopathic Membranous Nephropathy by Yiqi Huoxue Huashi Project and Analysis of Correlative Influencing Factors

目的:回顾性分析益气活血化湿方案治疗特发性膜性肾病的临床疗效及肾脏存活率,并分析影响该方案治疗膜性肾病疗效的相关因素。方法:回顾性分析1997年～2008年收治的234例特发性膜性肾病患者临床资料,并进行统计学分析。结果:234例患者的完全缓解率为42.31%,总有效率分别为76.07%,治疗1年、2年、3年、≥4年的总有效率分别为72.22%、74.48%、75.47%、78.38%;中药治疗、中西医结合治疗、西药无效停药后使用中药治疗的总有效率分别为80.31%77.53%、70.89%;其3年、5年、10年肾脏存活率分别为99%、95%、80%。单因素分析表明年龄、吸烟史、高血压史、肌酐、尿素氮、血浆白蛋白、尿蛋白定量是影响缓解的相关因素;多因素分析筛选出4个比较重要的影响因素:年龄、吸烟史、随访时间、血浆白蛋白。结论:中药益气活血化湿方案治疗特发性膜性肾病疗效确切而巩固,复发率低,并可保护肾功能,延长肾脏存活时间。年龄、吸烟史、随访时间及血浆白蛋白水平可能是影响该方案疗效的重要因素。

Objective：To summarize and analyze the therapeutic effect of Yiqi Huoxue Huashi Project for patients with idiopathic membranous nephropathy（IMN）,and to observe the factor that influence the therapeutic effect.Methods：Two hundred and thirty four IMN patients were treated with Yiqi Huoxue Huashi Project.Clinical data including the common informations,course of disease,laboratory examination and follow-up office visit of IMN patients were collected and analyzed.Results：The rate of complete remission was 42.31%. The total effective rate was 76.07%. The total effective rates at year 1,2,3 and more than 4-year were 72.22%,74.48%,75.47% and 78.38%,respectively.The total effective rate of using Chinese medicine,combination of Chinese medicine and Western medicine and Chinese medicine after withdrawl of various western drugs showed no effectives was 80.31%,77.53%,70.89%.The renal survival rates of three years’,five years’ and ten years’were 99%,95% and 80% respectively.Univariate analysis showed that age,smoking,hypertension,serum creatinine,blood urea nitrogen,albumin,24 hours’urinary protein were the influence factors of remission.Multiple analysis showed four important influencing factors,which were age,smoking,follow time and albumin.Conclusion：The treatment of Yiqi Huoxue Huashi Project had good curative effect in evidence,even consolidated and low recurrence rate.The project was effective to protect renal function,and prolong renal survival time.The important factors that influenced curative effect were age,smoking,follow-up time and albumin level.