中药联合苯那普利治疗慢性肾小球肾炎的临床研究

Clinical study of integrated traditional medicine and Benazepril in treating chronic glomerulonephritis

目的探讨中药联合苯那普利治疗慢性肾小球肾炎的疗效。方法将60例慢性肾小球肾炎患者随机分为中药（Ⅰ组）、西药（Ⅱ组）、中西医结合治疗组（Ⅲ组），每组20例；采用双盲法给予中药、苯那普利、中药联合苯那普利治疗，疗程24周。收集投药初始以及第12、24周的实验室指标及中医症状积分进行对照分析。结果经24周治疗，3组中医症状积分均降低（P〈0．05）。Ⅲ组24h尿蛋白定量下降较Ⅰ组有显著性差异（P〈0．05）。Ⅱ、Ⅲ组血浆自蛋白较治疗前升高（P〈0．05）。Ⅱ组血肌酐较Ⅰ组及Ⅲ组升高（P〈0．05）。依据中医证侯疗效标准判定，Ⅲ组有效率为89％、Ⅰ组为65％、Ⅱ组为40％，3组间差异有统计学意义（P〈0．01）；根据西医疗效标准判定，Ⅲ组有效率为94％、Ⅱ组为85％、Ⅰ组为75％，3组间差异有统计学意义（P〈0．05）。结论中药联合苯那普利较单纯中药或苯那普利能更好的改善慢性肾小球肾炎的临床症状，降低尿蛋白，延缓肾功能减退。

Objective To observe the effect of integrated traditional Chinese medicine （TCM） and Benazepril in treating chronic glomerulonephritis （CGN）. Methods Sixty patients with CGN were divided into TCM group （group Ⅰ ）, Benazepril group （group Ⅱ） and integrated group （group ]]] ） randomly, with 20 cases in each group. All the patients were treated for 24 weeks. The scores of TCM syndrome and laboratory indices were compared at 0, 12, 24 weeks. Results At 24^th week, scores of TCM syndromes in three groups were decreased significantly as compared with those before treatment （P〈0. 05）. 24-h urinary protein in group Ⅲ was decreased significantly as compared with group Ⅰ （P〈0. 05）. Albumin in groups Ⅱand Ⅲ was increased significantly to baseline （P〈0. 05）. Serum creatinine in group Ⅱ was increased significantly as compared with groups Ⅰ and Ⅲ （P〈0. 05）. According to the criterion of Chinese medicine syndrome therapeutic effect, the effective rate in groups Ⅲ, Ⅰ and Ⅱ was 89%, 65%and 40% respectively （P〈0. 01）. However, the effective rate to Western medicines standards was 94G in group Ⅲ, 85G in group Ⅱ and 75G in group Ⅰ （P〈0.05）. Conclusions The integrated TCM combined with Benazepril can more effectively improve clinical syndromes, reduce urine protein and delay the progression of renal function in patients with ehronic glomerulonephritis than TCM or benazepril alone.