益气滋阴、清热活血法治疗狼疮性肾炎临床研究

Clinical Study on Lupus Nephritis Treated with Qi-Enriching and Yin-Reinforcing,Blood-Activating and Heat-Clearing Therapy

目的观察以中医益气滋阴、清热活血原则组方的滋阴清斑汤配合西药治疗狼疮性肾炎(LN)阴虚内热型的临床疗效,以及对患者自身抗体、补体的影响。方法将阴虚内热型LN患者60例随机分为试验组40例和对照组20例。2组均给予控制感染,维持水、电解质、酸碱平衡,控制并发症,应用激素等治疗,试验组在此基础上配合服用滋阴清斑汤,用药6个月。观察2组治疗前后临床症状及实验室检查的变化情况。结果试验组总有效率为87.5%(35/40),对照组为70.0%(14/20),2组比较差异有统计学意义(P<0.05);试验组在改善患者临床症状积分,升高红细胞、血红蛋白、补体C3,及降低血肌酐、尿蛋白等方面效果优于对照组(P<0.05或P<0.01),且对改善某些临床症状效果较好。结论中西医结合治疗在改善LN患者临床症状和实验室指标、提高整体疗效方面效果更好。

Objective To investigate the clinical effect on lupus nephritis（LN） patients with yin deficiency and inner heat syndrome,and the influence on autoantibodies and complements treated by Ziyin Qingban soup,which was formed with the principle of qi-enriching and yin-reinforcing,blood-activating and heat-clearing therapy,combined with western medicine.Methods Sixty LN patients with yin deficiency and inner heat syndrome were randomly divided into 2 groups,40 cases in the trial group and 20 cases in the control group.Both groups were treated with controlling infecting,maintaining balance of water,electrolyte and acid-base,controlling complication and immunity-restraining drugs,such as adrenocortical hormones.The trial group was treated with Ziyin Qingban soup additionally for 6 months.The clinical symptoms and laboratory indicators of the two groups before and after treatment were observed.Results The total effective rate of the trial group was 87.5%（35/40）,while that of the control group was 70.0%（14/20）,there was a significant difference（P〈0.05）.The trial group was superior to the control group in improving the clinical symptoms scores,raising RBC,Hb,C3,and lowering SCr and proteinuria,etc（P〈0.05 or P〈0.01）.Conclusion The integrated treatment of TCM and western medicine had good effect on symptoms and laboratory indexes of LN patients,thus may improve the whole curative effect.