补气活血泄浊法治疗马兜铃酸肾病68例临床观察

Clinical Study on Method of Tonifying Qi and Promoting Blood Circulation to Purge the Turbid in Treating 68 Cases of Aristolochic Acid nephropathy

目的:观察补气活血泄浊法治疗马兜铃酸肾病的临床疗效。方法:选取冠心苏合丸致慢性肾小管间质性肾病68例,西医予基础对症治疗,中医分为脾肾气虚、肾阳虚衰、气阴两虚三型辨证治疗,观察患者临床症状改善及临床疗效,包括血肾功能、尿肾功能、24 h尿蛋白定量。结果:患者临床症状明显改善,总有效率达89.70%。治疗后血肌酐(Scr)、尿素氮(BUN)、尿N-乙酰葡萄胺酶(NAG)、β2微球蛋白(β2-MG)、24 h尿蛋白定量(Tupr)均有不同程度下降(P<0.05);肌酐清除率(Ccr)有所升高,肾功能较治疗前有一定程度好转(P<0.05)。脾肾气虚型有效率为93.55%,气阴两虚型为90%,肾阳虚衰型为82.35%。结论:补气活血泄浊法治疗马兜铃酸肾病疗效显著。

Objective ： To observe the clinical effect of the method of tonifying qi and promoting blo（xt circulation to purge the tur- bid in treating aristolochic acid nephropathy（ AAN ）. Method： 68 patients with chronic tubular- interstiti.,d, nephropathy caused by Guanxinsu Compound Pills at random were given Western medicine as a basic symptomatic treatment, and the disease was dif- ferentiated into three syndromes： qi deficiency of both spleen and kidney, deficiency of kidney yang, deficiency of qi and yin. Then observed the patients＇ improvement of clinical symptoms and clinical t.ffeets including renal fimction through blood test and urine test, accumulation of urine protein in 24 h. Results： Patients＇ clinical symptoms have been improved significantly with an efficiency rate of 89： 7%. After the treatment, SCR, BUN, NAG, [3z MG and Tupr decreased in different degrees （ P 〈0.05） ; Ccr increased slightly. Renal function has recovered to some degree （ P 〈 O. 05 ）. The effective rate of qi deficiency of both spleen and kidney is 93.55% , the deficiency of both qi and yin 90% , the deficiency of kidney yang 82.35%. Conclusion： The method of tonifying qi and promoting blood circulation to purge the turbid has the significant effects in treating aristolochic acid nephropathy.