化瘀通络解毒法治疗瘀血阻络型IgA肾病60例临床观察

Observation of dispersing blood stasis,dredging collateral and detoxication therapy on IgA nephropathy with blood stasis obstructing the collaterals type

目的观察化瘀通络解毒中药治疗IgA肾病的临床疗效。方法将90例血阻络型IgA肾病患者随机分为2组。对照组30例采用西医常规治疗,治疗组30例在西医常规治疗基础上加用化瘀通络解毒中药治疗。2组均以治疗3个月为1个疗程,连续治疗2个疗程。观察比较2组治疗前后尿常规中红细胞计数及24 h尿蛋白定量,比较2组血肌酐(Cr)及尿素氮(BUN)水平变化,并记录2组患者治疗期间的外感次数。结果治疗后治疗组总有效率81.7%,对照组总有效率53.3%,2组总有效率比较差异有统计学意义(P<0.05),治疗组疗效优于对照组;治疗组治疗后尿常规中红细胞计数、24 h尿蛋白定量与治疗前比较差异均有统计学意义(P<0.05);对照组治疗后24 h尿蛋白定量与治疗前比较差异有统计学意义(P<0.05);治疗组治疗后尿常规中红细胞计数、24 h尿蛋白定量与对照组治疗后比较差异均有统计学意义(P<0.05);2组治疗前后血Cr、BUN比较差异均无统计学意义(P>0.05);2组外感不良事件比较差异有统计学意义(P<0.05)。结论化瘀通络解毒中药治疗IgA肾病临床效果确切,可以明显改善患者血尿和蛋白尿症状,提高患者免疫力,减少外感的发生,应用方便,安全可靠。

Objective To observe the clinical effect of dispersing blood stasis, dredging collateral and detox- ication Chinese medicine on IgA nephropathy. Methods 90 patients with IgA nephropathy with blood stasis ob- structing the collaterals type were randomly divided into two groups. 30 cases in control group were treated by conven- tional western medicine. 60 cases in treatment group were treated by conventional western medicine combined with dispersing blood stasis, dredging collateral and detoxication therapy. The course was three months in two groups. The changes of RBC, 24h urine protein quantitation, Cr and BUN before and after treatment were observed in two groups. The number of exogenous affection of patients during treatment was recorded in two groups. Results The total effec- tive rate in treatment group （81.7%） was higher than that in control group （53.3% , P 〈0.05）. There was signifi- cant difference between before and after treatment on RBC and 24h urine protein quantitation in treatment group （ P 〈 0.05 ）. There was significant difference between before and after treatment on 24h urine protein quantitation in control group （ P 〈 0.05 ）. There was significant difference between two groups on RBC and 24h urine protein quantitation after treatment （P 〈 0.05 ）. There was no significant difference between two groups on Cr and BUN （P 〉 0.05）. There was significant difference between two groups on exogenous ad- verse events （P 〈 0.05 ）. Conclusion Dispersing blood stasis, dredging collateral and detoxication therapy has defi- nite effect on IgA nephropathy, can significantly improve symptoms in patients with hematuria and proteinuria, im- prove patient immunity and reduce the incidence of exogenous, it has convenient, safe and reliable.