健脾益肾活血祛风法治疗特发性膜性肾病临床研究

Clinical Observation of Therapy of Invigorating Spleen and Kidney,Activating Blood and Dispelling Wind for Idiopathic Membranous Nephropathy

目的:观察健脾益肾活血祛风法治疗特发性膜性肾病的临床疗效。方法:选择63例特发性膜性肾病患者,随机分为治疗组32例和对照组31例,2组均采用常规西医治疗方法,治疗组加用中医健脾益肾活血祛风法治疗,观察治疗前后尿蛋白、肾功能、血白蛋白等变化。结果:治疗组完全缓解16例,基本缓解12例,有效3例,无效1例,缓解率87.5%。对照组完全缓解4例,基本缓解14例,有效9例,无效4例,缓解率58.1%。2组缓解率比较,差异有显著性意义(P<0.05)。2组患者治疗前的24 h尿蛋白定量、血清白蛋白(Alb)、血肌酐(SCr)、血尿素氮(BUN)比较,差异无显著性意义(P>0.05),具有可比性。2组治疗后24 h尿蛋白定量、血SCr比较,差异有显著性意义(P<0.01),血Alb、BUN比较,差异无显著性意义(P>0.05)。治疗后治疗组24 h尿蛋白定量、血Alb、血SCr与治疗前比较改善显著(P<0.05),对照组24h尿蛋白定量与治疗前比较改善显著(P<0.05)。结论:健脾益肾活血祛风法治疗特发性膜性肾病疗效肯定。

Objective： To investigate the clinical effect of therapy of invigorating spleen and kidney, activating blood and dispelling wind for idiopathic membranous nephropathy. Methods： Sixty-three patients with idiopathic membranous nephropathy were randomly divided into treatment group and control group. Both groups were given conventional western medicine treatment, and the treatment group was treated with Chinese herbal medicine with the actions of invigorating spleen and kidney, activating blood and dispelling wind. Urinary protein, renal function, and blood albumin（AIb） were observed before and after treatment. Results： After treatment, among 32 cases of the treatment group, complete remission was shown in 16 cases, partial remission in 12 cases, effectiveness in 3 cases, failure in one case and the remission rate was 87.5%, and among 31 case of the control group, complete remission was shown in 4 cases, partial remission in 14 cases, effectiveness in 9 cases, failure in 4 cases and the remission rate was 58.1%, the difference of remission rate being significant（P〈 0.05）. Before treatment, the differences of quantitation of 24-hour urinary protein（24h-pro）, serum creatinine（SCr）, blood urea nitrogen（BUN）, and AIb between the two groups were insignificant（P〉 0.05）. After treatment, the differences of 24h-pro and SCr between the two groups were significant（P〈 0.05）, while the differences of BUN and AIb between the two groups were insignificant （P 〉0.05）.Compared with those before treatment, 24h-pro, SCr and AIb were much improved in the treatment group（P〈0.05）, and 24h-pro was much improved in the controlgroup（P 〈0.05） after treatment. Conclusion： The therapy of invigorating spleen and kidney, activating blood and dispelling wind has certain therapeutic effect for idiopathic membranous nephropathy.