224例慢性肾炎蛋白尿CKD1～2期患者的血脂水平和中医证型的关系

Relationship between Lipid Levels and TCM Syndrome in 224 Proteinuria Patients of Chronic Glomerulonephritis CKD1～2

目的：观察慢性肾炎蛋白尿CKD1～2期患者的血脂水平及中药的影响。方法：6个中心前瞻性随机对照研究。224例患者中医辨证为脾肾两虚的患者,分为试验组168例,对照组56例。试验组予中药免煎颗粒每日1袋,对照组予氯沙坦50 mg/d。疗程6个月。观察治疗前后总胆固醇（TC）、甘油三酯（TG）、低密度脂蛋白（LDL）水平及变化。结果：最终有212例患者完成试验。所有患者TC、TG、LDL水平在治疗前后均在正常范围。在3个兼证中,兼瘀血的患者血脂水平最高,尤其是LDL（P〈0.05）。两组患者的TC、TG水平在治疗前后组间及组内比较无统计学差异（P＞0.05）。LDL水平在治疗前组间比较无统计学差异（P＞0.05）,治疗后对照组明显高于试验组（P〈0.05）;试验组在治疗后LDL水平有明显下降（P〈0.05）。结论：慢性肾炎蛋白尿CKD1～2期患者TC、TG、LDL水平均在正常范围。其证型分布特点与高血脂类似。中药在治疗蛋白尿的同时能降低LDL水平。

Objective：To evaluate the lipid levels in proteinuria of chronic glomerulonephritis CKD1 ～ 2 patients and the impact of traditional Chinese medicine.Methods：Six-center prospective randomized study was carried out.224 patients of TCM spleen and kidney deficiency were divided into test group 168 cases and control group 56 cases.The patients in test group received Chinese medicine granules daily.And the control group received losartan 50 mg/day.The total treatment period was 6 months.We observed the levels and changes of total cholesterol（TC）,triglyceride（TG）,low density lipoprotein（LDL） before and after treatment.Results：212 patients completed the test finally.TC,TG,LDL levels of all patients were within normal range before and after treatment.Lipid levels in syndrome of blood stasis patients was the highest,especially LDL（P〈0.05）.The levels of TC and TG had no significant difference between two groups（P〉0.05） before and after treatment.The levels of LDL in control group was significant higher than that of treatment group（P〈0.05） after treatment.LDL levels in treatment group were decreased significantly（P 〈 0.05） after treatment.Conclusion：TC,TG and LDL levels in proteinuria of chronic glomerulonephritis CKD1 ～ 2 patients were within the normal range.TCM syndrome distribution characteristics were similar with high cholesterol.LDL levels can be lowered in the treatment of proteinuria by Chinese medicine.