一半汤联合氯沙坦治疗气阴两虚兼湿热型慢性肾小球肾炎蛋白尿的临床观察

Clinical observation on the combination of “Yiban Decoction”and Losartan for the treatment of Qi Yin deficiency and damp-heat chronic nephritis proteinuria

目的观察一半汤联合氯沙坦治疗气阴两虚兼湿热型慢性肾小球肾炎蛋白尿的临床疗效。方法将70例慢性肾小球肾炎蛋白尿患者随机分为治疗组和对照组,每组35例。对照组予氯沙坦钾片,治疗组在对照组基础上加用一半汤。两组疗程均为3个月,观察临床疗效,比较24 h尿蛋白定量、尿红细胞水平、中医证候积分及肾功能相关指标水平的变化情况。结果 1治疗组、对照组临床总有效率分别为77.14%和62.86%;组间临床疗效比较,差异有统计学意义(P<0.05)。2组间治疗后比较,24 h尿蛋白定量及尿红细胞水平差异有统计学意义(P<0.05)。3治疗前后组内比较,两组中医证候积分差异有统计学意义(P<0.05);组间治疗前后中医证候积分差值比较,差异有统计学意义(P<0.05)。4治疗前后组内比较,两组BUN、Cr、ALB水平差异均有统计学意义(P<0.05);组间治疗后比较,ALB水平差异有统计学意义(P<0.05)。结论一半汤联合氯沙坦治疗气阴两虚兼湿热型慢性肾小球肾炎蛋白尿,可显著降低尿蛋白,改善临床症状。

Objective To observe the clinical efficacy of＂Yiban Decoction＂and Losartan for the treatment of chronic nephritis proteinuria. Methods 70 patients with chronic nephritis proteinuria were randomly divided into treatment group and control group,35 in each group. Both groups were treated with Losartan,and treatment group was treated with＂Yiban Decoction＂additionally,with the course of three months for both groups. The clinical efficacy were observed,24 h urinary protein,plasma protein,TCM syndrome differentiation and renal function related index were compared. Results 1The total effective rate was 62. 86% in the control group and 77. 1% in the treatment group,with a difference between the two groups（ P 〈 0. 05）. 2Comparison before and after treatment,there were significant differences in the levels of 24 hour urine protein and plasma protein between the two groups（ P 〈 0. 05）. 3Compared before and after the treatment,there was significant difference in the level of TCM syndrome differentiation in each group（ P 〈 0. 05）. Compared before and after the treatment,there was significant difference in the level of TCM syndrome differentiation between the two groups（ P 〈 0. 05）. 4 Compared before and after the treatment,there was significant difference in the level of BUN,Cr,ALB in each group（ P 〈 0. 05）. Compared before and after the treatment,there was significant difference in the level of ALB between the two groups（ P 〈 0. 05）. Conclusion ＂Yiban Decoction＂and Losartan for the treatment of Qi Yin deficiency and damp-heat chronic nephritis proteinuria can decrease urinary protein and improve clinical syndrome.