肾素-血管紧张素系统阻断剂联合中医辨证治疗轻度蛋白尿60例临床观察

Clinical observation of RAS blocker combined with TCM syndrome differentiation on mild proteinuria

目的观察肾素-血管紧张素系统(RAS)阻断剂联合中医辨证治疗轻度蛋白尿的临床疗效。方法将60例轻度蛋白尿患者随机分为2组,对照组30例予RAS阻断剂、控制血压和血糖等西医对症基础治疗,治疗组30例在对照组治疗基础上加用中医辨证治疗。2组均治疗12周后统计临床疗效,并观察2组治疗前后24 h尿蛋白定量(24 h UTP)及中医证候积分情况。结果治疗组总有效率90.0%,对照组总有效率63.3%,2组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24 h UTP、中医证候积分较治疗前明显减少,比较差异均有统计学意义(P<0.05);对照组治疗前后24 h UTP、中医证候积分比较差异均无统计学意义(P>0.05);2组治疗后24 h UTP、中医证候积分组间比较差异均有统计学意义(P<0.05)。结论 RAS阻断剂联合中医辨证治疗轻度蛋白尿疗效确切,不仅能降低尿蛋白定量,更能减少中医证候积分,改善生活质量。

Objective To observe the clinical effects of renin-angiotensin system（ RAS） blocker combined with traditional Chinese medicine（ TCM） syndrome differentiation on the treatment of mild proteinuria. Methods 60 patients with mild proteinuria were randomly divided into two groups. The control group（ n = 30） was treated by western medicine symptomatic treatment,including the RAS blockers,control blood pressure and blood glucose,etc. The treatment group（ n = 30） was treated by TCM syndrome differentiation based on the control group treatment. The curative effects were evaluated after 12 weeks treatment in two groups. The 24-hour urine protein（ 24 h UTP） and the scores of TCM symptom before and after treatment were observed in two groups. Results The total effective rate in treatment group（ 90. 0%） was superior to that in control group（ 63. 3%,P〈0. 05）. The 24 h UTP and the scores of TCM symptom after treatment were reduced in treatment group,with statistical differences（ P〉0. 05）. There was no statistical difference on 24 h UTP and the scores of TCM symptom between before and after treatment in control group（ P〈0. 05）. There were statistical differences on 24 h UTP and the scores of TCM symptom after treatment between the treatment and control group（ P〈0. 05）. Conclusion RAS blocker combined with TCM syndrome differentiation has exact effects on the treatment of mild proteinuria,not only reduce the protein quantification,but also reduce the scores of TCM syndrome,improve the quality of life.