补肾调肝化瘀法治疗气阴两虚型IgA肾病临床观察

Clinical Observation of Bushen Tiaogan Huayu Method in Treatment of IgA Nephropathy

目的:观察补肾调肝化瘀法治疗原发性IgA肾病的临床疗效与安全性。方法:采用随机对照的设计方案,将62例符合纳入标准中医辨证为气阴两虚的IgA肾病患者随机分为对照组和治疗组各31例治疗组,两组均以西医基础治疗,治疗组在此基础上加用加减乙癸方,治疗12周,观察4、8、12周时24 h尿蛋白定量(UP)、尿红细胞计数(URBC)、血肌酐(Scr)、血清白蛋白(ALB)、中医证候积分等疗效指标及肝功能和不良事件等安全性指标。结果:治疗组临床疗效有效率(83.87%,26/31)优于对照组(61.29%,19/31,P<0.05)。12周治疗后,治疗组中医症候积分、UP、URBC、ALB均明显改善(P<0.01、P<0.01、P<0.01、P<0.01),与对照组相比,差异有统计学意义(P<0.01、P<0.01、P<0.05、P<0.05)。治疗前后,治疗组Scr改善差异无统计学意义(P>0.05),但与对照组相比,差异有统计学意义(P<0.05)。结论:补肾调肝化瘀法联合西医基础治疗气阴两虚证的IgA肾病,与单独西医基础治疗相比可更有效减少中医症候积分,降低UP、URBC、Scr,且可以升高ALB,改善患者临床症状,且安全性高、不良反应发生率低。

Objective：To observe the clinical efficacy and safety of Bushen Tiaogan Huayu method in the treatment of primary IgA nephropathy. Methods ： Randomized controlled trial was conducted in 62 IgA nephropathy patients of Qi - Yin deficiency syndrome, who were randomly assigned to two groups treated with self - made Jiajian Yigui Decoction combined with Western medicine basic treatment （ treatment group, n = 31 ） and Western medicine basic treatment alone （ control group, n = 31 ） for 12 weeks. The changes of TCM syndrome scores, 24 -hour urine protein quantity, urinary red blood cell, serum creatinine and serum albumin were recorded. Results： The effective rate in the treatment group （83.87%, 26/31 ） was better than that in the control group （61.29%, 19/31, P 〈 0.05 ）. After 12 weeks of treatment, the TCM syndrome scores, UP, URBC and ALB of the treatment group were significantly improved（ P 〈 0.01 ,P 〈 0. 01 ,P 〈 0. 01, P 〈 0. 01 ）. Compared with the control group, the difference was statistically significant （P 〈 0. 01, P 〈 0.01,P 〈 0.05, P 〈 0. 05）. There was no significant difference in Scr change between the two groups before and after treatment （ P 〉 0. 05）, but there was significant difference compared with the control group （ P 〈 0. 05 ）. Conclusion ： Compared with Western medicine basic treatment alone, Bushen Tiaogan Huayu method combined with Western medicine basic treatment can more effectively reduce UP, URBC, Scr, TCM syndrome scores and improve ALB.