活血化瘀方联合西药治疗血瘀型慢性肾小球肾炎随机平行对照研究

Randomized and Parallel Control Study of Huoxue Huayu Fang combined with Western Medicine in Treatment of Chronic Glomerulonephritis with Blood Stasis

[目的]观察活血化瘀方联合西药治疗血瘀型慢性肾小球肾炎疗效。[方法]使用随机平行对照方法,将80例住院患者按病志号抽签简单随机分为两组,控制饮食(低盐、优质蛋白质);控制血压。对照组40例地塞米松,3mg/次,2次/d,口服;厄贝沙坦,15mg/次,1次/d,口服;硝苯地平10~20mg/次,3次/d,口服;阿司匹林,40mg/次,3次/d,口服。治疗组40例活血化瘀方:人参30g,黄芪60g,当归20g,熟地黄、赤芍、桃仁各15g,三七25g,川芎30g,红花15g,猪苓20g,泽泻、茯苓各15g,水煎400mL,1剂/d,2次/d。;西药治疗同对照组。连续治疗1个月为1疗程。观测临床症状、尿素氮(BUN)、肌酐(Cr)、肌酐清除率(Ccr)、尿蛋白排泄量(Upro)、不良反应。连续治疗1个月,判定疗效。[结果]治疗组显效23例,有效12例,无效5例,总有效率77.50%;对照组显效9例,有效4例,无效27例,总有效率32.50%;治疗组疗效优于对照组(P<0.01)。BUN、Cr两组均有改善(P<0.01,P<0.05),治疗组改善优于对照组(P<0.01),Upro、Ccr治疗组均有改善(P<0.01),对照组无显著变化(P>0.05)。[结论]活血化瘀方联合西药治疗血瘀型慢性肾小球肾炎,疗效满意,无严重不良反应,值得推广。

[Objective] To observe the curative effect of Huoxue Huayu Fang combined with western medicine in treating chronic glomerulonephritis with blood stasis syndrome. [Methods] Using random parallel control method, 80 patients were randomly divided into two groups according to the number of sick patients. The diet（low salt, high quality protein） was controlled and blood pressure was controlled. The control group 40 cases, dexamethasone, 3 mg/times, 2 times/d, oral, irbesartan, 15 mg/times, 1 times/d, oral, nifedipine 10 to20 mg/times, 3 times/d, oral, aspirin, 40 mg/times, 3 times/d, oral. The treatment group of 40 cases of Huexue Huayufang： Renshen 30 g, Huangqi 60 g, Danggui 20 g, Shudihuang, Chishao, Taoren each 15 g,Sanqi 25 g,Chuanxiong 30 g, Hoanghua 15 g, Zhuling 20 g, Zexie, Fuling each 15 g, decoction 400 mL, 1 Ji/d, 2 times/d. Western medicine treatment with the control group. Continuous treatment for 1 months is the 1 course of treatment. The clinical symptoms, urea nitrogen（BUN）, creatinine（Cr）, creatinine clearance rate（Ccr）,urinary protein excretion（Upro） and adverse reactions were observed. Continuous treatment for 1 months,to determine the efficacy. [Results] 23 cases were effective in the treatment group, 12 cases were effective,5 cases were ineffective, the total effective rate was 77.50%; the control group was markedly effective in 9 cases, effective in 4 cases, ineffective in 27 cases, the total effective rate was 32.50%; the curative effect of the treatment group was better than that of the control group（P〈0.01）. The BUN and Cr two groups improved（P〈0.01, P〈0.05）, the treatment group improved better than the control group（P〈0.01）, Upro and Ccr treatment group all improved（P〈0.01）, the control group did not change significantly（P〈0.05）. [Conclusion]Huoxue Huayu Fang combined with western medicine in treatment of chronic glomerulonephritis with blood stasis has satisfactory curative effect and no serious adverse reaction. It is worth popularizing.