加味参芪地黄汤治疗难治性原发性肾病综合征的临床研究

Clinical study of Modified Shenqi Dihuang Decoction in the treatment of refractory primary nephrotic syndrome

目的观察加味参芪地黄汤治疗难治性原发性肾病综合征患者的临床效果。方法选择2015年1月~2017年7月于辽宁省葫芦岛市中心医院就诊及住院的68例难治性原发性肾病综合征患者作为研究对象,按照随机数字表法将其分为对照组和试验组,每组各34例。对照组给予西医基础治疗,试验组在此基础上给予加味参芪地黄汤治疗,疗程均为8周。比较两组患者治疗前后24 h尿蛋白定量、血白蛋白、肌酐、尿素氮水平等肾功能指标及中医证候积分的差异,观察并记录病情复发情况。研究所得数据均采用统计学软件SPSS 17.0作分析处理。结果两组治疗后24 h尿蛋白定量、血白蛋白、肌酐、尿素氮水平及中医证候积分较治疗前均有明显改善,差异有统计学意义(P<0.05)。与对照组比较,试验组治疗后各项肾功能指标和中医证候积分改善更为显著,差异均有统计学意义(P<0.05)。治疗后,试验组和对照组的复发率分别为8.82%和17.65%,差异有统计学意义(P<0.05)。结论加味参芪地黄汤可有效改善难治性原发性肾病综合征的肾功能指标,减少蛋白尿,并能改善临床症状,其临床价值值得深入探讨。

Objective To observe the clinical efficacy of Modified Shenqi Dihuang Decoction in the treatment of refractory primary nephrotic syndrome.Methods Sixty-eight patients with refractory primary nephrotic syndrome treated and hospitalized in Huludao Central Hospital from January 2015 to July 2017 were selected as research objects,and they were divided into control group and experimental group according to the random number table.The control group was given the basic treatment of western medicine,on basis of which,the experimental group was treated with Modified Shenqi Dihuang Decoction.The total course of both groups was 8 weeks.The urine protein,serum albumin,creatinine and urea nitrogen levels were compared between the two groups before and after treatment,and the differences of renal function indices and TCM syndrome scores were recorded.The data of the study was analyzed by SPSS 17.0.Results The levels of urinary protein quantitation for 24 hours,serum albumin,creatinine,urea nitrogen and TCM syndrome scores of the two groups after treatment were all significantly improved compared with those before treatment,the differences were statistically significant（P〈0.05）.Compared with the control group,the renal function index and TCM syndrome score of the experimental group improved more significantly,the differences were statistically significant（P 0.05）.After treatment,the recurrence rate of the experimental group and the control group was 8.82% and 17.65% respectively,the difference was statistically significant（P 0.05）.Conclusion Modified Shenqi Dihuang Decoction can effectively improve renal function indices,reduce proteinuria and improve the clinical symptoms in patients with refractory primary nephrotic syndrome.The clinical value is worthy of in-depth exploration.