补肾益气化瘀汤治疗亚高原地区原发性膜性肾病的疗效及作用机制

Effect and mechanism of the Decoction of Benefiting Kidney Qi and Promoting Blood Circulation on primary membranous nephropathy in sub-plateau area

目的初步探讨中藏药补肾益气化瘀汤辅助治疗亚高原地区原发性膜性肾病的临床疗效及作用机制。方法将98例原发性膜性肾病患者随机分为观察组(46例)和对照组(52例)。对照组口服环孢素A胶囊;观察组在对照组治疗基础上予中藏药补肾益气化瘀汤口服;两组疗程均为60天。观察两组患者治疗前后临床症状变化及24小时尿蛋白定量、尿微量蛋白、血浆白蛋白、甘油三脂、水平及肾功能的变化情况,并对补肾益气化瘀汤做相关辨证分析。结果两组患者治疗后的临床症状和血肌酐、血尿素氮、24小时尿蛋白定量、尿微量蛋白、血浆白蛋白、甘油三脂相比存在显著性差异(P<0.05)。观察组优于对照组。结论中藏药补肾益气化瘀汤辅助治疗亚高原地区原发性膜性肾病可提高临床疗效,其作用机制可能与其能够改善肾脏微循环、清除免疫复合物、促进足细胞修复、干预补体激活途径有关。

Objective To observe the clinical efficacy and mechanism of tion of Benefiting Kidney Qi and Promoting Blood Circulation in the treatment traditional Tibetan medicine Decoc- of primary membranous nephropathy in sub-plateau areas.Methods Ninety eight patients with primary membranous nephropathy were randomly divided into observation group（46 cases）and control group （52 cases）.The control group was given oral cyclosporine A cap- sules ;the observation group was given the Tibetan medicine Benefiting Kidney Qi and Promoting Blood Circulation Decoction on the basis of the treatment of the control group.Both groups were treated for 60 days.The clinical symp- toms, serum creatinine, blood urea nitrogen,24-hour urinary protein, urinary microprotein, plasma albumin and tri- glyceride were tested in both groups.Results The clinical symptoms, serum creatinine, blood urea nitrogen,24-hour urinary protein, urinary microprotein, plasma albumin and triglyceride in observation group were all respectively su-perior to the control group （ P〈0.05, P〈0.05, P〈0.05, P〈0.05, P〈0.05, P〈0.05, P〈0.05 ）. Conclusion The Benefi- ting Kidney Qi and Promoting Blood Circulation Decoction can improve the primary membranous nephropathy in the sub-plateau.The mechanism may be related to the effects of it improving renal microcirculation, remove immune complexes,promote podocyte repair and intervention complement activation pathway.