通淋健肾方加减联合激素治疗IgA肾病(下焦湿热证)的疗效及对蛋白尿症状的改善观察

Curative Effect of Using Modified Tonglin Jianshen Decoction Combined with Hormone in the Treatment of IgA Nephropathy (Damp-heat Syndrome in Lower Energizer) and Observation on Relieving the Symptom of Proteinuria

目的:观察通淋健肾方加减联合激素治疗Ig A肾病(下焦湿热证)患者的疗效及对蛋白尿症状的影响。方法:采用计算器随机数字法将90例下焦湿热证Ig A肾病患者分为对照组和观察组,每组45例;对照组采取激素标准疗法,观察组在对照组基础上给予通淋健肾方加减治疗。治疗1个月后,比较两组临床疗效及中医证候积分、24小时尿蛋白定量、尿红细胞计数、血肌酐、血尿素氮等水平,并观察用药安全性。结果:观察组治疗总有效率为82. 22%,明显高于对照组的60. 00%,差异有统计学意义(P<0. 05)。治疗1个月后,观察组小便黄赤、脘腹纳呆、口干不思饮、腰困重等证候积分均明显低于对照组(P<0. 05);治疗1个月后,观察组24小时尿蛋白定量、尿红细胞计数水平水平低于对照组(P<0. 05),而两组血肌酐、血尿素氮水平比较差异无统计学意义(P>0. 05)。两组治疗过程中均未见明显不良反应,血常规、心电图等监测也未见异常。结论:通淋健肾方加减联合激素治疗Ig A肾病(下焦湿热证)疗效显著,能够有效改善患者中医证候积分,减少蛋白尿及血尿,且安全性较高。

Objective： To observe the curative effect of using Modified Tonglin Jianshen Decoction combined with hormone in the treatment of Ig A nephropathy（ damp-heat syndrome in lower energizer） and the relief of proteinuria. Methods： 90 patients with Ig A nephropathy of damp-heat syndrome in lower energizer were randomly divided into the controlled group and the observation group with 45 cases in each group. The controlled group was treated with standard hormone therapy. On the basis,the observation group was treated with Tonglin Jianshen Decoction. After 1 month of treatment,the clinical curative effect,TCM syndrome scores,24 h urine protein quantitation,urine red blood cell count,serum creatinine and blood urea nitrogen levels were compared between the two groups,and the medication safety was observed. Results： The total effective rate of treatment in the observation group was significantly higher than that in the controlled group（ 82. 22% vs 60. 00%）（ P〈0. 05）. After 1 month of treatment,scores of deep-colored urine,abdominal anorexia,dry mouth and no desire for drinking and waist weight difficulties in the observation group were significantly lower than those in the controlled group（ P〈0. 05）. After 1 month of treatment,the 24 h urine protein quantitation and urine red blood cell count in the observation group were lower than those in the controlled group（ P〈0. 05）,but there was no statistically significant difference in serum creatinine or blood urea nitrogen between the two groups（ P〈0. 05）. There was no obvious adverse reactions,no abnormal blood routine or electrocardiogram in the two groups. Conclusion：Modified Tonglin Jianshen Decoction combined with hormone is markedly effective in the treatment of Ig A nephropathy（ dampheat syndrome in lower energizer）. The treatment can effectively improve TCM syndrome scores and reduce proteinuria and hematuria,with high safety.