基于真实世界的加味黄芪赤风汤治疗IgA肾病的临床疗效评价

Efficacy Study on Modified Huangqi Chifeng Decoction in Treatment of IgA Based on Real World Study

目的:观察加味黄芪赤风汤治疗Ig A肾病蛋白尿的疗效并探讨BMI水平对其疗效的影响。方法:采用真实世界研究的方法,对2015年1月至2016年12月中国中医科学院西苑医院就诊的Ig A肾病并符合气虚血瘀证的患者295例,以加味黄芪赤风汤治疗24周;以BMI水平分层,探讨其对不同BMI水平患者疗效是否有差异。结果:治疗后24 h蛋白尿水平及中医症状积分下降,与治疗前比较,差异有统计学意义(P <0. 01); 24 h蛋白尿水平方面:总有效率达77%; BMI达标患者的有效率达82. 4%,超重患者有效率为72. 4%,经χ2检验,差异有统计学意义(P <0. 05);中医症状方面:有效率达72%;以BMI分层,2组有效率经统计学分析,差异无统计学意义(P> 0. 05)。结论:在真实的临床条件下,加味黄芪赤风汤对气虚血瘀型Ig A肾病蛋白尿患者的治疗效果显著; BMI水平可能影响Ig A肾病患者的恢复治疗。

Objective：To observe the effects of Modified Huangqi Chifeng Decoction on proteinuria in IgA and investigate the effect of Body Mass Index （BMI） level on its effect. Methods：Real world study was conducted as study design. A total of 295 IgA patients with qi deficiency and blood stasis in Xiyuan Hospital, China Academy of Chinese Medical Sciences from January 2015 to December 2016 were lrealed wilh Modified Huangqi Chifeng Decoction in 24 weeks. The effect of BMI level on its effect after lay ered at BMI level was investigated. Results：After the end of treatment,the level of 24 h proteinuria and traditional Chinese medicine （TCM） symptonl score decreased. Compared with that before treatment, the difference was statistically significant （P 〈 0. 01 ）. The total effective rate was 77% on part of 24 h proteinuria. The effective rate of BMI standard patients was 82.4% ,while the effective rate of overweight patients was 72.4%. Through the chi-square test,the difference was statistically significant （P 〈 0. 05）. The total effective rate was 72% on part of TCM symptonl score,and there was no difference between BMI standard and o- verweight patients （ P 〉 0. 05 ）. Conclusion ： Under realistic clinical conditions, Modified Huangqi Chifeng Decoction has remarka- ble effects on the treatment of proteinuria in IgA with qi deficiency and blood stasis. BMI levels may affect the treatment of patients with IgA nephropathy.