益气固本调免方治疗IgA肾病脾肾气虚证的临床观察

Clinical Observation of Yiqi Guben Tiaomian Formula(益气固本调免方)in Treatment of IgA Nephropathy

目的:观察益气固本调免方治疗IgA肾病脾肾气虚证的临床疗效。方法:将120例CKD1~3期诊断为IgA肾病的患者随机分为两组。治疗组60例给予益气固本调免方治疗,对照组60例给予肾炎康复片治疗,疗程4个月。结果:治疗后,对照组患者尿蛋白较治疗前降低(P<0.05);治疗组患者尿红细胞数和尿蛋白较治疗前显著降低(P<0.01或P<0.05)。治疗后两组比较,治疗组患者尿红细胞数和尿蛋白均低于对照组(P<0.05)。治疗组总有效率为86.67%,对照组总有效率为63.33%,治疗组疗效优于对照组(P<0.05)。治疗后,两组的中医证候均有不同程度的改善,症状积分和症状总积分较治疗前降低(P<0.05或P<0.01)。治疗组患者治疗后腰脊酸痛、疲倦乏力、大便溏薄、浮肿等积分和症状总积分均低于对照组,差异有统计学意义(P<0.05);各中医证候积分中,治疗组肠道症状积分变化与尿红细胞数(r=0.8243,P<0.01)、24 h尿蛋白定量(r=0.5862,P<0.05)呈正相关。结论:益气固本调免方能有效治疗IgA肾病脾肾气虚证,可缓解血尿和蛋白尿,并改善中医证候。

Objective: To observe the effect of Yiqi Guben Tiaomian Formula(益气固本调免方, YQGBTMF on IgA nephropathy. Methods: The 120 patients with IgA nephropathy CKD1~3 were randomly divided into two groups. 60 cases in the treatment group were treated with YQGBTMF, while 60 cases in the control group were treated with Shenyan Kangfu Tablet(肾炎康复片) for 4 months. Results: After treatment, the urinary protein in the control group was lower than that before treatment(P<0.05), and the urinary erythrocyte count and urinary protein in the treatment group were significantly lower than those before treatment(P <0.01 or P <0.05). After treatment, the urinary erythrocyte count and urinary protein in the treatment group were lower than those in the control group(P<0.05). The total effective rate was 86.67% in the treatment group and 63.33% in the control group, the curative effect of the treatment group was better than that of the control group(P<0.05). After treatment, the TCM syndromes of both groups were improved in varying degrees, and the scores of symptoms and total symptoms were lower than those before treatment(P<0.05 or P<0.01). After treatment, the scores of lumbar spine pain, fatigue, thin stool, edema and other symptoms in the treatment group were lower than those in the control group(P<0.05). Among the TCM syndrome scores, the intestinal symptom scores in the treatment group were positively correlated with urinary erythrocyte count(r=0.8243, P<0.01) and 24-hour urinary protein quantification(r=0.5862, P<0.05). Conclusions: Yiqi Guben Tiaomian Formula can effectively treat IgA nephropathy with deficiency of spleen and kidney qi, alleviate hematuria and proteinuria, and improve TCM syndromes.