加味补阳还五汤治疗特发性膜性肾病临床研究

Clinical Study of Jiawei Buyang Huanwu Decoction (加味补阳还五汤) in Treatment of Idiopathic Membranous Nephropathy

目的:观察加味补阳还五汤治疗气虚血瘀型特发性膜性肾病(IMN)临床疗效及对血脂的影响。方法:选取IMN患者60例,按就诊顺序随即分为观察组与对照组,每组30例,对照组在基础治疗的同时口服血脂康,观察组在基础治疗的同时给予加味补阳还五汤免煎颗粒,每日1剂,疗程均为8周。对比治疗前后两组患者24 h尿蛋白定量(UTP)、血浆白蛋白(ALB)、血浆总蛋白(TP)、甘油三酯(TG)、总胆固醇(TCH)、低密度脂蛋白(LDL)、脂蛋白a[LP(a)]水平,评价临床疗效。结果:两组治疗后24 h UTP、TG、TCH、LDL、LP(a)均显著降低,ALB和TP均明显提高,与治疗前比较差异有统计学意义(P<0.01),观察组表现优于对照组(P<0.01);临床总有效率比较,观察组86.67%,优于对照组的53.33%(P<0.05)。结论:加味补阳还五汤可有效减轻IMN患者临床症状,调节脂代谢。

Objective:To observe the influence of Jiawei Buyang Huanwu Decoction(加味补阳还五汤 ) on idiopathic membranous nephropathy(IMN) of qi deficiency and blood stasis type and its influence on blood lipid. Methods:Sixty patients with IMN were randomly divided into two groups according to the time order,30 patients in each group. The control group was given oral administration of Xuezhikang,and the observation group was given boil-free granules of Jiawei Buyang Huanwu Decoction. Both groups were treated for 8 weeks. Before and after the treatment,24 hr urine protein quantification(U-TP),plasma albumin(ALB),plasma total protein(TP),triglycerides(TG),total cholesterol(TCH),low-density lipoprotein(LDL) and lipoprotein a[LP(a)] were observed to evaluate clinical efficacy.Results:After the treatment,levels of U-TP,TG,TCH,LDL,LP(a) decreased significantly in the two groups while ALB and TP increased,with statistical difference compared with before treatment(P<0.01).Also,after the treatment,the observation group was significantly better than the control group(P<0.01). The total effective rate of observation group was 86.67%,which was better than the control group(53.33%)(P<0.05). Conclusion:Jiawei Buyang Huanwu Decoction can effectively alleviate the clinical symptoms of IMN patients and regulate lipid metabolism.