凉血散瘀方加减对肾虚血瘀型IgA肾病肾脏纤维化的影响分析

Effect of Liangxue Sanyu Fang Modified on Renal Fibrosis of IgA Nephropathy with Kidney Deficiency and Blood Stasis

目的:探讨凉血散瘀法加减治疗肾虚血瘀型IgA肾病的效果。方法:本次研究对象为2018年10月-2019年10月三明市中西医结合医院和福建中医药大学附属人民医院接收的80例肾虚血瘀型IgA肾病患者,根据随机数字表法将其分为对照组(40例)和观察组(40例)。对照组采取常规西药治疗,观察组在对照组基础上给予凉血散瘀方加减治疗。比较两组临床疗效、治疗前后24 h尿蛋白定量、尿红细胞计数、尿微量白蛋白肌酐比值(ACR)、血清肌酐(Scr)。比较两组Ⅳ型胶原(C-Ⅳ)、基质金属蛋白酶组织抑制剂-1(TIMP-1)、层粘连蛋白(LN)。结果:观察组治疗总有效率明显优于对照组,差异有统计学意义(P<0.05)。治疗后,两组24 h尿蛋白定量、尿红细胞计数、ACR及Scr均较治疗前明显降低(P<0.05),且观察组明显低于对照组,差异有统计学意义(P<0.05)。治疗后观察组C-Ⅳ、TIMP-1及LN均明显低于对照组,差异有统计学意义(P<0.05)。结论:凉血散瘀方加减治疗肾虚血瘀型IgA肾病的效果显著,能够降低患者24 h尿蛋白定量及尿红细胞计数,有助于改善肾脏纤维化,值得临床采纳。

Objective:To explore the effect of Liangxue Sanyu Fang modified in the treatment of IgA nephropathy with kidney deficiency and blood stasis.Method:The subjects of this study were 80 cases of IgA nephropathy patients with kidney deficiency and blood stasis received in Sanming Integrated Traditional Chinese and Western Medicine Hospital and the People’s Hospital Affiliated to Fujian University of Traditional Chinese Medicine from October 2018 to October 2019.According to the random number table method,they were divided into the control group (40 cases) and the observation group (40 cases).The control group was treated with conventional western medicine,and the observation group was treated with Liangxue Sanyu Fang modified on the basis of the control group.The clinical efficacy,24 h urinary protein quantification,urinary red blood cell count,urinary microalbumin creatinine ratio (ACR),serum creatinine (Scr) were compared between the two groups.Collagen type Ⅳ (C-Ⅳ),tissue inhibitor of matrix metalloproteinase-1 (TIMP-1) and laminin (LN) were compared between the two groups.Result:The total effective rate of the observation group was significantly better than that of the control group,and the difference was statistically significant (P<0.05).After treatment,24 h urinary protein quantification,urinary red blood cell count,ACR,and Scr of the two groups were significantly decreased compared with those before treatment (P<0.05),and the observation group was significantly lower than the control group,the differences were statistically significant (P<0.05).After treatment,the C-Ⅳ,TIMP-1 and LN in the observation group were significantly lower than those in the control group,the differences were statistically significant (P<0.05).Conclusion:Liangxue Sanyu Fang modified in the treatment of IgA nephropathy with kidney deficiency and blood stasis has a significant effect,which can reduce the 24 h urinary protein quantification and urinary red blood cell count of the patients,and help improve renal fibrosis,which is worthy of clinical adoption.