自拟活血消癥颗粒治疗原发性肾病综合征合并高凝血症的疗效观察

Observation on the effect of self-designed Huoxuexuoxiaojie granules on p rimary nephrotic syndrome complicated with hypercoagulability

目的:探讨用自拟活血消癥颗粒治疗原发性肾病综合征合并高凝血症的效果。方法:选取2018年10月至2020年6月期间桂林市中医医院肾病科收治的53例肾病综合征合并高凝血症患者作为研究对象。将这些患者分为对照组(n=25)和治疗组(n=28)。在两组患者住院期间,均对其进行常规治疗。在此基础上,为治疗组患者使用自拟活血消癥颗粒进行治疗,为对照组患者使用低分子肝素进行治疗。治疗8周后,比较两组患者治疗的效果、出血性并发症的发生率及在治疗前后其24 h尿蛋白排泄率、凝血酶原时间(PT)、活化部分凝血酶原时间(APTT)、血清白蛋白(Alb)、纤维蛋白原(FIB)、D-二聚体(D-D)、血小板计数(PLT)、抗凝血酶原Ⅲ(ATⅢ)、胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)的水平。结果:治疗后,治疗组患者治疗的总有效率、血清Alb的水平均高于对照组患者,P<0.05;其PT、APTT均短于对照组患者,P<0.05;其出血性并发症的发生率、24 h尿蛋白排泄率及血清TC、TG、LDL-C的水平均低于对照组患者,P<0.05。两组患者血清FIB、D-D、ATⅢ、HDL-C的水平相比,P>0.05。结论:用自拟活血消癥颗粒治疗原发性肾病综合征合并高凝血症的效果较为理想,可有效地降低此病患者血液的黏稠度,提高其血液纤溶系统的功能,改善其肾功能,且安全性较高。

Objective:To investigate the effect of treating primary nephrotic syndrome complicated with hypercoagulaemia with self-designed Huoxuoxiaojie granules.METHODS:A total of 53 patients with nephrotic syndrome complicated with hypercoagulaemia admitted to the Department of Nephrology of Guilin Hospital of Traditional Chinese Medicine from October 2018 to June 2020 were selected as the research subjects.These patients were divided into control group(n=25)and treatment group(n=28).Patients in both groups received routine treatment during their hospitalization.On this basis,patients in the treatment group were treated with self-designed Huoxue Xiaoxie Granules,and patients in the control group were treated with low molecular weight heparin.8 weeks after treatment,compared two groups of patients,the incidence of hemorrhagic complications and the effect of the 24 h urine albumin excretion rate before and after therapy,prothrombin time(PT),activated partial prothrombin time(APTT),serum albumin(propagated),fibrinogen(FIB),D-dimer(D-D),platelet count(PLT),originalⅢantithrombin(ATⅢ),cholesterol(TC),triglyceride(TG),high-density lipoprotein cholesterol(HDL-C),low density lipoprotein cholesterol(LDL-C)levels.RESULTS:After treatment,the total effective rate and serum ALB level in treatment group were higher than those in control group(P<0.05).PT and APTT were shorter than those in control group(P<0.05).The incidence of hemorrhagic complications,urinary protein excretion rate at 24 h and the levels of TC,TG and LDL-C in serum were lower than those in control group(P<0.05).FIB,D-D,serum of two groups of patients ATⅢ,compared to the level of HDL-C,P>0.05).Conclusion:The effect of treating primary nephrotic syndrome complicated with hypercoagulaemia with self-designed Huoxuexiaoyi granules is relatively ideal,which can effectively reduce the blood viscosity,improve the function of blood fibrinolysis system,and improve the renal function of pa tients with primary nephrotic syndrome with high safety.