凉血散瘀方对肾虚血瘀型IgA肾病患者的疗效观察

Evaluation of Treatment Effects of the Cooling Blood and Dissipating Stasis Recipe on Patients with IgA Nephropathy of Renal Deficiency and Blood Stasis Type

目的:分析凉血散瘀方加减辅助雷公藤多苷、醋酸泼尼松片治疗肾虚血瘀型IgA肾病患者的临床效果。方法:选取三明市中西医结合医院2019年6月至2020年6月期间收治的70例肾虚血瘀型IgA肾病患者,依照治疗方案不同分为观察组与对照组,各35例。对照组给予西药治疗;观察组在对照组基础上加用凉血散瘀方加减治疗。比较两组治疗效果。结果:观察组患者治疗总有效率为91.43%,高于对照组的71.43%,差异具有统计学意义(P<0.05)。治疗前两组患者的尿红细胞个数、血清肌酐(Scr)、血尿酸(SUA)、24 h尿蛋白定量、Ⅳ型胶原(C-Ⅳ)、基质金属蛋白酶组织抑制物-1(TIMP-1)及层粘连蛋白(LN)比较,差异无统计学意义(P>0.05);治疗后两组患者的尿红细胞个数、Scr、SUA、24 h尿蛋白定量、C-Ⅳ、TIMP-1及LN均低于治疗前,且观察组患者的尿红细胞个数、Scr、SUA、24 h尿蛋白定量、C-Ⅳ、TIMP-1及LN均低于对照组,差异具有统计学意义(P<0.05)。观察组患者不良反应发生率为2.86%,与对照组的8.57%比较,差异无统计学意义(P>0.05)。结论:凉血散瘀方联合雷公藤多苷、醋酸泼尼松片治疗肾虚血瘀型IgA肾病患者,可进一步改善患者病情,调节血脂水平,改善肾脏纤维化,且安全性不受影响。

Objective To analyze the clinical effect of the modified cooling blood and dissipating stasis recipe plus/minus adjuvant tripterygium glycosides tablets and prednisone acetate tablets on patients with IgA nephropathy of renal deficiency and blood stasis type.Methods 70 patients with IgA nephropathy of renal deficiency and blood stasis type admitted into Sanming Integrated Medicine Hospital from June 2019 to June 2020 were selected and divided into observation group and control group according to their treatment protocols,with 35 patients in each group.The control group was given western medicine;the observation group received modified treatment of the cooling blood and dissipating stasis recipe on the basis of the control group.The treatment effects were compared between the two groups.Results The treatment effective rate of the observation group was 91.43%,higher than 71.43% of the control group,and the difference was statistically significant(P<0.05),Before treatment,there was no significant difference in the number of urinary erythrocytes,serum creatinine(Scr),serum uric acid(SUA),24h urinary protein quantitative,collagen type IV(C-IV),tissue inhibitor of matrix metalloproteinase-1(TIMP-1)and laminin(LN)between the two groups(P>0.05).After treatment,the number of urinary erythrocytes,Scr,SUA,24h urinary protein quantitative,C-Ⅳ,TIMP-1 and LN in the two groups were lower than those before treatment,and the number of urinary erythrocytes,Scr,SUA,24h urinary protein quantitative,C-Ⅳ,TIMP-1 and LN in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).The incidence of adverse reactions of the observation group was 2.86%,which had no significant difference compared with 8.57% of the control group(P>0.05).Conclusion The cooling blood and dissipating stasis recipe combined with tripterygium glycosides tablets and prednisone acetate tablets have a significant curative effect on IgA nephropathy of renal deficiency and blood stasis type.It can further improve the conditions of patients,regulate the blood lipid level and improve renal fibrosis,without reducing safety.