益气活血利水法治疗特发性膜性肾病临床研究

Clinical Study on Treatment of Idiopathic Membranous Nephropathy by Yiqi Huoxue Lishui Method

目的观察益气活血利水法治疗特发性膜性肾病的临床疗效,探索中医治疗特发性膜性肾病的诊疗思路。方法本研究为回顾性研究,数据来源于2015年3月-2017年6月西京医院中医科、肾内科门诊及住院部膜性肾病患者30例,分为对照组与治疗组,每组各15例,进行西药治疗和中药联合西药治疗,观察24周,分别对24小时尿蛋白定量、血清白蛋白、肌酐等实验室指标进行统计分析,同时观察患者症状改善、中医症候积分变化等,对中医药治疗膜性肾病疗效做出评价。结果治疗组总有效率73.3%,对照组总有效率46.7%,在降低患者24小时尿蛋白定量、降低血脂、改善患者水肿、乏力、腰膝酸软、肢体麻木等症状效果优于单纯西药组,在升高血浆总蛋白、白蛋白方面效果相当,两组治疗前后均无肝肾功能损害。结论益气活血利水中药联合西医治疗气虚血瘀型特发性膜性肾病效果优于单纯西药组,临床疗效确切。

Objective To observe the clinical efficacy of Yiqi Huoxue Lishui method in the treatment of idiopathic membranous nephropathy and explore the diagnosis and treatment ideas of traditional Chinese medicine in the treatment of idiopathic membranous nephropathy.Methods This study was a retrospective study.The data came from 30 patients with membranous nephropathy in the outpatient and inpatient departments of traditional Chinese medicine and Nephrology of Xijing Hospital from March 2015 to June 2017.They were divided into control group and treatment group,with 15 cases in each group.They were treated with western medicine and traditional Chinese medicine combined with western medicine.They were observed for 24 weeks.The 24-hour urinary protein,serum albumin creatinine and other laboratory indicators were statistically analyzed,and the improvement of patients symptoms and the change of TCM symptom score were observed to evaluate the efficacy of traditional Chinese medicine in the treatment of membranous nephropathy.Results The total effective rate of the treatment group was 73.3%and that of the control group was 46.7%.The effect was better than that of the simple western medicine group in reducing the 24-hour urinary protein,reducing blood lipid,improving the symptoms of edema,fatigue,waist and knee soreness and numbness,and increasing the total plasma protein and albumin.There was no damage to liver and kidney function before and after treatment.Conclusion The effect of Yiqi Huoxue Lishui traditional Chinese medicine combined with western medicine in the treatment of idiopathic membranous nephropathy of Qi deficiency and blood stasis type is better than that of simple western medicine group.