益肾清毒方联合常规疗法治疗早期艾滋病病毒/艾滋病相关性肾损害临床研究

Clinical Study on Yishen Qingdu Prescription Combined with Routine Therapy for Early HIV/AIDS-Related Kidney Damage

目的:观察益肾清毒方联合常规疗法治疗脾肾两虚、瘀浊内阻型早期艾滋病病毒(HIV)/艾滋病(AIDS)相关性肾损害的疗效。方法:选取60例脾肾两虚、瘀浊内阻型早期HIV/AIDS相关性肾损害患者,随机分为2组,治疗组完成29例,对照组完成30例。2组均予一线高活性抗逆转录病毒疗法(HAART),适时加用厄贝沙坦片,治疗组加用益肾清毒方治疗,2组疗程均为24周。比较2组的临床疗效,分别于治疗前、治疗24周检测尿蛋白、尿红细胞、尿微量白蛋白(MA)、尿β2微球蛋白(β2-MG)、尿α1微球蛋白(α1-MG)、尿免疫球蛋白(IGU)、尿微量白蛋白肌酐比值(ACR)等早期肾损害指标及血常规、肝肾功能等安全性指标。结果:治疗24周,治疗组临床疗效总有效率为93.10%,对照组总有效率为66.67%,2组比较,差异有统计学意义(P<0.01)。2组尿蛋白情况均较治疗前改善(P<0.05),治疗组尿蛋白改善情况优于对照组(P<0.05)。2组尿红细胞、MA、α1-MG、β2-MG、IGU水平与ACR均较治疗前下降,差异均有统计学意义(P<0.01),治疗组6项指标值均低于对照组(P<0.05,P<0.01)。2组血常规、肝肾功能指标与治疗前比较,差异均无统计学意义(P>0.05);2组血常规、肝肾功能指标比较,差异均无统计学意义(P>0.05)。结论:在常规疗法基础上加用益肾清毒方治疗脾肾两虚、瘀浊内阻型早期HIV/AIDS相关性肾损害患者,能有效减少尿蛋白、减轻肾功能损害,缓解患者的临床症状,疗效显著,安全性较好。

Objective:To observe the curative effect of Yishen Qingdu prescription combined with routine therapy on early human immunodeficiency virus(HIV)/acquired immune deficiency syndrome(AIDS)-related kidney damage of spleen-kidney deficiency and internal obstruction of stasis and turbidity type.Methods:A total of 60 patients with early HIV/AIDS-related kidney damage of spleen-kidney deficiency and internal obstruction of stasis and turbidity type were randomly divided into the treatment group and the control group,with 29 and 30 cases completed respectively.Both groups were given highly active anti-retroviral therapy(HAART),and additionally given with irbesartan tablets timely.The treatment group was additionally treated with Yishen Qingdu prescription.Both groups were treated for 24 weeks.The clinical effects were compared between the two groups.Before and the 24thweek of the treatment,the indexes of early kidney damage,including urine protein,urine red blood cell,urinary microalbumin(MA),urinaryβ2-microglobulin(β2-MG),urinaryα1-microglobulin(α1-MG),urinary immunoglobulin(IGU)and urinary albumin-creatinine ratio(ACR),and safety indexes,including blood routine and liver and kidney function,in the two groups were detected respectively.Results:After 24 weeks of treatment,the total clinical effective rate was 93.10%in the treatment group and 66.67%in the control group,the difference being significant(P<0.01).The levels of urine protein in the two groups were improved when compared with those before treatment(P<0.05),and the improvement in the above level in the treatment group was better than that in the control group(P<0.05).The levels of urine red blood cell,MA,α1-MG,β2-MG and IGU and ACR were decreased when compared with those before treatment,differences being significant(P<0.01),and the above six indexes in the treatment group were lower than those in the control group(P<0.05,P<0.01).There was no significant difference being found in the comparisons of indexes of blood routine and liver and kidney function in the two groups before and after treatment(P>0.05);there was no significant difference being found in the comparisons of above two indexes between the two groups(P>0.05).Conclusion:The therapy of Yishen Qingdu prescription based on routine therapy for patients with early HIV/AIDS-related kidney deficiency of spleen-kidney deficiency and internal obstruction of stasis and turbidity type can effectively lessen the urine protein,reduce the damage of kidney function,and alleviate the clinical symptoms of patients,with a significant curative effect and good safety.