芪苓益肾通络方对脾肾气虚型特发性膜性肾病肾功能及血脂水平的影响

Effect of Qiling Yishen Tongluo Decoction(芪苓益肾通络方)on Renal Function and Blood Lipid Levels in Patients with Idiopathic Membranous Nephropathy of Spleen-Kidney Qi Deficiency Type

目的观察芪苓益肾通络方在脾肾气虚型特发性膜性肾病(IMN)中的应用效果及对肾功能及血脂水平的影响。方法收集衡水市中医医院内分泌肾病科门诊及病房就诊的脾肾气虚型IMN患者100例,根据随机数字表法将入组患者分为治疗组与对照组,各50例。其中对照组给予糖皮质激素联合环磷酰胺治疗,治疗组在使用糖皮质激素联合环磷酰胺基础上加用芪苓益肾通络方,治疗周期均为3个月。观察治疗前后肾功能及血脂水平的变化及药物不良反应情况,并对治疗前后中医证候严重程度进行积分,评价其总体疗效。结果治疗后24h尿总蛋白定量(24 UTP)、尿白蛋白/尿肌酐比值(ACR)、肾小球滤过率(GFR)、血清胱抑素C(CysC)、血肌酐(SCr)、尿素氮(BUN)、血浆白蛋白(ALB)、总胆固醇(TC)、甘油三酯(TG)均有所改善(P<0.05),且治疗组改善程度优于对照组(P<0.05);治疗组不良反应发生率略低于对照组,但差异无统计学意义(P>0.05)。结论将芪苓益肾通络方用于IMN中,疗效良好,相比于常规治疗来说,其在降低尿蛋白,改善肾功能、血脂,延缓疾病进展等方面的优势更显著。

Objective To observe the application effect of Qiling Yishen Tongluo Decoction(芪苓益肾通络方)in idiopathic membranous nephropathy(IMN)of spleen-kidney Qi deficiency type and its influence on renal function and blood lipid levels.Methods One hundred patients with IMN of spleen-kidney Qi deficiency type who were admitted to the Department of Endocri⁃nology and Nephrology at Hengshui Hospital of Traditional Chinese Medicine were selected.According to random number table method,the patients enrolled were divided into treatment group and control group,with 50 patients in each group.Patients in the control group were treated with glucocorticoid combined with cyclophosphamide,while those in the treatment group were treated with Qiling Yishen Tongluo Decoction based on the treatment of the control group.Both groups underwent 3 months of treatment.Changes in renal function and blood lipid levels before and after treatment,and adverse drug reactions were observed.TCM syn⁃drome scores before and after treatment were recorded,and the overall curative effect was evaluated.Results After treatment,the 24 h urinary total protein(24 h UTP),urine albumin/creatinine ratio(ACR),M-type phospholipase A2 receptor(PLA2R)anti⁃body titer,glomerular filtration rate(GFR),serum cystatin C(CysC),serum creatinine(SCr),urea nitrogen(BUN),plasma albu⁃min(ALB),total cholesterol(TC)and triglyceride(TG)were improved(P<0.05),and the improvement of the treatment group was better than that of the control group(P<0.05).The incidence of adverse reactions was slightly lower than that in the control group(P>0.05).Conclusion Qiling Yishen Tongluo Decoction is effective in the treatment of IMN.Compared with the conven⁃tional treatment,it has more advantages in reducing urine protein,improving renal function and blood lipids,and delaying disease progression.