参芪地黄汤合多靶点免疫抑制治疗IgA肾病合并膜性肾病个案报道

Case Report of Shenqi Dihuang Decoction(参芪地黄汤)Combined with Multi-target Immunosuppression in Treatment of IgA Nephropathy and Membranous Nephropathy

报道1例IgA肾病重复肾活检为IgA肾病合并膜性肾病的病例。患者病史长达11年且多种免疫抑制治疗均疗效不佳,属于难治性肾病,临床主要表现为大量蛋白尿及肾功能异常,伴有血尿、高血压。李伟教授根据多年用药经验及相关文献研究结果,给予参芪地黄汤联合多靶点免疫抑制治疗,重点分析中医辨证论治同西医病理结合,以益气活血清泄为原则,探讨其治疗方案及疾病转归,并复习相关文献,为中西医结合诊治IgA肾病合并膜性肾病提供治疗方向和临床依据。

One case of IgA nephropathy with membranous nephropathy after repeated renal biopsy was reported in this paper.The patient has a history of up to 11 years,and many immunotherapies were of poor curative effect.It is a refractory nephropathy.Major clinical manifestations are massive proteinuria and abnormal renal function,accompanied by hemuria and hypertension.Professor LI Wei prescribed Shenqi Dihuang Decoction(参芪地黄汤)combined with multi-target immunosuppression treatment according to years of clinical experience and relevant literature research results,focusing on the analysis of the combination of traditional Chinese medicine syndrome differentiation and pathology of western medicine.Based on the principle of supplementing qi,activating blood and clearing,the treatment protocol and disease outcome were discussed,and the related literature was reviewed,so as to provide a treatment direction and clinical basis for the diagnosis and treatment of IgA nephropathy complicated with mem⁃branous nephropathy.