芪苓益肾通络方治疗脾肾气虚型膜性肾病患者的疗效及对其肾功能指标的影响

Effect of Qiling Yishen Tongluo Prescription on Renal Function Indexes in Patients with Membranous Nephropathy(Spleen and Kidney Qi Deficiency)

目的探讨芪苓益肾通络方对脾肾气虚型膜性肾病患者肾功能指标的影响。方法选取2019年3月—2021年4月期间就诊于衡水市中医医院内分泌肾病科门诊及病房的脾肾气虚型膜性肾病患者100例作为研究对象,按随机数表法分为对照组和观察组,每组各50例。对照组给予糖皮质激素+环磷酰胺进行治疗,观察组在对照组基础上加用芪苓益肾通络方进行治疗。两组患者治疗均3个月为1个疗程,观察2个疗程。观察比较两组患者临床疗效、不良反应发生率,治疗前后中医证候积分、肾功能指标[血清尿素氮(Serum urea nitrogen,BUN)、血清肌酐(Serum creatinine,Scr)、肾小球滤过率(Glomerular filtration rate,GFR)]及血红蛋白(Hemoglobin,Hb)水平。结果治疗后观察组临床疗效总有效率92.00%(46/50)明显高于对照组74.00%(37/50),差异有统计学意义(P<0.05)。治疗后两组患者各项中医证候积分均较治疗前降低,差异有统计学意义(P<0.05);且观察组低于对照组,差异有统计学意义(P<0.05)。治疗后两组患者BUN、Scr较治疗前降低,Hb、GFR较治疗前升高,差异有统计学意义(P<0.05);且观察组BUN、Scr低于对照组,Hb、GFR高于对照组,差异有统计学意义(P<0.05)。治疗期间,两组患者不良反应发生率比较,差异无统计学意义(P>0.05)。结论芪苓益肾通络方用于脾肾气虚型膜性肾病患者临床疗效显著,改善中医证候积分及肾功能指标效果显著,且安全性较好。

Objective To investigate the effect of Qiling Yishen Tongluo Prescription on renal function indexes in patients with membranous nephropathy(spleen and kidney qi deficiency).Methods A total of 100 patients with membranous nephropathy(spleen and kidney qi deficiency)who visited the outpatient department and ward of the Department of Endocrinology and Nephrology,Hengshui Hospital of Traditional Chinese Medicine from March 2019 to April 2021 were selected as the study subjects.They were divided into a control group and an observation group using the random number table,with 50 in each group.The control group was treated with glucocorticoid+cyclophosphamide,while the observation group was given Qiling Yishen Tongluo Prescription on the basis of the control group.The treatment lasted for 6 months,with 3 months as one course of treatment.The clinical efficacy and adverse reactions were compared between the two groups.The traditional Chinese medicine(TCM)syndrome scores,renal function indexes[serum urea nitrogen(BUN),serum creatinine(Scr),glomerular filtration rate(GFR)]and hemoglobin(Hb)were compared between the two groups before and after treatment.Results The total effective rate of the observation group was 92.00%(46/50),higher than 74.00%(37/50)in the control group(P<0.05).The TCM syndrome scores of the two groups after treatment were lower than those of the same group before treatment(P<0.05),and the observation group had more decrease than the control group(P<0.05).After treatment,BUN and Scr in both groups were reduced,while Hb and GFR were increased(P<0.05),with the observation group having lower or higher levels than the control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups during treatment(P>0.05).Conclusion Qiling Yishen Tongluo Prescription has remarkable clinical efficacy in patients with membranous nephropathy(spleen and kidney qi deficiency),which improves TCM syndrome scores and renal function indexes,with high safety.