中医治疗慢性肾小球肾炎蛋白尿的临床研究

Clinical Study of Chinese Medicine on Proteinuria of Chronic Glomerulonephritis

目的观察中药辨证方对慢性肾炎蛋白尿的疗效。方法将40例患者按区组随机化方法分为治疗组和对照组。治疗组30例,对照组10例,治疗组用中药辨证方,每天2次煎服,对照组采用氯沙坦钾50mg,每天1次口服;两组疗程均为8周,观察24h尿蛋白定量、中医症状积分的变化、尿微量白蛋白肌酐比(MAU/Cr)、血浆白蛋白(Alb)、尿β2微球蛋白(β2-MG)及总疗效。结果与治疗前比较,治疗组24h尿蛋白定量明显下降,差异有统计学意义(P<0.01),对照组24h尿蛋白定量下降,差异有统计学意义(P<0.05),治疗后治疗组与对照组比较,差异有统计学意义(P<0.05);与治疗前相比,治疗组中医证候积分明显下降(P<0.01),对照组不降反升(P>0.05),两者有显著性差异(P<0.01);总疗效比较:依据中医证候疗效标准判定,中药组总有效率为66.7%、西药组为20%,组间差异有统计学意义(P<0.01);根据临床疗效标准判定,中药组有效率为60%、西药组为40%,组间差异有统计学意义(P<0.05)。结论中药辨证方较氯沙坦钾能更好的改善CGN的临床症状,降低尿蛋白,延缓肾功能进展。

Objective To observe the effect of chinese medicine on the levels of urinary albumin in Chronic GlomerulonePhritis. Methods Forty patients were blocking assigned randomly to two groups,thirty patients in the treatment group and ten in the control group. Chinese medicine was given additionally to patients in the treatment group after decocting,one dose per day( taken in two times). Control group took Losartan Potassium 50 mg,once daily. The treatment course for both groups was eight weeks. The 24 h urinary albumin,scores of TCM syndrome and contents of microalbumin,β2-MG in urine and Alb of all subjects were observed. Results Compared with before treatment the24 h urinary albumin was obviously reduced in the treatment group,showing significant difference( P < 0. 01). The urinary 24 h albumin decreased in the control group,with statistical significance( P < 0. 05). Statistical difference existed between the treatment group and the control group after treatment( P < 0. 05). Scores of TCM syndromes in treatment group decreased significantly comparing to 0th( P <0.01),but control group rise. According to the criterion of Chinese medicine syndrome therapeutical effect,the effective rate in Chinese medicine group was 66.7%,Losartan Potassium group was 20%( P < 0. 01). However,the effective rate to Western medicines standards was 60% in Chinese medicine group,40% in Losartan Potassium group( P < 0. 05). Conclusion The Chinese medicine was better than western medicine to improve clinical syndrome,to reduce urine protein and to delay the progression of renal function.