慢性肾小球肾炎病理分型与中医治疗分析

An Analysis on TCM Treatment in Chronic Glomerulonephritis according to Histopathologic Type

189例慢性肾炎均经肾穿刺活检作病理组织分型。西药对照组77例总有效率55.8%,中西医结合组50例总有效率86%,单纯中药组62例总有效率67.3%。中医及中西医结合组共112例,其中具有湿热证候占全部病例67%,因此清热利湿是慢性肾炎的重要治则之一。中西医结合对系膜增生性肾炎及膜型肾病疗效优于对照组。IgA肾病、膜增生型及局灶硬化性肾炎,西医治疗较为棘手,运用益气健脾、清热利湿、活血化瘀等中药治疗可获得一定疗效。

The histopathologic type of 189 cases of chronic glomerulonephritis (GN) were confirmed by renal biopsies, they were subdivided into 3 groups. 77 patients of Western medicine (WM) group was treated by conventional WM (prednison or CTX), and after treatment the total effective rate was 55.8%. The TCM-WM group was treated by the same WM plus treatment according to Syndrome Differentation with Chinese medicinal herbs, and the total effective rate was 86% in 50 patients. The TCM group was treated by Chinese medicinal herbs, and the total effective rate was 67.3% in 62 cases. There was very significant difference (P<0.01) between the WM and the TCM-WM group.Among the patients of TCM-WM and TCM groups, 67% of 112 cases were manifested as Dampness- Heat Syndrome, so it suggested that one of the important method for GN treatment is clearing away Dampness-Heat. The effects of TCM-WM group is much better than the WM group in treating mesangio-proliferative GN and membranous GN. It was difficult for WM in treating IgA nephropathy, membrano-proliferative GN and focal glomerulosclerosis, but Chinese medicinal herbs were effective with replenishing Qi and strengthening the Spleen, clearing away Dampness-Heat, promoting blood Circulation and relieving Stasis, etc.