乙肝肾合剂辨证加减联合常规西药综合治疗乙型肝炎病毒相关性肾炎的临床观察

发布时间：2018-03-31 13:55

本文选题：乙型肝炎　切入点：肾炎　出处：《辽宁中医杂志》2017年10期

【摘要】：目的:观察乙肝肾合剂辨证加减联合常规西药综合治疗乙型肝炎病毒相关性肾炎(HBV-GN)临床疗效。方法:纳入48例我院门诊和住院部HBV-GN患者,依据治疗方式不同,随机分为对照组和治疗组(各24例),均给予常规西药治疗,治疗组加用乙肝肾合剂辨证加减综合治疗,比较两组治疗前后临床症状改善、肝、肾功能指标、HBV血清标记物变化和治疗效果。结果:治疗后,肝、肾功能异常、蛋白尿、血尿和下肢水肿患者均显著显著减少,且治疗组减少例数多于对照组,差异显著(P0.05);治疗后两组TBIL、DBIL、ALT、PT水平显著下降,白蛋白水平显著上升,24 h尿蛋白、Scr和BUN水平均显著降低,Ccr水平显著升高,且治疗组降低或升高水平显著高于对照组,差异显著(P0.05);治疗组HBeAg阴转率40%,HBs Ag阴转率25%,对照组分别为28.57%和20.83%,两组差异不显著(P0.05);治疗后治疗组HBV-DNA拷贝量下降水平显著高于对照组(P0.05);治疗组治疗总有效率91.67%,对照组66.67%,两组差异显著(P0.05)。结论:乙肝肾合剂辨证加减联合常规西药治疗可显著改善乙型肝炎病毒相关性肾炎临床症状,改善患者肝、肾功能,疗效显著,值得临床推广应用。
[Abstract]:Objective: to observe the clinical curative effect of hepatitis B virus associated glomerulonephritis (HBV-GNN) treated by syndrome differentiation and subtraction of hepatitis B kidney mixture combined with routine western medicine. Methods: 48 patients with HBV-GN in outpatient and inpatient departments of our hospital were included, according to different treatment methods. The control group and the treatment group were randomly divided into control group and treatment group (each 24 cases were treated with routine western medicine), and the treatment group was treated with syndrome differentiation and subtractive therapy of hepatitis B and kidney mixture. The clinical symptoms were improved before and after treatment in the two groups. Results: after treatment, the patients with abnormal liver and kidney function, proteinuria, hematuria and edema of lower extremities were significantly decreased, and the decrease of patients in treatment group was more than that in control group. After treatment, the levels of TBILD, alt and PT decreased significantly, and the levels of urinary protein SCR and BUN increased significantly after treatment, and the levels of SCR and BUN in the treatment group were significantly lower than those in the control group. The negative conversion rate of HBeAg in the treatment group was 40%, the negative conversion rate of HBs Ag in the control group was 28.57% and 20.83% in the control group, the difference between the two groups was not significant (P0.05); the level of HBV-DNA copy reduction in the treatment group was significantly higher than that in the control group (P 0.05); the total effective rate of the treatment group was 91.67%, and that in the control group was 91.67%. There was significant difference between the two groups (P 0.05). Conclusion: the clinical symptoms of hepatitis B virus associated glomerulonephritis can be significantly improved by adding and subtracting hepatitis B kidney mixture in combination with routine western medicine. Improve the liver and kidney function of patients, the curative effect is remarkable, it is worth clinical popularizing application.
【作者单位】：衡水市人民医院肾内科;
【分类号】：R512.62;R692.3

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