参芪益阴活血方联合雷公藤多甙治疗IgA肾病的临床观察

发布时间：2019-06-03 13:07

【摘要】：目的:观察参芪益阴活血方联合雷公藤多甙治疗IgA肾病脾肾气虚、瘀血阻络型的临床疗效,探讨该方法在治疗IgA肾病中的价值,研究该方法的作用机理及特点,提供更适合该型病人的治疗方法。方法:本研究收集IgA肾病中符合中医辨证为脾肾气虚、瘀血阻络证的患者60例,随机分为两组,试验组30例,对照组30例,课题期间,对照组有1名患者脱落。对照组按2011年KDIGO临床实践指南给予常规ACEI/ARB及西医对症治疗,试验组给予雷公藤多甙片配合导师经验方参芪益阴活血方,疗程2个月。观察患者临床症状、体征、实验室检查指标的变化,并对其症状及体征进行量化评分,判定其疗效。结果:两组治疗均能减少患者的尿蛋白定量及尿RBC计数。根据综合疗效评分:试验组完全缓解率23.33%,显效率为46.67%,有效率为26.67%,总有效率为90%;对照组完全缓解率10.34%,显效率为37.93%、有效率为24.14%,总有效率为71.41%,试验组总有效率高于对照组,统计学有显著性差异(P0.05)。试验组与对照组治疗前后24小时尿蛋白定量、尿红细胞计数、血浆白蛋白比较,P值均小于0.05,具有统计学意义。两组治疗后对肾功能无明显影响。结论:该方法能够有效改善IgA肾病脾肾气虚,瘀血阻络型患者的临床症状和体征,明显减少患者24小时尿蛋白定量以及尿RBC计数,提高血浆白蛋白水平,体现了该方法在治疗该型IgA肾病中的优势。
[Abstract]:Objective: to observe the clinical effect of Shenqi Yiyin Huoxue recipe combined with Tripterygium wilfordii polyglycosides in the treatment of spleen and kidney qi deficiency and blood stasis blocking collaterals in IgA nephropathy, to explore the value of this method in the treatment of IgA nephropathy, and to study the mechanism and characteristics of this method. To provide a more suitable treatment for this type of patients. Methods: in this study, 60 patients with IgA nephropathy according to TCM syndrome differentiation of spleen and kidney qi deficiency and blood stasis blocking collaterals were randomly divided into two groups: experimental group (n = 30) and control group (n = 30). During the subject period, 1 patient in the control group fell off. The control group was treated with routine ACEI/ARB and western medicine according to the clinical practice guide of KDIGO in 2011, and the experimental group was given Tripterygium wilfordii polyglycoside tablets combined with mentor experience prescription Shenqi Yiyin Huoxue recipe for 2 months. The changes of clinical symptoms, signs and laboratory examination indexes were observed, and the symptoms and signs were quantitatively scored to determine the curative effect. Results: both groups could reduce the quantity of urinary protein and the count of urinary RBC. According to the comprehensive curative effect score, the complete remission rate was 23.33%, the effective rate was 46.67%, the effective rate was 26.67%, and the total effective rate was 90%. The complete remission rate of the control group was 10.34%, the effective rate was 37.93%, the effective rate was 24.14%, and the total effective rate was 77.41%. The total effective rate of the experimental group was significantly higher than that of the control group (P 0.05). Compared with the control group, the 24-hour urinary protein quantity, urine red blood cell count and plasma albumin in the experimental group were less than 0.05, which were statistically significant. There was no significant effect on renal function in the two groups after treatment. Conclusion: this method can effectively improve the clinical symptoms and signs of patients with spleen and kidney qi deficiency and blood stasis blocking collaterals in IgA nephropathy, significantly reduce the 24-hour urinary protein quantity and urine RBC count, and increase the level of plasma albumin. It shows the advantages of this method in the treatment of this type of IgA nephropathy.
【学位授予单位】：山东中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R277.5

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