摘要
目的:观察中西医三环治疗IgA肾病(IgAN)蛋白尿的临床疗效及其对肾功能的影响。方法:234例患者按病理Lee氏分级进行分组,Lee氏分级<Ⅲ级为A组,随机分为治疗组(A1组32例)和对照组(A2组35例);Lee氏分级>Ⅲ级为B组,随机分为治疗组(B1组102例)和对照组(B2组65例)。A1组使用中医药三环+中医新辨证方案,A2组使用ACEI/ARB+中医原辨证方案;B1组使用中西医结合三环(中医药三环+中医新辨证方案+ACEI/ARB+免疫抑制剂),B2组使用激素+中医原辨证方案。观察项目包括24h尿蛋白、肾功能、血白蛋白(Alb)、肝功能、血常规、尿常规及不良反应。观察时间6～8个月。结果:A1组蛋白尿、血肌酐(Scr)及血红蛋白(Alb)的改善好于A2组,A1组的总缓解率(完全缓解率+基本缓解率)为75%,高于A2组的48.6%(P<0.05);B1组降蛋白尿的速度及幅度均强于B2组,B1组的总缓解率为80.4%,高于B2组的64.6%,两组比较(P<0.05)。且B组在治疗前肾功能已下降(Scr>133μmol/L)18例患者,其肾功能改善的程度B1组(12例)好于B2组(6例)。结论:中西医三环治疗能有效减少IgAN患者的蛋白尿,稳定并改善肾功能。
Objective：To study the effect of Chinese medical combined western medical three target therapeutic regimen on proteinuria and renal function of IgA nephropathy.Methods：234 patients were enrolled in prospective clinical control study.According to Lee pathological grade,they were assigned to four groups ：less than grade Ⅲ as group A,more than grade Ⅲ as group B.Group A were randomly divided into therapeutic group A1（n=32） and control group A2（n=35）.Group B were randomly divided into therapeutic group B1（n=102） and control group B2（n=65）.Group A1 were given Chinese medical three target therapeutic regimen and new Chinese medical differentation regimen.Group A2 were given ACEI/ARB and old Chinese medical differetation regimen.Group B1 were given Chinese medical combined western medical three target therapeutic regimen：Chinese medical three target therapeutic regimen,new Chinese medical differentation regimen,ACEI/ARB and immunosuppressive agent.Group B2 were given glucocorticoid and old Chinese medical differetation regimen.Urinary protein secretion,renal function,serum albumin,liver function,blood routine,urinary routine and adverse effect were observed.All patients were followed up for 6-8 months.Results：Extent of proteinuria,serum creatinine and albumin level change in group A1 were higher than group A2.Remission rate（complete and partial remission） in group A1 was 75%,higher than group A2（48.6%,P〈0.05）.Decreasing rate and extent of proteinuria in group B1 was higher than group B2.Remission rate in group B1 was 80.4%,higher than group A2（64.6%,P〈0.05）.18 patients in group B had impairment renal funtion before treatment.Renal function improvement in group B1（n=12） was better than group B2（n=6）.Conclusion：These findings suggested the Chinese medical combined western medical three target therapeutic regimen decreased proteinuria and improved renal function of IgA nephropathy.
出处
《中国中西医结合肾病杂志》
2008年第6期512-516,共5页
Chinese Journal of Integrated Traditional and Western Nephrology
基金
杭州市科学技术局基金资助项目(No2004433Q02)
关键词
IGA肾病
中医药
中西医结合
蛋白尿
IgA nephropathy Chinese medical therapeutic regimen Chinese medical combined western medical therapeutic regimen Proteinuria
