辨证分型联合西药治疗IgA肾病随机平行对照研究  

Syndromes of IgA Nephropathy combined with Western Medicine Randomized Controlled Study

作　　者：王占云 

机构地区：[1]河南省长垣县中医院内科,河南长垣453400

出　　处：《实用中医内科杂志》2015年第9期87-89,共3页Journal of Practical Traditional Chinese Internal Medicine

摘　　要：[目的]观察辨症分型联合西药治疗IgA肾病疗效。[方法]使用随机平行对照方法，将150例住院患者按病志号抽签法简单随机分为两组。对照组75例免疫抑制剂-雷公藤，10~20mg/次，2~3次/d；爱若华10~20mg/次，1次/d；骁悉，1~2g次，1次/d；环孢素A，25mg/次，1次/d。治疗组75例辨证分型，肾功能急速衰竭伴随尿蛋白含量较高用协定方（枸杞4g，柴胡6g，白术12g，黄岑6g，菊花15g，白芍12g，杜仲8g，黄芪30g，川芎12g，葛根8g，黄精10g）；蛋白尿伴血尿用肾二方（生蒲黄12g，女贞子15g，生地18g，龟板6g，旱莲草12g）；病情严重用通络方（白蒺藜6g，夏枯草12g，藤梨根6g，留行子10g，僵蚕4g，白芥子6g）；肾功能衰退用百令胶囊，1g/次，3次/d；西药治疗同对照组。连续治疗28d为1疗程。观测临床症状、24hU-Pro、U-RBC、BuN、SCr、GFR、不良反应。连续治疗3疗程，判定疗效。[结果]治疗组痊愈45例，显效18例，有效10例，无效2例，总有效率97.33%。对照组痊愈30例，显效15例，有效20例，无效10例，总有效率86.67%。治疗组疗效优于对照组（P＜0.05）。两组相关指标大部分有改善（P＜0.05），GFR无显著改善（P＞0.05），治疗组改善大部分优于对照组（P＜0.05），GFR两组无显著差异（P＞0.05）。[结论]辨症分型联合西药治疗IgA肾病疗效满意，无严重不良反应，值得推广。[Objective]To observe Bianzheng type IgA nephropathy combined with western medicine. [Methods]randomized,parallel controlled method,150 cases of hospitalized patients by disease Zhi No.lottery method is simple and randomly divided into two groups.The control group 75 cases of immunosuppressant- tripterygium,l 0-20mg/times,2 to 3 times/d;love,if China 10~20mg/time,1 time/d;MMF, 1-2g times, 1/d ;cyclosporin A,25mg/times,1 times/d.The treatment group 75 cases Syndromes,renal failure,accompanied by rapid urine protein content higher by agreement parties（Gouqi 4g,Chaihu 6g,Baizhu 12g,Huangqin 6g,Juhua 15g,Baishao 12g,Duzhong 8g,Huangqi 30g,Chuanxiong 12g,Gegen 8g,Huangjing 10g）;proteinuria and hematuria with kidney two parties（Puhuang 12g,Nvzhenzi 15g,Shengdi 18g,Guiban 6g,Hanliancao 12g）;a serious condition with Tongluo Recipe（Baijili 6g,Xiakucao 12g, Tengligen 6g, Liuxingzi 10g,Jiangehan 4g, Baijiezi 6g）;renal fimction decline with Bailing Capsule,lg/time,3 times/d;Western medicine with the control group.28d for a course of continuous treatment.Observation of clinical symptoms,24hU-Pro,U-RBC,BuN,SCr,GFR,adverse reactions. Continuous treatment of 3 courses,to determine efficaey.[Results]The cure 45 cases,18 cases markedly effective in 10 cases,2 eases,the total efficiency of 97.33%.The control group cured 30 cases,15 cases markedly effective in 20 cases,10 cases,the total efficiency of 86.67%.Treatment group than the control gr0up（P〈0.05）.Most groups related indicators have improved（P〈0.05）,GFR was no significant improvcment（P〉0.05）,the treatment group than the control group improved most（P〈0.05）,GFR was no significant difference（P〉0.05）.[Conclusion] Bianzheng type IgA nephropathy combined with western medicine treatment satisfaction,no side effects,worthy of promotion.

关 键 词：IGA肾病 血尿 水肿 腰痛 肾风 虚劳 辨症分型 协定方 肾二方 通络方 百令胶囊 雷公藤 爱若华 骁悉 环孢素A 24hU-Pro U-RBC BuN SCr GFR 中西医结合治疗 随机平行对照研究 

分 类 号：R692.31[医药卫生—泌尿科学]