益肾化湿颗粒联合来氟米特治疗无症状尿检异常型IgA肾病的临床观察  

Clinical Comparative Study of IgA Nephropathy with Asymptomatic Abnormal Urinalysis Treated with a Combined Regime of Yishen Huashi Granules Plus Leflunomide Tablets

作　　者：罗志锋[1] 彭颖[1] 薛雯[1] 刘富华[1] 马井生[1] 胡广[1] 邹贵勉[1] 车文体[1] 向月应[1] 眭维国[1] 

机构地区：[1]解放军第181医院肾脏科全军器官移植与透析治疗中心广西代谢性疾病研究重点实验室,桂林541002

出　　处：《中国中西医结合肾病杂志》2016年第11期974-977,共4页Chinese Journal of Integrated Traditional and Western Nephrology

基　　金：解放军总后勤部卫生部全军保健专项项目(No.12BJZ14)

摘　　要：目的：探讨益肾化湿颗粒联合来氟米特治疗无症状尿检异常型IgA肾病（IgAN）的临床效果。方法：选取我院于2014年1月~2015年12月收治的确诊为无症状尿检异常型IgAN患者共84例,随机分为对照组与治疗组,每组各42例,两组患者均给予来氟米特片口服,治疗组患者在此基础上加用口服益肾化湿颗粒,每2个月为一疗程,治疗3个疗程,每个疗程后观察两组患者尿红细胞（RBC）计数、24 h尿蛋白定量的变化,同时比较两组患者的治疗有效率及不良反应发生率。结果：治疗组患者在治疗2个月时疗效显著,尿RBC计数和24 h尿蛋白定量较治疗前均显著下降（P〈0.05）;随着疗程的延长,至6个月时,治疗组患者的尿RBC计数和24 h尿蛋白定量较治疗前进一步显著下降（P〈0.05）;与治疗前比较,在治疗2个月时,对照组患者的尿RBC计数和24 h尿蛋白定量差异均无统计学意义（P〉0.05）,在治疗4个月时才显著下降（P〈0.05）;与同期对照组比较,在治疗2月、4月和6月时,治疗组患者的尿RBC计数和24 h尿蛋白定量均显著下降（P〈0.05）,治疗总有效率均显著升高（P〈0.05）;治疗组患者不良反应发生的总频数比对照组显著降低（7.1%vs 23.8%,P〈0.05）;所有患者治疗前后肾功能均保持稳定。结论：益肾化湿颗粒联合来氟米特对无症状尿检异常型IgAN有显著疗效,可有效减轻血尿和蛋白尿,稳定肾功能,且不良反应少。Objective： To evaluate the clinial effects of a combined regime with Yishen Huashi granules plus Leflunomide for IgA nephropathy（ IgAN） with asymptomatic abnormal urinalysis. Methods： 84 cases of patients diagnosed as IgA nephropathy（ IgAN） with asymptomatic abnormal urinalysis from January 2014 to December 2015 were randomly assigned into treatment group and control group（ each group contained 42cases）. The patients of treatment group received the combined regime of Yishen Huashi granules（ 20 g,3 / d） plus Leflunomide tablets（ 20 mg,1 / d）,and the patients of control group received the Leflunomide tablets only（ 20 mg,1 /d）. After 2,4 and 6 months,the levels of urine red blood cell（ RBC） and 24 h urine protein,effective rate of treatment and incidence rate of adverse reaction were observed and compared between the two groups. Results： After 2,4 and 6 months,the levels of urinary RBC and 24 h urinary protein of patients in treatment group were significantly lower than those before treatment（ P〈0. 05）,this effects were more and more significant with the extension of treatment course. Compared with before treatment,there was no significant change in the levels of urine RBC and 24 h urinary protein of patients in control group after 2 months（ P〉0. 05）,and those in control group significantly decreased until 4 months later. The levels of urine RBC and 24 h urinary protein in the treatment group were significantly lower than those in the control group at 2,4 and 6 months separately（ P〈0. 05）. The total effective rate of the patients in treatment group was significantly higher than that in control group（ P〈0. 05）. In addition,the incidence rate of adverse reactions of the patients in treatment group was significantly lower than that in the control group（ 7. 1% vs 23. 8%,P〈0. 05）,and the level of serum creatinine（ Scr） kept stable in all patients. Conclusion： The combined regime with Yishen Huashi granules plus Leflunomide was effective and safe for tr

关 键 词：益肾化湿颗粒 来氟米特 无症状尿检异常型IgA肾病 

分 类 号：R692.3[医药卫生—泌尿科学]