归脾汤联合强的松治疗紫癜性肾炎顽固性血尿随机平行对照研究  

A Randomized Controlled Trial of Guipi Decoction combined with Prednisone in the Treatment of Refractory Purpura Nephritis Hematuria

作　　者：徐敏[1] 

机构地区：[1]江苏省靖江市中医院肾内科,江苏靖江214500

出　　处：《实用中医内科杂志》2017年第6期25-27,共3页Journal of Practical Traditional Chinese Internal Medicine

摘　　要：[目的]观察归脾汤联合强的松治疗紫癜性肾炎顽固性血尿疗效。[方法]使用随机平行对照方法,将40例住院患者按病志号抽签方法简单随机分两组。对照组20例强的松,5mg/d,晨间顿服。治疗组20例归脾汤(党参、黄芪各15g,白术、当归、茯苓、大枣、远志、炒酸枣仁各12g,龙眼肉、生姜各10g,三七3g,仙鹤草30g,白茅根20g,木香6g;小便频、尿急加车前草、黄柏;脾肾阳虚加肉桂、附子;关节痛加苍术、川断;腹痛加元胡、白芍;发热皮肤瘀点多加水牛角),1剂/d,水煎500m L,早晚口服;强的松治疗同对照组。连续治疗4周为1疗程。观测临床症状、U-PT、Scr、BUN、ALB、不良反应。连续治疗2疗程,判定疗效。[结果]治疗组临床控制10例,显效6例,无效4例,总有效率80.00%;对照组临床控制5例,显效5例,无效10例,总有效率50.00%;治疗组疗效优于对照组(P<0.05)。U-PT、Scr、BUN、ALB改善治疗组优于对照组(P<0.05,P<0.01)。[结论]归脾汤联合强的松治疗紫癜性肾炎顽固性血尿,疗效满意,无严重不良反应,值得推广。[Objective] To observe the Guipi decoction combined with prednisone in the treatment of refractory purpura nephritis hematuria curative effect. [Method] Using random parallel control method, 40 cases of hospitalized patients according to the serial number of draw simple disease were randomly divided into two groups. The control group of 20 cases of prednisone, 5 mg/d, morning meal. The treatment group of 20 cases of Guipi decoction （Radix Codonopsis, Astragalus 15g, Atractylodes, angelica, Poria, jujube, Polygala, fried Suanzaoren the 12g, longan pulp, ginger 10g, Sanqi 3g, Xianhecao 30g,Baimaogen 20g of Rhizoma imperatae, agrimony, woody 6g; frequent urination, urgency, plantain herb, Phellodendron; Yang deficiency of spleen and kidney with cinnamon, aconite root and Atractylodes; joint pain, abdominal pain; C Hu, Radix Paeoniae Alba; heat the skin more water）, 1 horns petechia agent/d, decoction 500mL, and oral prednisone; treatment with the control group. 4 weeks of continuous treatment for 1 course of treatment. Observation of clinical symptoms, U-PT, Scr, BUN, ALB, adverse reaction. Continuous 2 courses of treatment, the curative effect. [Results] The treatment group 10 cases were clinically controlled, 6 cases were markedly effective, 4 cases ineffective, the total efficiency of 80%; control group, clinical control 5 cases, 5 cases were markedly effective, 10 cases ineffective, the total efficiency of 50%; the treatment group than the control group （P〈0.05）. U-PT, SCr, BUN, ALB in treatment group better than the control group （P〈0.05, P〈0.01）. [Conclusion] Guipi decoction combined with prednisone in the treatment of refractory purpura nephritis hematuria, satisfactory curative effect, no serious adverse reactions, worthy of promotion.

关 键 词：紫癜性肾炎 顽固性血尿 归脾汤 强的松 U-PT Scr BUN ALB 中西医结合治疗 随机平行对照研究 

分 类 号：R977.11[医药卫生—药品]