通络宁血汤治疗IgA肾病血尿  

Clinical observation on Tongluo-Ningxue decoction for hematuria of the patients with IgA nephropathy

作　　者：魏华娟[1] 多慧玲[1] 刘洪德[2] 董绍英[1] Wel Huajuan;Duo Huiling;Liu Hongde;Dong Shaoying(Department of Nephrology,the Chinese Medicine Hospital of Shijiazhuang,Shijiazhuang 050000,China)

机构地区：[1]河北省石家庄市中医院肾内科,050000 [2]河北省石家庄市第五医院感染一科,050051

出　　处：《国际中医中药杂志》2018年第10期918-921,共4页International Journal of Traditional Chinese Medicine

基　　金：河北省中医药管理局科研课题（2015198）

摘　　要：目的评价通络宁血汤治疗IgA肾病血尿的疗效。方法将符合入选标准的60例IgA肾病血尿患者采用随机数字表法分为2组，每组30例。对照组口服洛丁新与潘生丁，观察组服用通络宁血汤。2组均治疗12周。分别于治疗前后对倦怠乏力、腰膝酸软、咽喉肿痛、潮热盗汗进行症状评分。采用全自动尿沉渣分析仪，以干化学法检测尿RBC；收集24h尿液标本，以比色法检测24h尿蛋白量。采用全自动生化分析仪，以肌氨酸氧化酶法检测血SCr；以免疫比浊法检测IgA、IgG、IgM，评价临床疗效。结果观察组总有效率为86．7％（26／30），对照组为63．3％（19／30），2组比较差异有统计学意义（χ^2=4．356，P=0．037）。治疗后，观察组倦怠乏力[（0．7±0．1）分比（1．4±0．2）分，f=18．954]、腰膝酸软[（0．7±0．1）分比（1．4±0.2）分，t=21．071]、咽喉肿痛[（0．6±0．1）分比（1．4±0.2）分，t=20．723]、潮热盗汗[（0．6±0．1）分比（1．5±0．2）分，t=20．732]评分低于对照组（P〈0．05）；观察组24h尿蛋白量[（0．53±0．12）g比（0．74±0．15）g，t=5．988]、RBC[（16．84±5．38）个／gl比（21．42±9．73）个／gl，t=2．256]、SCr[（56．34±7．21）μmol／L比61．27±8．45）gmol／L，t=2．431]、IgA[（2-35±0．43）g/L比（2．62±0．45）g／L，t=2．376]低于对照组（P〈0．05）。结论通络宁血汤可有效缓解IgA肾病血尿患者的临床症状，降低24h尿蛋白量，下调lgA水平，缓解肾功能损伤。Objective To explore the clinical effect of Tongluo-Ningxue decoction for hematuria from IgA nephropathy. Methods A total of 60 patients with IgA nephropathy in the hospital between July 2015 and August 2016 were randomly divided into two groups, with 30 cases in each group. The control group was treated with western medicine （Benazepril Hydrochloride plus dipyridamole）, whereas the observation group took Tongluo-Ningxue decoction for treatment. The clinical efficacy, clinical symptom score, biochemical index and humoral immune index in the two groups were compared. Results The effective rate was 86.7% （26/30） in the observation group, and 63.3% （19/30） in the control group, with the difference between the two groups being statistically significant （χ^2=4.356, P=-0.037）. After treatment, the scores of fatigue and weakness （0.7 ＋ 0.1 vs. 1.4 ＋ 0.2, t=18.954）, soreness and weakness of waist and knees （0.7 q- 0.1 vs. 1.4±0.2, t=21.071）, swollen sore throat （0.6 ± 0.1 vs. 1.4 ±0.2, t=20.723）, and hot flashes and night-time sweating （0.6 ±01 vs. 1.5 ± 0.2, t=20.732） in the observation group were significantly lower than those in the control group （P〈0.05）. After treatment, the 24h UP （0.53± 0.12 g vs. 0.74±0.15 g, t=5.988）, RBC （16.84 ± 5.38 vs. 21.42±9.73, t=2.256）, SCr （56.34 ±.21 μmol/L vs. 61.27 ± 8.45μmol/L, t=2.431）, and IgA （2.35 ± 0.43 g/L vs. 2.62± 0.45 g/L, t=2.376） in the observation group were significantly lower than those in the control group （P〈0.05）. Conclusions The Tongluo-Ningxue decoction can improve the biochemical indicators, enhance immunity, improve renal function and relieve clinical symptoms, and therefore, it is worthwhile for the clinical application.

关 键 词：肾小球肾炎 IGA 血尿 通络宁血汤 免疫力 临床研究 

分 类 号：R277.5[医药卫生—中医学]