通络解毒法治疗原发性系膜增生性肾小球肾炎蛋白尿临床研究及安全性评价  

Clinical Study and Safety Evaluation on Treatment of Proteinuria in Primary Mesangial Proliferative Glomerulonephritis with Tongluo Jiedu Method

作　　者：王霞 魏华娟[2] 刘洪德[3] 贾智玲 赵丹 解纪惠 WANG Xia;WEI hua-juan;LIU Hong-de;JIA Zhi-ling;ZHAO Dan;XIE Ji-hui(School of Basic Medicine,Hebei University of Chinese Medicine,Shijiazhuang 050200)

机构地区：[1]河北中医学院基础医学院,石家庄050200 [2]河北省石家庄市中医院肾内科,石家庄050051 [3]河北省石家庄市第五医院,石家庄050021

出　　处：《河北中医药学报》2020年第1期4-7,共4页Journal of Hebei Traditional Chinese Medicine and Pharmacology

基　　金：河北省科技计划项目:No.17277710D

摘　　要：目的:探讨通络解毒法治疗原发性系膜增生性肾小球肾炎(MsPGN)蛋白尿的临床疗效,并对其进行安全性进行评价。方法:将80例原发性MsPGN蛋白尿患者随机分为对照组与中药组各40例,2组均接受西医基础治疗,对照组在此基础上采用糖皮质激素和(或)免疫抑制剂治疗,中药组在此基础上采用通络解毒方治疗,2组疗程均为3个月。比较2组患者临床疗效指标(包括治疗总有效率、治疗前后中医证候积分、24 h尿蛋白定量、肾功放免指标血β2-微球蛋白(β2-MG)、尿β2-MG、尿白蛋白(Alb)和尿免疫球蛋白G(IgG)及安全性指标(包括肝功能、血常规及不良反应发生情况)。结果:中药组临床疗效总有效率(87.50%)显著高于对照组(65.00%),组间比较差异有显著性(P<0.05)。2组治疗后中医证候积分、24 h尿蛋白定量、肾功放免4项指标均较本组治疗前显著降低(P<0.01);2组治疗后比较,中药组中医证候积分、24 h尿蛋白定量、肾功放免4项指标均低于对照组(P<0.05或P<0.01)。治疗随访期间,中药组肝功能、血常规指标未发现明显异常者,对照组1例患者肝功能转氨酶轻度升高,2例患者加用环磷酰胺后白细胞降低;中药组头晕、恶心、皮疹等不良反应发生率显著低于对照组。结论:通络解毒法能减轻MsPGN患者临床症状,有效改善放免肾功能,减少其24 h尿蛋白排量,且安全性较高,可作为优选治疗方案予以推广应用。Objective:To explore the clinical effect of Tongluo Jiedu method in the treatment of proteinuria in primary mesangial proliferative glomerulonephritis(MsPGN),and to evaluate its safety.Methods:80 cases of primary MsPGN proteinuria were randomly divided into control group and TCM group,40 cases in each group.Both groups received basic Western medicine treatment.On this basis,the control group was treated with glucocorticoid and(or)immunosuppressant while the TCM group was treated with Tongluo Jiedu formula.The course of treatment in both groups was 3 months.The clinical efficacy indexes(including total effective rate,TCM syndrome score before and after treatment,24-h urine protein quantity,renal power amplifier immune index blood β2-microglobulin(β2-MG),urine β2-MG,urine albumin(ALB),urine immunoglobulin G(IgG)and safety indexes(including liver function,blood routine and adverse reactions)were compared between the two groups.Results:The total effective rate(87.50%)of theTCM group was significantly higher than that of the control group(65.00%).There was a significant difference between the two groups(P<0.05).After treatment,the TCM syndrome score,24-h urine protein quantity and four markers of radioimmunoassay of renal function(RIA)in the two groups were significantly lower than those before treatment(P<0.01);after treatment,the TCM syndrome score,24-h urine protein quantity and four markers of RIA were lower than those in the control group(P<0.05 or P<0.01).During the follow-up period of treatment,no obvious abnormality was found in liver function and Blood Routine Indexes in TCM group.In the control group,1 patient had a slight increase in liver function transaminase,and 2 patients had a decrease in leukocyte after cyclophosphamide treatment.The incidence of dizziness,nausea,rash and other adverse reactions in the TCM group was significantly lower than that in the control group.Conclusion:Tongluo Jiedu method can alleviate the clinical symptoms of MsPGN patients,effectively improve the function of radio and im

关 键 词：原发性系膜增生性肾小球肾炎 蛋白尿 赵玉庸 通络解毒法 肾络瘀阻 安全性 

分 类 号：R256.5[医药卫生—中医内科学]