越婢加术汤合五苓散治疗成人原发性肾病综合征风水相搏证临床观察  

Clinical Observation of Using Yuebi Jiashu Decoction Combined with Wuling Powder in Treating Adult Primary Nephrotic Syndrome of Fighting of Wind with Water Syndrome

作　　者：付会玲 FU Huiling(Department of Nephrology,the Central Hospital of Wuhan,Tongji Medical College,Huazhong University of Science and Technology,Hubei Wuhan 430014,China)

机构地区：[1]华中科技大学同济医学院附属武汉中心医院肾内科

出　　处：《四川中医》2020年第2期125-128,共4页Journal of Sichuan of Traditional Chinese Medicine

摘　　要：目的:观察成人原发性肾病综合征(PNS)风水相搏证应用越婢加术汤合五苓散治疗的临床效果。方法:选取98例成人PNS患者,随机分成观察组49例与对照组49例。对照组予以常规西医治疗(醋酸泼尼松片+注射用环磷酰胺),观察组在此基础上内服越婢加术汤合五苓散治疗,所有患者均治疗6个月。比较两组临床疗效,治疗前后一般临床指标[24小时尿蛋白定量(24h-UTP)、白蛋白(ALB)、低/高密度脂蛋白胆固醇比值(LDL-C/HDL-C比值)、中医症状总积分]、肾功能参数[肌酐(Cr)、尿素氮(BUN)]、细胞因子[白介素(IL-4、IL-6)]、补体C3、外周血T淋巴细胞亚群(CD4^+/CD8^+比值)变化,毒副反应发生情况。结果:观察组总有效率(87.8%)明显高于对照组(71.4%,P<0.05)。两组治疗后24h-UTP、血清LDL-C/HDL-C比值及中医症状总积分较治疗前均显著下降(P<0.05),血清ALB水平则均显著升高,血清Cr和BUN浓度、IL-4和IL-6浓度均显著减少,而血清补体C3水平及外周血CD4^+/CD8^+比值均显著增高;且以上指标观察组改善更显著(P<0.05)。观察组不良反应率(12.2%)较对照组(28.6%)低(P<0.05)。结论:风水相搏型成人PNS应用越婢加术汤合五苓散辅助治疗能显著缓解患者风水相搏证的相关症状,降低尿蛋白,保护肾功能,抑制体内炎症反应,正性调节机体免疫功能,延缓疾病进展,整体疗效显著,且表现出一定的减毒优势。Objective:To explore the clinical efficacy of Yuebi Jiashu Decoction combined with Wuling Powder in treating adult primary nephrotic syndrome(PNS)of fighting of wind with water syndrome.Methods:98adult PNS patients were randomly divided into observation group(n=49)and controlled group(n=49).The controlled group was treated with conventional western medicine(prednisone acetate+cyclophosphamide for injection).On the basis of the controlled group,the observation group was treated with Yueqi Jiashu Decoction and Wuzhi Powder orally.All patients were treated for 6months.The clinical efficacy,the general clinical indicators24h urinary protein quantification(24h-UTP),albumin(ALB),low/high-density lipoprotein cholesterol ratio(LDL-C/HDL-C ratio),the total score of TCM symptoms J,renal function parameters[creatinine(Cr),urea nitrogen(BUN)],cytokines[interleukin(IL-4,IL-6)],complement C3,peripheral blood T lymphocyte subsets(CD4^+/CD8^+ratio)change,the occurrence of toxic side effects of the two groups before and after treatment were compared.Results:The total effective rate of the observation group(87.8%)was significantly higher than that of the controlled group(71.4%,P<0.05).The 24h-UTP,serum LDL-C/HDL-C ratio and TCM symptom scores of the two groups were significantly lower than those before treatment(P<0.05),serum ALB levels were significantly increased,the concentrations of serum Cr,BUN,IL-4and IL-6were significantly decreased,while the levels of serum complement C3 and peripheral blood CD4^+/CD8^+were significantly increased;and the improvement of the above indicators in observation group was more significant(P<0.05).The adverse reaction rate of the observation group(12.2%)was lower than that of the controlled group(28.6%)(P<O.05).Conclusion:In treating adult PNS with syndrome of fighting of wind with water,the combination of Yueqi Jiashu Decoction and Wuling Powder can significantly alleviate the symptoms related to wind with water syndrome,reduce urine protein,protect kidney function,inhibit inflammation in the bod

关 键 词：成人原发性肾病综合征 风水相搏证 越婢加术汤合五苓散 肾功能 炎症反应 

分 类 号：R692[医药卫生—泌尿科学]