芪桂二白汤联合缬沙坦胶囊治疗慢性肾小球肾炎临床研究  

Clinical Study on Qigui Erbai Tang Combined with Valsartan Capsules for Chronic Glomerulonephritis

作　　者：建晓珂[1] 荆志强[2] 张倩[1] JIAN Xiaoke;JING Zhiqiang;ZHANG Qian

机构地区：[1]河南中医药大学第三附属医院肾病科,河南郑州450008 [2]陕西中医药大学第二附属医院肾病科,陕西咸阳712000

出　　处：《新中医》2021年第14期85-89,共5页New Chinese Medicine

摘　　要：目的:观察芪桂二白汤联合缬沙坦胶囊治疗慢性肾小球肾炎的临床疗效。方法:选择116例慢性肾小球肾炎患者为研究对象,按随机数字表法分为观察组和对照组各58例。对照组给予缬沙坦胶囊口服,观察组在对照组基础上加用芪桂二白汤口服。比较2组临床疗效,检测尿蛋白、肾功能指标[尿素氮(BUN)、血浆白蛋白(Alb)、血肌酐(SCr)]、血清中纤维蛋白溶解酶原激活物抑制剂-1(PAI-1)、组织型纤溶酶原激活物(t-PA)、胱抑素C(Cys C)水平,观察不良反应发生情况。结果:观察组总有效率为91.38%,对照组为77.59%,2组比较,差异有统计学意义(P<0.05)。治疗前,2组24 h尿蛋白定量、肾功能指标比较,差异无统计学意义(P>0.05)。治疗后,2组24 h尿蛋白定量、BUN、SCr水平较治疗前降低,Alb水平较治疗前升高;观察组24 h尿蛋白定量、BUN、SCr水平低于对照组,Alb水平高于对照组;差异均有统计学意义(P<0.05)。治疗前,2组血清PAI-1、Cys C、t-PA水平比较,差异无统计学意义(P>0.05)。治疗后,2组血清PAI-1、Cys C水平较治疗前降低,t-PA水平治疗前升高;观察组血清PAI-1、Cys C水平低于对照组,t-PA水平高于对照组;差异均有统计学意义(P<0.05)。观察组不良反应发生率为8.62%,对照组为17.24%,组间比较,差异无统计学意义(χ^(2)=1.914,P=0.167>0.05)。结论:芪桂二白汤联合缬沙坦胶囊治疗慢性肾小球肾炎在降低蛋白尿、保护肾功能方面疗效较好,初步推断原因可能与调控血清中PAI-1、Cys C、t-PA水平以修复肾脏局部受损的血管功能有关,用药安全可靠。Objective:To observe the clinical effect of Qigui Erbai tang combined with valsartan capsules for chronic glomerulonephritis.Methods:A total of 116 cases of patients with chronic glomerulonephritis were selected as the study objects,and were divided into the observation group and the control group according to the random number table method,58 cases in each group.The control group was given the oral administration of valsartan capsules,and the observation group was additionally given the oral administration of Qigui Erbai tang based on the treatment of the control group.The clinical effect was compared between the two groups.Urinary protein,the indexes of the lung function[blood urea nitrogen(BUN),plasma albumi(Alb),serum creatinine(SCr)],as well as levels of plasminogen activator inhibitor-1(PAI-1),tissue-plasminogen activator(t-PA),and cystatin C(Cys C)in serum were detected.The incidence of adverse reactions was observed.Results:The total effective rate was 91.38%in the observation group,and 77.59%in the control group,the difference being significant(P<0.05).Before treatment,when compared 24-hour urine protein excretion and the indexes of the kidney function between the two groups,there was no significance in the difference(P>0.05).After treatment,levels of 24-hour urine protein excretion,BUN,and SCr in the two groups were decreased when compared with those before treatment,and the level of Alb was increased;levels of 24-hour urine protein excretion,BUN,and SCr in the observation group were lower than those in the control group,and the level of Alb was higher;differences were significant(P<0.05).Before treatment,when compared levels of PAI-1,Cys C,and t-PA in serum between the two groups,there was no significance in the difference(P>0.05).After treatment,levels of PAI-1 and Cys C in serum in the two groups were decreased when compared with those before treatment,and the level of t-PA was increased;levels of PAI-1 and Cys C in serum in the observation group were lower than those in the control group,and the lev

关 键 词：慢性肾小球肾炎 脾肾两虚、湿瘀互结证 芪桂二白汤 缬沙坦胶囊 尿蛋白 肾功能 纤维蛋白溶解酶原激活物抑制剂-1 

分 类 号：R692.3[医药卫生—泌尿科学]