益气固本调免方治疗慢性肾炎脾肾气虚证的临床研究  

A Clinical Study of Yiqi Guben Tiaomian Formula(益气固本调免方)in Treatment of Chronic Glomerulonephritis with the Spleen Kidney Qi Deficiency Syndrome

作　　者：沈姣姣[1] 徐飞鹏 沈沛成[1] 何立群[1] SHEN Jiao-jiao;XU Fei-peng;SHEN Pei-cheng;HE Li-qun(Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine/TCM Institute of Kidney Disease,Shanghai University of Traditional Chinese Medicine/Key Laboratory of Liver and Kidney Diseases(Shanghai University of Traditional Chinese Medicine),Ministry of Education/Shanghai Key Laboratory of Traditional Chinese Clinical Medicine,Shanghai 200021,China)

机构地区：[1]上海中医药大学附属曙光医院/上海中医药大学中医肾病研究所/肝肾疾病病证教育部重点实验室(上海中医药大学)/上海市中医临床重点实验室,上海200021

出　　处：《中医药导报》2022年第1期91-95,共5页Guiding Journal of Traditional Chinese Medicine and Pharmacy

基　　金：上海市科委医学引导类(中、西医)科技支撑项目(18401903300)。

摘　　要：目的:观察益气固本调免方治疗慢性肾炎脾肾气虚证的临床疗效。方法:将128例慢性肾炎CKD1~3期脾肾气虚证患者随机分为治疗组(益气固本调免方)和对照组(肾炎康复片)各64例,疗程4个月,比较两组患者治疗前后血尿、蛋白尿、肾功能、中医证候情况。结果:治疗组患者临床疗效优于对照组,差异有统计学意义(P<0.05)。治疗后,对照组患者尿红细胞数目无明显变化(P>0.05),24 h尿蛋白定量较治疗前降低(P<0.05)。治疗组患者治疗后尿红细胞数和24 h尿蛋白定量均较治疗前降低,差异均有统计学意义(P<0.01)。治疗后,治疗组患者尿红细胞数和24 h尿蛋白定量均低于对照组,差异均有统计学意义(P<0.01)。两组患者治疗前、治疗后eGFR比较,差异均无统计学意义(P>0.05)。治疗组患者中医证候疗效优于对照组,差异有统计学意义(P<0.01)。两组患者治疗后中医证候积分和总积分均较治疗前降低,差异均有统计学意义(P<0.05)。治疗组患者治疗后纳少、胃脘胀、尿频、浮肿积分与对照组比较,差异均无统计学意义(P>0.05)。治疗组患者治疗后腰脊酸痛、疲倦乏力、大便溏薄、夜尿多积分和总积分均低于对照组,差异均有统计学意义(P<0.05)。治疗组患者大便溏薄和疲倦乏力积分变化与尿红细胞数、24 h尿蛋白定量呈正相关。结论:益气固本调免方可有效改善慢性肾炎脾肾气虚证患者的血尿和蛋白尿,同时能改善患者的中医证候。Objective:To investigate the effect of Yiqi Guben Tiaomian Formula in chronic glomerulonephritis patients with the spleen kidney Qi deficiency syndrome.Methods:In this randomized controlled clinical study,128 chronic glomerulonephritis patients with spleen kidney Qi deficiency syndrome in chronic kidney disease(CKD)stage 1-3 were enrolled.They were randomized into treatment and control groups,64 cases in each group.Patients were treated by Yiqi Guben Tiaomian Formula in treatment group and Shenyan Kangfu tablet(肾炎康复片)in control group,with a four-month course of therapies.The hematuria,proteinuria,renal function and traditional Chinese medicine(TCM)syndromes were compared between the two groups.Results:The treatment group showed better clinical effect than control group,with significant difference(P<0.05).After treatment,there was no significant change in the number of urine red blood cells(P>0.05),while 24 h urinary protein excretion reduced in the control group(P<0.05).The number of urine red and 24 h urinary protein excretion were obviously reduced in the treatment group(P<0.01),and the treatment group showed lower number of urine red and 24 h urinary protein excretion than control group,with significant differences(P<0.01).There was no significant difference in estimated glomerular filtration rate(EGFR)before and after treatment in the two groups(P>0.05).The treatment group showed better curative effect of TCM syndromes than control group,and the difference was statistically significant(P<0.01).After treatment,each symptom score and total score of TCM syndromes decreased in the two groups,and the differences were statistically significant(P<0.05).After treatment,the treatment group showed lower scores of lumbago,asthenia,diarrhea and frequent urination at night,than control group(P<0.05),but there was no significant difference between the two groups in score of decreased appetite,epigastric distention,frequency of urinatior and edema(P>0.05).The positive relationship between the score of diarrhea and

关 键 词：慢性肾炎 脾肾气虚证 益气固本调免方 肾炎康复片 蛋白尿 血尿 

分 类 号：R256.51[医药卫生—中医内科学]