参芪地黄汤加减治疗肾病综合征疗效及对患者血清免疫球蛋白和补体的影响  

Effect of modified Shenqi Dihuang decoction on nephrotic syndrome and its effect on serum immunoglobulin and complement

作　　者：高锐 高珺[1] 孙玲[1] 沈建军[2] GAO Rui;GAO Jun;SUN Ling;SHEN Jianjun(Department of Nephrology,Xuzhou Central Hospital,Xuzhou 221009,China)

机构地区：[1]徐州市中心医院肾内科,江苏徐州221009 [2]南京市第二医院中西医结合科,江苏南京210003

出　　处：《陕西中医》2022年第8期1060-1063,共4页Shaanxi Journal of Traditional Chinese Medicine

基　　金：江苏省中医药管理局科研项目(YB2020038)。

摘　　要：目的:探究参芪地黄汤加减治疗气阴两虚证肾病综合征疗效及对患者血清免疫球蛋白及补体的影响。方法:选取106例气阴两虚证肾病综合征患者为研究对象,随机分为对照组(醋酸泼尼松龙片)和试验组(醋酸泼尼松龙片+参芪地黄汤加减),各53例,共治疗12周。统计两组患者治疗前后的中医症候积分变化、肾功能指标、血清免疫球蛋白及补体水平,统计两组患者治疗后的临床疗效、安全性及出院后10个月复发情况。结果:治疗后,试验组患者的中医证候积分低于对照组,24 h尿蛋白、血肌酐(SCr)、尿素氮(BUN)水平低于对照组,肾小球滤过率高于对照组,血清免疫球蛋白M(IgM)、免疫球蛋白G(IgG)、补体C_(3)(C_(3))、补体C_(4)(C_(4))水平高于对照组,IgA水平低于对照组,临床总有效率高于对照组(均P<0.05),两组肾病综合征患者的不良反应总发生率比较差异无统计学意义(P>0.05)。结论:采用参芪地黄汤加减治疗气阴两虚证肾病综合征临床疗效确切,可以调节机体的免疫水平,且未增加不良反应,安全性较好。Objective:To explore the effect of Shenqi Dihuang decoction on nephrotic syndrome(deficiency of Qi and Yin)and its effect on serum immunoglobulin and complement.Methods:106 patients with nephrotic syndrome(deficiency of Qi and Yin)were randomly divided into control group(prednisolone acetate tablets)and experimental group(prednisolone acetate tablets+Shenqi Dihuang decoction)for 12 weeks.The changes of TCM symptom scores,renal function indexes,serum immunoglobulin and complement levels of patients with nephrotic syndrome in the two groups before and after treatment were counted,and the clinical efficacy,safety and recurrence 10 months after discharge were counted.Results:After treatment,the TCM syndrome score of the experimental group was lower than that of the control group,the levels of 24-hour urinary protein,SCr and BUN were lower than that of the control group,the glomerular filtration rate was higher than that of the control group,the levels of serum immunoglobulin M(IgM),immunoglobulin G(IgG),complement C_(3)(C_(3)),complement C_(4)(C_(4))were higher than that of the control group,and the level of IgA was lower than that of the control group.The total clinical effective rate was higher than that in the control group(all P<0.05).There was no significant difference in the total incidence of adverse reactions between the two groups(P>0.05).Conclusion:Shenqi Dihuang decoction is effective in the treatment of nephrotic syndrome(Qi and Yin deficiency syndrome),which can regulate the immune level of the body without increasing adverse reactions.

关 键 词：肾病综合征 气阴两虚 参芪地黄汤 免疫球蛋白 肾功能 免疫功能 

分 类 号：R692[医药卫生—泌尿科学]