健脾祛湿法辅助他克莫司治疗脾虚湿热型特发性膜性肾病的前瞻性研究  

A Prospective Study of Invigorating Spleen and Eliminating Dampness Combined with Tacrolimus in the Treatment of Idiopathic Membranous Nephropathy of Spleen Deficiency and Damp Heat Type

作　　者：郭建军 GUO Jianjun(Shouguang Traditional Chinese Medicine Hospital,Shandong Province,Shouguang 262700,China)

机构地区：[1]山东省寿光市中医医院,山东寿光262700

出　　处：《中国医学创新》2022年第33期74-78,共5页Medical Innovation of China

基　　金：潍坊市中医药科学技术研究项目(2021(第四类)36号)。

摘　　要：目的:通过前瞻性研究分析健脾祛湿法辅助他克莫司治疗脾虚湿热型特发性膜性肾病(idiopathic membranous nephropathy,IMN)的临床效果。方法:将寿光市中医医院于2019年1月-2021年11月接收的104例脾虚湿热型IMN患者作为研究对象,用电脑随机数字表法分为西医组和联合组,各52例。西医组口服他克莫司治疗,联合组在西医组基础上加用健脾祛湿法治疗。比较两组疗效、不良反应与治疗前后中医症候积分、肾功能指标、免疫功能指标。结果:联合组总有效率较西医组高(P<0.05);治疗后,两组中医症候积分、肾功能指标、免疫功能指标均明显改善,且联合组以上指标均优于西医组(P<0.05);两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:健脾祛湿法辅助他克莫司治疗脾虚湿热型IMN,可提高患者免疫功能及肾功能,缓解临床症状,提高疗效,且安全性可观。Objective:To analyze the clinical effect of invigorating spleen and eliminating dampness combined with Tacrolimus in the treatment of idiopathic membranous nephropathy(IMN)of spleen deficiency and damp heat type through a prospective study.Method:A total of 104 patients with IMN of spleen deficiency and damp heat type who were admitted to Shouguang Traditional Chinese Medicine Hospital from January 2019 to November 2021 were selected as the research subjects,and divided into western medicine group and combined group by random mumber table method,with 52 cases in each group.The western medicine group was treated with Tacrolimus,and the combined group was treated with invigorating spleen and eliminating dampness on the basis of the western medicine group.The curative effects,adverse reactions,TCM syndrome scores,renal function indexes and immune function indexes before and after treatment were compared between the two groups.Result:The total effective rate in the combined group was higher than that in the western medicine group(P<0.05);after treatment,the TCM syndrome scores,renal function and immune function indexes in the two groups were significantly improved,and the above indexes in the combined group were better than those in the western medicine group(P<0.05);there was no significant difference in the total incidence of adverse reactions between the two groups(P>0.05).Conclusion:Invigorating spleen and eliminating dampness combined with Tacrolimus in the treatment of IMN of spleen deficiency and damp heat type can improve immune function and renal function,alleviate clinical symptoms,improve the curative effect with considerable safety.

关 键 词：特发性膜性肾病 他克莫司 健脾祛湿法 脾虚湿热型 中医症候积分 肾功能 免疫功能 

分 类 号：R692[医药卫生—泌尿科学]