黄葵胶囊治疗IgA肾病、糖尿病肾病及膜性肾病疗效比较  

Comparison of Therapeutic Effects of Huangkui Capsule on IgA Nephropathy,Diabetic Nephropathy and Membranous Nephropathy

作　　者：邢增辉 张一绚 韩冰[1] 李思晨 王义琴 刘超[1] 林洪丽[2] 倪兆慧 占永立[4] 蔡广研[1] 陈钦开[5] 王小琴[6] 张佩青 李鹏[8] 汪年松[9] 苗里宁[10] 王涌[1] 陈香美[1] 孙雪峰[1] XING Zenghui;ZHANG Yixuan;HAN Bing(Department of Nephrology,First Medical Center of Chinese PLA General Hospital,Nephrology Institute of the Chinese People’s Liberation Army,State Key Laboratory of Kidney Diseases,National Clinical Research Center for Kidney Diseases,Beijing Key Laboratory of Kidney Disease Research,Beijing,100853)

机构地区：[1]解放军总医院第一医学中心肾脏病医学部,肾脏疾病国家重点实验室,慢性肾病国家临床医学研究中心,北京100853 [2]大连医科大学附属第一医院肾内科,大连116011 [3]上海交通大学医学院附属瑞金医院肾脏科,上海200127 [4]中国中医科学院广安门医院肾病科,北京100053 [5]南昌大学附属第一医院肾内科,南昌330006 [6]湖北省中医院肾病内科,武汉430060 [7]黑龙江省中医院中医肾病科,哈尔滨150036 [8]烟台毓璜顶医院肾内科,烟台264000 [9]上海交通大学医学院附属第六医院,上海200233 [10]吉林大学第二医院肾病内科,长春130041

出　　处：《中国中西医结合肾病杂志》2023年第3期207-212,共6页Chinese Journal of Integrated Traditional and Western Nephrology

基　　金：国家自然科学基金面上项目(No.92049103);国家重大新药创制专项“十二五”计划项目(No.2013ZX09104-003)。

摘　　要：目的:评估黄葵胶囊治疗IgA肾病、膜性肾病及糖尿病肾病的疗效差异。方法:基于多中心、前瞻性、单臂、开放式队列研究(NCT02231138)数据进行二次分析,倾向性评分匹配平衡基线差异后,比较IgA肾病、膜性肾病及糖尿病肾病临床疗效。以尿蛋白下降率≥30%定义为治疗有效,尿蛋白下降率<30%定义为无效,分析影响黄葵胶囊降低尿蛋白的危险因素。结果:共纳入964例患者,其中IgA肾病患者745例,膜性肾病患者96例,糖尿病肾病患者123例。IgA肾病、膜性肾病和糖尿病肾病组黄葵胶囊治疗后尿蛋白水平均较基线显著降低,但6个月尿蛋白降低率和有效率3组间无明显差别;基线尿蛋白、体重指数、血肌酐和血清白蛋白是黄葵胶囊降低尿蛋白的独立危险因素,尿蛋白每增加100 mg,尿蛋白降低率增加3.6%;血清白蛋白每增加1 g/L,尿蛋白降低率增加5.9%;而血肌酐每增加1μmmol/L,尿蛋白降低率减少0.7%,体重指数每升高1 kg/m^(2),尿蛋白降低率减少6.7%。结论:黄葵胶囊治疗6个月,降低IgA肾病、膜性肾病和糖尿病肾病尿蛋白的疗效无明显差别;合理选择黄葵胶囊为治疗慢性肾脏病患者提供了参考。Objective:To evaluate the difference of curative effect of Huangkui capsule on IgAN(IgA nephropathy),MN(membranous nephropathy)and DN(diabetic nephropathy).Methods:Secondary analysis was conducted based on the data of multicenter,prospective,single-arm and open cohort study(NCT02231138).After the propensity score matched the balanced baseline difference,the clinical efficacy of IgAN,MN and DN was compared.The treatment was defined as effective with the decrease rate of urine protein≥30%,and ineffective with the decrease rate of urine protein<30%.The risk factors affecting the decrease of urine protein in Huangkui capsule were analyzed.Results:A total of 964 patients were included,including 745 patients with IgAN,96 patients with MN and 123 patients with DN.The urine protein level of IgA,MN and DN groups after treatment with Huangkui Capsule was significantly lower than that of baseline,but there was no significant difference in the urine protein reduction rate and effective rate among the three groups at 6 months.24 h baseline urinary protein,body mass index(BMI),serum albumin(Alb),and serum creatinine(Scr)were the independent influencing factors of Huangkui capsule in reducing urinary protein.After 6 months of Huangkui capsule treatment,the decrease rate of urine protein increased by 3.6%for every 100 mg increase of 24 h urinary protein and 5.9%for every 1 g/L increase of Alb,while decreased by 0.7%and 6.7%respectively,for every 1μmmol/L increase of Scr and 1 kg/m^(2)increase of BMI.Conclusion:Huangkui capsule has no significant difference in reducing urinary protein of IgAN,MN and DN after 6 months of treatment.The research results provide a reference for the rational selection of Huangkui capsule in the treatment of patients with chronic kidney disease.

关 键 词：黄葵胶囊 IGA肾病 糖尿病肾病 膜性肾病 疗效 

分 类 号：R277.5[医药卫生—中医学]