参芪真武汤加味治疗原发性肾病综合征疗效及对患者肾功能、微炎状态、凝血纤溶功能的影响  

Effect of Shenqi Zhenwu decoction on primary nephrotic syndrome and its influence on renal function,micro-inflammatory state,coagulation and fibrinolytic function

作　　者：任剑雄[1] 韦淇元 梁建亮 REN Jianxiong;WEI Qiyuan;LIANG Jianliang(Foshan Hospital of Traditional Chinese Medicine,Foshan 528000,China)

机构地区：[1]佛山市中医院,广东佛山528000

出　　处：《陕西中医》2024年第8期1052-1055,1060,共5页Shaanxi Journal of Traditional Chinese Medicine

基　　金：广东省科技厅科技计划项目(2022A0505020029);广东省佛山市科学技术局自筹经费类科技创新项目(2220001005371)。

摘　　要：目的:探讨参芪真武汤加味治疗原发性肾病综合征效果及对患者肾功能、微炎状态、凝血纤溶功能的影响。方法:选取脾肾阳虚证原发性肾病综合征患者110例,根据治疗方案分为两组,观察组和对照组各55例。对照组给予常规对症治疗,观察组在对照组基础上给予参芪真武汤加味治疗,两组均连续治疗8周。比较两组治疗总有效率及不良反应发生情况,同时观察治疗前后中医证候积分、肾功能[24 h尿蛋白定量(24 hTP)、血白蛋白(ALB)、尿素氮(BUN)、血清肌酐(Cr)]、微炎状态[高敏-C反应蛋白(hs-CRP)、白细胞介素-21(IL-21)、白细胞介素-13(IL-13)]、凝血纤溶功能[纤维蛋白原(FIB)、D-二聚体(D-D)]变化情况。结果:观察组临床总有效率为90.91%,高于对照组的76.36%(P<0.05)。经治疗,观察组浮肿、面色白、畏寒肢冷、腰膝酸软、恶寒喜暖各项中医证候积分较对照组低(均P<0.05);观察组ALB水平较对照组高,24 hTP、BUN、Cr较对照组低(均P<0.05);观察组IL-13水平较对照组高,hs-CRP、IL-21水平较对照组低(均P<0.05)。两组FIB、D-D水平低于治疗前,且观察组低于对照组(均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:参芪真武汤加味治疗原发性肾病综合征脾肾阳虚证可提高临床效果,降低中医证候积分,促进肾功能和凝血纤溶功能改善,减轻机体微炎症状态,且安全性佳。Objective:To explore the effect of Shenqi Zhenwu decoction in the treatment of primary nephrotic syndrome and its influence on renal function,micro-inflammatory state,coagulation and fibrinolysis function.Methods:110 patients with primary nephrotic syndrome with spleen kidney yang deficiency syndrome were selected.They were divided into two groups according to the treatment plan,with 55 cases in the observation group and 55 cases in the control group.The control group received routine symptomatic treatment,while the observation group received modified Shenqi Zhenwu decoction treatment on the basis of the control group.Both groups were treated continuously for 8 weeks.Compare the total effective rate and incidence of adverse reactions between two groups.The traditional Chinese medicine syndrome scores,renal function[24-hour urine protein quantification(24 hTP),blood albumin(ALB),urea nitrogen(BUN),serum creatinine(Cr)],micro inflammatory status[high-sensitivity C-reactive protein(hs-CRP),interleukin-21(IL-21),interleukin-13(IL-13)],coagulation and fibrinolytic function[fibrinogen(FIB),D-dimer(D-D)]were observed before and after treatment.Results:The total effective rate of the observation group was 90.91%,which was significantly higher than 76.36%of the control group(P<0.05).After treatment,edema,pale complexion,cold limbs,lumbar debility,evil cold or warm score in the observation group were lower than the control group(all P<0.05).The level of ALB in the observation group was higher than that in the control group,and the 24 hTP,BUN and Cr were lower than those in the control group(all P<0.05).After treatment,the IL-13 in the observation group was higher than that in the control group,and the hs-CRP and IL-21 were lower than those in the control group(all P<0.05).FIB and D-D levels in the two groups were lower than those before treatment,and those in the observation group were lower than those in the control group(all P<0.05).There was no significant difference in adverse reactions(P>0.05).Conclusion:The modified

关 键 词：原发性肾病综合征 参芪真武汤 脾肾阳虚证 肾功能 微炎症状态 凝血纤溶功能 

分 类 号：R692[医药卫生—泌尿科学]