柴苓汤联合西药治疗风湿内扰证IgA肾病患者的临床疗效及不良反应分析  

Clinical Efficacy and Adverse Reaction Analysis of Chailing Decoction Combined with Western Medicine in the Treatment of IgA Nephropathy with Rheumatism Disturbance Syndrome

作　　者：雷小娟[1] 姜增凯[1] 张开 LEI Xiaojuan;JIANG Zengkai;ZHANG Kai(Department of Traditional Chinese Medicine,The Second People’s Hospital of Nanyang,Nanyang Henan 473000,China;Department of Nephrology and Rheumatology,The Second People’s Hospital of Nanyang,Nanyang Henan 473000,China)

机构地区：[1]南阳市第二人民医院中药科,河南南阳473000 [2]南阳市第二人民医院肾病风湿科,河南南阳473000

出　　处：《临床研究》2024年第11期107-110,共4页Clinical Research

摘　　要：目的分析柴苓汤联合西药治疗风湿内扰证免疫球蛋白A肾病(IgAN)患者的临床疗效及不良反应发生情况。方法选择2020年6月至2022年6月于南阳市第二人民医院接受治疗的94例风湿内扰证IgAN患者作为研究对象,按随机数字表法分为两组,各47例。对照组采取西药(口服缬沙坦胶囊)治疗,观察组在对照组基础上联合柴苓汤治疗。两组均连续治疗12周,比较治疗后临床疗效;治疗前、治疗后肾功能[血肌酐(Scr)、尿素氮(BUN)、肾小球滤过率(GFR)、血清白蛋白(ALB)]及免疫功能[免疫球蛋白G(IgG)、免疫球蛋白A(IgA)、补体C3];不同时间点(治疗前、治疗4周、治疗8周、治疗12周)24 h尿蛋白水平;记录并比较两组治疗期间不良反应发生情况。结果治疗后,观察组治疗有效率高于对照组,差异具有统计学意义(P<0.05);治疗后,两组Scr、BUN水平低于治疗前,ALB水平高于治疗前,且观察组Scr、BUN水平低于对照组,ALB水平高于对照组,差异均有统计学意义(P<0.05);治疗8周、治疗12周时两组24 h尿蛋白均低于治疗前、治疗4周,且观察组低于对照组,差异均有统计学意义(P<0.05);治疗后,两组IgG、IgA水平低于治疗前,C3水平高于治疗前,观察组IgG、IgA水平低于对照组,C3水平高于对照组,差异均有统计学意义(P<0.05);治疗期间,观察组与对照组不良反应发生率比较差异无统计学意义(P>0.05)。结论柴苓汤联合西药治疗能够有效改善IgA患者肾功能,恢复免疫功能平衡,提高临床疗效,且不会显著增加患者不良反应风险。Objective To analyze the clinical efficacy and adverse reactions of Chailing Decoction combined with Western medicine in the treatment of immunoglobulin A nephropathy(IgAN)with rheumatism disturbance syndrome.Methods Ninetyfour patients with IgAN and rheumatism disturbance syndrome treated at The Second People’s Hospital of Nanyang from June 2020 to June 2022 were selected as study subjects.They were randomly divided into two groups of 47 cases each using the random number table method.The control group was treated with Western medicine(oral valsartan capsules),while the observation group was treated with Chailing Decoction in addition to the treatment of the control group.Both groups were treated continuously for 12 weeks.Clinical efficacy was compared after treatment;renal function[serum creatinine(Scr),blood urea nitrogen(BUN),glomerular filtration rate(GFR),serum albumin(ALB)]and immune function[immunoglobulin G(IgG),immunoglobulin A(IgA),complement C3]were compared before and after treatment;24-hour urine protein levels were measured at different time points(before treatment,4 weeks,8 weeks,and 12 weeks after treatment);and adverse reactions during treatment were recorded and compared between the two groups.Results After treatment,the effective rate of the observation group was higher than that of the control group,with a statistically significant difference(P<0.05).After treatment,Scr and BUN levels in both groups were lower than before treatment,ALB levels were higher than before treatment,and Scr and BUN levels in the observation group were lower than those in the control group,while ALB levels were higher than those in the control group,with statistically significant differences(P<0.05).At 8 weeks and 12 weeks after treatment,24-hour urine protein levels in both groups were lower than before treatment and at 4 weeks after treatment,and the levels in the observation group were lower than those in the control group,with statistically significant differences(P<0.05).After treatment,IgG and IgA levels in b

关 键 词：免疫球蛋白A肾病 柴苓汤 肾功能 24 h尿蛋白 免疫功能 不良反应 

分 类 号：R96[医药卫生—药理学]