黄芪固肾丸治疗特发性膜性肾病脾肾气虚型  

Efficacy and safety of Huangqi Gushen pills in the treatment of idiopathic membranous nephropathy with the syndrome of qi deficiency of the spleen and kidney

作　　者：王宏安[1] 刘洪凯[1] 周青山 WANG Hongan;LIU Hongkai;ZHOU Qingshan(Affiliated Hospital of Changchun University of Chinese Medicine,Changchun 130021,China)

机构地区：[1]长春中医药大学附属医院,长春130021

出　　处：《吉林中医药》2024年第11期1326-1329,共4页Jilin Journal of Chinese Medicine

基　　金：吉林省自然科学基金项目(YDZJ202301ZYTS145);吉林省中医药科技项目(2022152);第七批全国老中医药专家学术经验继承工作(国中医药办人教函〔2021〕272号)。

摘　　要：目的观察黄芪固肾丸治疗特发性膜性肾病(idiopathic membranous nephropathy,IMN)脾肾气虚型患者的临床疗效与安全性。方法选择特发性膜性肾病脾肾气虚型患者72例,随机分为观察组和对照组,各36例。2组研究过程中各退出3例,完成研究均为33例。对照组采用肾素-血管紧张素-醛固酮系统(RAAS)阻断剂治疗,观察组在对照组治疗基础上应用黄芪固肾丸口服治疗,分别于治疗前及治疗8、16、24周后观察2组24h尿蛋白定量(24h-UTP)、血清白蛋白(ALB)水平及中医证候积分等变化情况。结果治疗8周后,2组临床疗效结果总有效率比较,差异无统计学意义(P>0.05);治疗16周,观察组临床疗效总有效率(63.64%,21/33)高于对照组(33.33%,11/33)(P<0.05),治疗24周,观察组临床疗效总有效率(84.85%,28/33)高于对照组(54.54%,18/33)(P<0.05);治疗8、16、24周后,2组24h-UTP水平及中医证候积分均下降,ALB水平均上升。观察组治疗16、24周后24h-UTP、中医证候积分低于对照组(P<0.05),治疗24周后ALB水平观察组明显优于对照组(P<0.05)。结论黄芪固肾丸能提高IMN治疗缓解率,可提高中医证候疗效,降低尿蛋白,临床疗效显著。Objective To observe the efficacy and safety of Huangqi Gushen pills in the treatment of idiopathic membranous nephropathy(IMN)with the syndrome of qi deficiency of the spleen and kidney.Methods A total of 72 IMN inpatients and outpatients with the syndrome of qi deficiency of the spleen and kidney from the nephrology department of our hospital from May 2022 to April 2023 were enrolled and randomly divided into an experimental group and a control group,with 36 cases in each group.The control group was treated with the renin-angiotensinaldosterone system(RAAS)blocking preparations,while the experimental group was treated with Huangqi Gushen pills based on the treatment of the control group.The changes in the levels of 24-hour urinary total protein(24h-UTP),serum albumin(ALB)and TCM syndrome scores were observed before treatment and after 8,16,and 24 weeks of treatment,respectively.Results After 8 weeks of treatment,there was no difference in clinical efficacy between the two groups(P>0.05).After 16 weeks of treatment,the total effective rate in the observation group(63.64%,21/33)was higher than that in the control group(33.33%,11/33)(P<0.05).After 24 weeks of treatment,the total effective rate in the observation group(84.85%,28/33)was higher than that in the control group(54.54%,18/33)(P<0.05).After 8,16 and 24 weeks of treatment,the 24h-UTP levels and TCM syndrome scores were both decreased in the two groups,while the ALB levels were both increased.The 24h-UTP levels and the TCM syndrome scores in the experimental group were significantly lower than those in the control group after 16 and 24 weeks of treatment(P<0.05).After 24 weeks of treatment,the level of ALB in the experimental group was significantly better than that in the control group(P<0.05).Conclusion Huangqi Gushen pills can improve the remission rate of IMN patients,and has a significant effect in improving the curative effect of TCM syndromes and reducing the level of urinary protein,which is worthy of clinical promotion.

关 键 词：黄芪固肾丸 特发性膜性肾病 脾肾气虚型 24 h尿蛋白 

分 类 号：R692[医药卫生—泌尿科学]