超声透入膜肾地龟汤治疗特发性膜性肾病(低、中风险)脾肾气虚兼血瘀证的临床观察  

Clinical observation on idiopathic membranous nephropathy with spleen-kidney qi deficiency and blood stasis(low and medium risk)received ultrasonic infiltration of Moshen Digui Decoction

作　　者：孙雪艳 刘志强 孟元[1] 张康 赵文景[1] SUN Xueyan;LIU Zhiqiang;MENG Yuan;ZHANG Kang;ZHAO Wenjing(Department of Nephrology,Beijing Hospital of Traditional Chinese Medicine,Capital Medical University,Beijing 100010,China;Department of Nephrology,Yanqing Hospital of Beijing Chinese Medicine Hospital,Beijing 102100,China)

机构地区：[1]首都医科大学附属北京中医医院肾病科,北京100010 [2]北京中医医院延庆医院肾病科,北京102100

出　　处：《中华中医药杂志》2024年第10期5641-5645,共5页China Journal of Traditional Chinese Medicine and Pharmacy

基　　金：北京市科技计划首都特色一般项目(No.Zl71100001017032);国家重点研发计划中医药现代化研究专项(No.2018YFC 1704102)。

摘　　要：目的:评价超声透入膜肾地龟汤治疗低、中风险特发性膜性肾病(IMN)患者的临床疗效。方法:本研究采用随机、单盲、安慰剂对照研究,纳入IMN(低、中风险)脾肾气虚兼血瘀证患者60例,随机分为治疗组和对照组,最终每组29例患者完成全部研究。两组在常规治疗基础上,治疗组/对照组分别于双肾俞穴予超声透入膜肾地龟汤/安慰剂耦合贴片,每次30 min,隔日1次。疗程均为12周。观察两组患者治疗前后临床疗效、24 h尿蛋白定量(24hUTP)、血白蛋白(Alb)、总蛋白、血肌酐、尿素氮、血清磷脂酶A2受体抗体(PLA2Rab)、中医证候积分及安全性指标的变化情况。结果:治疗组总缓解率显著优于对照组(P<0.05)。与本组治疗前比较,治疗组治疗8周后24hUTP、PLA2Rab水平、中医证候积分水平显著下降(P<0.05),血Alb水平显著升高(P<0.05)。治疗组治疗后24hUTP、PLA2Rab水平及中医证候积分水平显著低于对照组(P<0.05),PLA2Rab转阴率、血Alb显著高于对照组(P<0.05)。两组患者在研究过程中均未出现不良反应。结论:超声透入膜肾地龟汤对IMN(低、中风险)脾肾气虚兼血瘀证患者具有降低尿蛋白和PLA2Rab滴度,升高血浆Alb的肾脏保护作用且安全性良好。Objective:To evaluate the clinical efficacy of receiving ultrasonic infiltration of Moshen Digui(MSDG)Decoction in the treatment of low/moderate risk idiopathic membranous nephropathy(IMN).Methods:This was a randomized,single-blind,placebo-controlled study.Sixty patients with idiopathic membranous nephropathy(low and medium risk)with spleen-kidney qi deficiency and blood stasis syndrome were randomly divided into treatment group and control group,and 29 patients in each group completed the study.On the basis of routine treatment,the treatment group and the control group were respectively given ultrasonic infiltration of MSDG Decoction/placebo coupled patch at both Shenshu points(BL 23),once every other day,30 min each time.The course of treatment was 12 weeks.The clinical efficacy,24hUTP,serum albumin,total protein,serum creatinine,urea nitrogen,serum phospholipase A2 receptor antibody(PLA2Rab),traditional Chinese medicine(TCM)syndrome score and safety indicators were observed before and after treatment in the two groups.Results:The total remission rate of the treatment group was significantly better than that of the control group(P<0.05).Compared before treatment,the levels of 24hUTP,PLA2Rab titer and TCM syndrome score in the treatment group were decreased(P<0.05),and the serum albumin level was increased(P<0.05).Compared with the control group,the 24hUTP quantification,PLA2Rab titer and TCM syndrome score of the treatment group were lower(P<0.05),and the negative conversion rate of PLA2Rab and serum albumin were higher(P<0.05).There were no adverse reactions in the two groups during the study.Conclusion:Ultrasonic infiltration of MSDG Decoction can reduce urine protein and PLA2Rab titer,and increase plasma albumin in IMN patients(syndrome of spleen-kidney qi deficiency and blood stasis)with low/moderate risk,and has good safety.

关 键 词：特发性膜性肾病 超声透药 血清磷脂酶A2受体抗体 中药外治 临床研究 

分 类 号：R277.5[医药卫生—中医学]