基于证候学研究益气地黄汤对气阴两虚型IgA肾病患者临床疗效的影响  

Study on the impact of Yiqi Dihuang Decoction on the clinical efficacy of IgA nephropathy patients with deficiency of both Qi and Yin based on symptomatology

作　　者：黎凤仪 钟建[2] 罗锦伟[3] LI Feng-yi;ZHONG Jian;LUO Jin-wei(Faculty of Chinese Medicine Science Guangxi University of Chinese Medicine,Nanning 530200,China)

机构地区：[1]广西中医药大学赛恩斯新医药学院,530200 [2]广西中医药大学第一附属医院肾内科,530200 [3]广西中医药大学第一附属医院心血管内科,530200

出　　处：《中国现代药物应用》2025年第3期24-28,共5页Chinese Journal of Modern Drug Application

基　　金：广西高校中青年教师基础能力提升项目(项目编号:2023KY1746),项目名称:基于证候蛋白组学研究益气地黄汤对气阴两虚型IgA肾病表达蛋白的差异。

摘　　要：目的基于证候学研究益气地黄汤对气阴两虚型免疫球蛋白A(IgA)肾病患者临床疗效的影响,揭示其在该病证中的作用机制。方法选取60例气阴两虚型IgA肾病患者,随机分为对照组和治疗组,每组30例。对照组接受常规治疗,治疗组在常规治疗基础上加用益气地黄汤。比较两组患者的临床主要症状改善情况,临床疗效,中医症状评分,血常规指标[红细胞计数(RBC)、白细胞计数(WBC)、血红蛋白(HGB)]及肝功能指标[谷丙转氨酶(ALT)、谷草转氨酶(AST)],肾功能指标(尿沉渣红细胞计数、24 h尿蛋白定量、尿素氮和肌酐),不良反应发生情况。结果治疗组患者治疗后临床主要症状疲乏、气短、口干舌燥、五心烦热改善率分别为83.33%、80.00%、76.67%、73.33%,显著高于对照组的53.33%、50.00%、43.33%、33.33%,具有统计学意义(P<0.05)。治疗组总有效率为86.67%(26/30),显著高于对照组的63.33%(19/30),具有统计学意义(P<0.05)。治疗后,两组主要症状评分、次要症状评分以及总分均有所下降,且治疗组的主要症状评分(5.87±1.48)分、次要症状评分(3.10±1.35)分、总分(8.97±1.63)分显著低于对照组的(8.87±2.10)、(4.07±1.36)、(12.94±2.94)分,具有统计学意义(P<0.05)。治疗前后,两组患者的RBC、WBC、HGB、ALT、AST组间组内比较,均无显著差异(P>0.05)。治疗后,两组的尿沉渣红细胞计数、24 h尿蛋白定量、尿素氮和肌酐水平均有所下降,且治疗组的尿沉渣红细胞计数(8.23±1.96)个/μl、24 h尿蛋白定量(0.63±0.04)g/24 h、尿素氮(4.40±1.59)mmol/L、肌酐(74.17±2.43)μmol/L均显著低于对照组的(12.33±1.69)个/μl、(0.95±0.05)g/24h、(5.43±1.52)mmol/L、(82.17±2.20)μmol/L,具有统计学意义(P<0.05)。两组不良反应发生率比较,无显著差异(χ^(2)=0.577,P=0.448>0.05)。结论益气地黄汤能显著改善气阴两虚型IgA肾病患者的临床症状、体征及肾功能,减轻血尿和蛋白尿症状,治疗�Objective To study the impact of Yiqi Dihuang Decoction on the clinical efficacy of immunoglobulin A(IgA)nephropathy patients with deficiency of both Qi and Yin based on symptomatology,and to reveal its mechanism of action in the disease.Methods 60 cases of IgA nephropathy patients with deficiency of both Qi and Yin were selected and randomly divided into a control group and a treatment group,each consisting of 30 cases.The control group received conventional treatment,and the treatment group was treated with Yiqi Dihuang Decoction based on the control group.Both groups were compared in terms of main clinical symptoms improvement,clinical efficacy,traditional Chinese medicine syndrome score,blood routine indexes[red blood cell count(RBC),white blood cell count(WBC),hemoglobin(HGB)]and liver function indexes[alanine aminotrasferase(ALT),aspartate transaminase(AST)],renal function indexes(urinary sediment red blood cell count,24-h urinary protein quantification,urea nitrogen,and creatinine),and occurrence of adverse reactions.Results After treatment,the improvement rates of the main clinical symptoms of fatigue,shortness of breath,dry mouth and feverish sensation of five centers in the treatment group were 83.33%,80.00%,76.67% and 73.33%,which were significantly higher than 53.33%,50.00%,43.33% and 33.33% in the control group,and there was statistical significance(P<0.05).The total effective rate of the treatment group was 86.67%(26/30),which was significantly higher than 63.33%(19/30)of the control group,and there was statistical significance(P<0.05).After treatment,the main symptom score,secondary symptom score and total score were decreased in both groups;in the treatment group,the main symptom score was(5.87±1.48)points,the secondary symptom score was(3.10±1.35)points and the total score was(8.97±1.63)points,which were significantly lower than(8.87±2.10),(4.07±1.36)and(12.94±2.94)points in the control group;there was statistical significance(P<0.05).Before and after treatment,there were no significant dif

关 键 词：免疫球蛋白A肾病 气阴两虚型 益气地黄汤 临床疗效 肾功能 

分 类 号：R277.5[医药卫生—中医学]