中医中药

槐杞黄颗粒治疗IgA肾病的临床研究

孟庆阳

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【摘要】  【摘要】目的 研究槐杞黄颗粒治疗IgA肾病的临床效果。方法 选取我院2017年6月至2019年9月收治的60例IgAN患者进行研究,随机分为对照组与研究组,每组各30例患者,对照组选用厄贝沙坦进行常规西医治疗,研究组在对照组的治疗基础之上增加使用槐杞黄颗粒进行治疗。两组均治疗8周后,对比两组用药前后的Alb、BUN、Scr以及24 h尿蛋白定量的变化,对比两组用药后的治疗效率和不良反应情况。

【关键字】  槐杞黄颗粒,IgA肾病,治疗效果

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[Abstract] Objective To study the clinical effect of Huaiqihuang granules on IgA nephropathy. Methods Sixty patients with IgAN admitted to our hospital from June 2017 to September 2019 were selected for study. They were randomly divided into a control group and a research group, with 30 patients in each group. The control group used irbesartan for routine Western medicine treatment. In addition, the research group added Huaiqihuang granules for treatment based on the treatment of the control group. After 8 weeks of treatment in both groups, the quantitative changes of Alb, BUN, Scr and 24h urine protein before and after treatment were compared between the two groups, and the treatment efficiency and adverse reactions after treatment were compared between the two groups. Results Before medication, there was no significant difference in the quantitative of Alb, BUN, Scr and 24h urine protein (P>0.05); after medication, the quantitative of Alb, BUN, Scr and 24h urine protein of both groups were better than before medication (P<0.05), the improvement of Alb, BUN, Scr and 24h urine protein quantification in the study group was significantly higher than that in the control group (P<0.05), and the total effective rate of treatment in the study group was 93.33%, which was significantly higher than that in the control group, 73.33% (P<0.05), there was no significant difference in the incidence of adverse drug reactions between the two groups (P>0.05). Conclusion The treatment of IgA nephropathy patients with Huaiqihuang granules has a significant effect, which can effectively improve the Alb, BUN, Scr and 24h urine protein quantification of patients, improve the treatment efficiency, and is worthy of popularization and application.

IgA肾病(IgA nephropathy,IgAN)是指肾小球系膜区以IgA沉积或IgA沉积为主,同时还可能存在其他的免疫球蛋白沉积的一种原发性的肾小球疾病[1],是导致我国慢性肾衰竭的主要肾脏疾病之一[2]。该病的病变类型多样,有系膜增生性肾小球肾炎、毛细血管内增生性肾小球肾炎、新月体肾小球肾炎、局灶节段性肾小球硬化和增生硬化性肾小球肾炎等[3]。临床症状常常表现为镜下血尿或肉眼血尿,同时可带有一定程度的蛋白尿,甚至可能发生肾功能严重不全或高血压[4-5]。该病的临床治疗多为服用常规西药来保护肾脏,减少血尿和蛋白尿。近年来,槐杞黄颗粒治疗IgAN的临床效果明显,我院在IgAN的常规治疗中使用槐杞黄颗粒协同治疗,取得了较为理想的效果,现具体报道如下。 1 资料与方法 1.1 一般资料:选取我院收治的IgAN患者60例作为研究对象,选取时间范围是2017年6月至2019年9月,随机均分为两组,分别是对照组和研究组,每组各30例。对照组:男性有18例,女性有12例;年龄在20~58岁,平均年龄为(39.43±6.28)岁。研究组:男性有19例,女性有11例;年龄在22~59岁,平均年龄为(40.05±5.89)岁。选取标准:①经过肾活检诊断为IgAN的患者;②24 h尿蛋白定量为0.15~1 g;③估算肾小球滤过率(e GFR)≥60 mL/(min•1.73 m2);④知情本研究且签署过同意书者。排除标准:①病理显示需进行激素或免疫抑制剂治疗;②伴精神障碍;③资料不完整者。对比两组上述基线资料,P值>0.05,差异不具备统计学意义,可进行统计学分析。 1.2 方法:两组患者均给予饮食管理,限制食盐摄入量等治疗。对照组选用厄贝沙坦(生产企业:浙江华海药业股份有限公司,国药准字:H20030016)150 mg每日1次口服。研究组在对照组的常规治疗基础之上加用槐杞黄颗粒(生产企业:启东盖天力药业有限公司,国药准字:B20020074),开水冲服,每次剂量为10 g,每天2次。治疗时间为8周。 1.3 观察指标:对比两组用药前后的血清白蛋白(Alb)、血尿素氮(BUN)、血肌酐(Scr)以及24 h尿蛋白定量变化,对比两组用药后的治疗效果和不良反应的发生率。治疗效果分为完全缓解、基本缓解、部分缓解和无缓解,其中完全缓解指的是患者24 h尿蛋白定量低于200 mg,高倍镜检查无红细胞,肾功能恢复正常;基本缓解指的是者24 h尿蛋白定量降低一半,高倍镜检查出红细胞的数量不超过3个,肾功能基本恢复正常;部分缓解指的是24 h尿蛋白定量至少降低25%,高倍镜检查红细胞的数量不超过5个,肾功能得到明显的改善;除此之外的均为无缓解[6]。(完全缓解人数+基本缓解人数+部分缓解人数)/总人数×100%=总有效率。 1.4 统计学处理:所有数据分析均采用SPSS22.0版本统计软件进行分析。计量资料使用“均数±标准差”的格式表示,采用t检验;计数资料使用百分比的格式表示,采用卡方检验;若检验结果P值低于0.05,则两组数据的差异具有统计学意义。

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