【摘要】：目的:觀察參芪益陰活血方聯(lián)合雷公藤多甙治療IgA腎病脾腎氣虛、瘀血阻絡(luò)型的臨床療效,探討該方法在治療IgA腎病中的價(jià)值,研究該方法的作用機(jī)理及特點(diǎn),提供更適合該型病人的治療方法。方法:本研究收集IgA腎病中符合中醫(yī)辨證為脾腎氣虛、瘀血阻絡(luò)證的患者60例,隨機(jī)分為兩組,試驗(yàn)組30例,對照組30例,課題期間,對照組有1名患者脫落。對照組按2011年KDIGO臨床實(shí)踐指南給予常規(guī)ACEI/ARB及西醫(yī)對癥治療,試驗(yàn)組給予雷公藤多甙片配合導(dǎo)師經(jīng)驗(yàn)方參芪益陰活血方,療程2個(gè)月。觀察患者臨床癥狀、體征、實(shí)驗(yàn)室檢查指標(biāo)的變化,并對其癥狀及體征進(jìn)行量化評分,判定其療效。結(jié)果:兩組治療均能減少患者的尿蛋白定量及尿RBC計(jì)數(shù)。根據(jù)綜合療效評分:試驗(yàn)組完全緩解率23.33%,顯效率為46.67%,有效率為26.67%,總有效率為90%;對照組完全緩解率10.34%,顯效率為37.93%、有效率為24.14%,總有效率為71.41%,試驗(yàn)組總有效率高于對照組,統(tǒng)計(jì)學(xué)有顯著性差異(P0.05)。試驗(yàn)組與對照組治療前后24小時(shí)尿蛋白定量、尿紅細(xì)胞計(jì)數(shù)、血漿白蛋白比較,P值均小于0.05,具有統(tǒng)計(jì)學(xué)意義。兩組治療后對腎功能無明顯影響。結(jié)論:該方法能夠有效改善IgA腎病脾腎氣虛,瘀血阻絡(luò)型患者的臨床癥狀和體征,明顯減少患者24小時(shí)尿蛋白定量以及尿RBC計(jì)數(shù),提高血漿白蛋白水平,體現(xiàn)了該方法在治療該型IgA腎病中的優(yōu)勢。
[Abstract]:Objective: to observe the clinical effect of Shenqi Yiyin Huoxue recipe combined with Tripterygium wilfordii polyglycosides in the treatment of spleen and kidney qi deficiency and blood stasis blocking collaterals in IgA nephropathy, to explore the value of this method in the treatment of IgA nephropathy, and to study the mechanism and characteristics of this method. To provide a more suitable treatment for this type of patients. Methods: in this study, 60 patients with IgA nephropathy according to TCM syndrome differentiation of spleen and kidney qi deficiency and blood stasis blocking collaterals were randomly divided into two groups: experimental group (n = 30) and control group (n = 30). During the subject period, 1 patient in the control group fell off. The control group was treated with routine ACEI/ARB and western medicine according to the clinical practice guide of KDIGO in 2011, and the experimental group was given Tripterygium wilfordii polyglycoside tablets combined with mentor experience prescription Shenqi Yiyin Huoxue recipe for 2 months. The changes of clinical symptoms, signs and laboratory examination indexes were observed, and the symptoms and signs were quantitatively scored to determine the curative effect. Results: both groups could reduce the quantity of urinary protein and the count of urinary RBC. According to the comprehensive curative effect score, the complete remission rate was 23.33%, the effective rate was 46.67%, the effective rate was 26.67%, and the total effective rate was 90%. The complete remission rate of the control group was 10.34%, the effective rate was 37.93%, the effective rate was 24.14%, and the total effective rate was 77.41%. The total effective rate of the experimental group was significantly higher than that of the control group (P 0.05). Compared with the control group, the 24-hour urinary protein quantity, urine red blood cell count and plasma albumin in the experimental group were less than 0.05, which were statistically significant. There was no significant effect on renal function in the two groups after treatment. Conclusion: this method can effectively improve the clinical symptoms and signs of patients with spleen and kidney qi deficiency and blood stasis blocking collaterals in IgA nephropathy, significantly reduce the 24-hour urinary protein quantity and urine RBC count, and increase the level of plasma albumin. It shows the advantages of this method in the treatment of this type of IgA nephropathy.
【學(xué)位授予單位】：山東中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2016
【分類號】：R277.5

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