摘要
目的:观察温阳活血利水法治疗特发性膜性肾病(idiopathic membranous nephropathy,IMN)的临床疗效及安全性。方法:78例脾肾阳虚兼瘀水互结型IMN患者随机分为试验组与对照组,每组各39例。对照组给予低盐低脂优质限量蛋白饮食、血管紧张素转化酶抑制剂/血管紧张素Ⅱ受体阻滞剂等西医常规治疗,试验组在对照组治疗基础上给予温阳活血利水法方药。所有受试者均进入48周的临床治疗及观察随访期,入组后每8周定期测定24小时尿蛋白定量、血清白蛋白;每16周检测血清抗磷脂酶A2受体抗体(phospholipase A2 receptor-antibody,PLA2R-Ab)定量、血液分析、尿液分析、肝肾功能、血脂,评价中医证候积分。结果:治疗48周后,试验组中医证候积分明显低于对照组(P<0.001)。试验组在降低24小时尿蛋白(P=0.021)、血清抗PLA2R-Ab(P=0.033)、总胆固醇(P=0.039)、三酰甘油(P=0.046)以及升高血清白蛋白(P=0.017)方面均优于对照组,差异均有统计学意义。两组受试者均未发生严重药物不良反应。结论:温阳活血利水法可有效减轻IMN脾肾阳虚兼瘀水互结证患者的临床不适症状,降低24小时尿蛋白、血脂及血清抗PLA2R-Ab水平,升高血清白蛋白。
Objective:To observe the clinical efficacy and safety of Wenyang Huoxue Lishui method in the treatment of Idiopathic Membranous Nephropathy(IMN).Methods:78 patients with IMN of spleen-kidney yang deficiency and syndrome of stagnation of water and blood were randomly divided into experimental group and control group,39 cases in each group.The control group was given low salt,low fat,high quality limited protein diet,angiotensin converting enzyme inhibitors(ACEI)/angiotensin receptor blocker(ARB) and other conventional western medicine treatment.The experimental group was given Wenyang Huoxue Lishui medcines on the basis of the control group treatment.All subjects entered a 48-week clinical treatment and follow-up period.24-hour urinary protein and serum albumin were measured regularly every 8 weeks after admission.Serum phospholipase A2 receptor-antibody(PLA2 R-Ab) was measured every 16 weeks,including quantitative analysis,blood analysis,urine analysis,liver and kidney function,blood lipid and the scores of TCM syndromes.Results:After 48 weeks of treatment,the scores of TCM syndromes in the experimental group were significantly lower than those in the control group(P<0.001).The experimental group was superior to the control group in reducing 24-hour urinary protein(P=0.021),serum anti-PLA2 R-Ab(P=0.033),total cholesterol(P=0.039),triglyceride(P=0.046) and increasing serum albumin(P=0.017).No serious adverse drug reactions occurred in both groups.Conclusion:The method of Wenyang Huoxue Lishui can effectively alleviate the clinical discomfort symptoms of IMN patients with spleen-kidney yang deficiency and syndrome of stagnation of water and blood,reduce 24-hour urinary protein,blood lipid and serum anti-PLA2 R-Ab levels,and increase serum albumin.
作者
柳强
薛雪
程虹
孟祥燕
袁军
LIU Qiang;XUE Xue;CHENG Hong;MENG Xiangyan;YUAN Jun(Hubei Provincal Hospital of Chinese Medicine,Wuhan Hubei China 430061;Hubei Province Academy of Chinese Medicine,Wuhan Hubei China 430074;The first clinical college,Hubei University of Chinese Medicine,Wuhan Hubei China 430061)
出处
《中医学报》
CAS
2019年第10期2231-2235,共5页
Acta Chinese Medicine
关键词
温阳活血利水法
特发性膜性肾病
脾肾阳虚证
瘀水互结证
中西医结合
Wenyang Huoxue Lishui method
Idiopathic Membranous Nephropathy(IMN)
syndrome of spleen-kidney yang deficiency
syndrome of stagnation of water and blood
integration of traditional and western medicine
