摘要
目的:观察益气滋肾活血方治疗难治性膜性肾病(refractory membranous nephropathy,RMN)脾肾两虚、瘀血阻络证临床疗效。方法:采用前瞻性、单组临床试验目标值法选取RMN患者34例,予益气滋肾活血方联合西医基础治疗,连续治疗24周。观察治疗第12周及治疗24周后患者主要疗效指标(总有效率)、次要疗效指标[血白蛋白、抗磷脂酶A2受体(anti-phospholipase A2 receptor,PLA2R)抗体、血肌酐、总胆固醇、甘油三酯、低密度脂蛋白]及安全性指标(血红蛋白)变化情况。结果:治疗第12周时,患者抗PLA2R抗体、血肌酐、甘油三酯、低密度脂蛋白水平均降低,但差异无统计学意义(P>0.05),而总胆固醇水平与治疗前比较差异有统计学意义(P<0.05)。治疗24周后,抗PLA2R抗体、总胆固醇、甘油三酯、低密度脂蛋白水平与治疗前比较差异有统计学意义(P<0.05)。治疗第12周及治疗24周后,血红蛋白较治疗前降低,但差异无统计学意义(P>0.05)。结论:益气滋肾活血方能够提高脾肾两虚、瘀血阻络型RMN患者临床疗效,其可降低抗PLA2R抗体水平,升高血清白蛋白水平,改善血脂代谢,有较好安全性。
Objective:To observe clinical effects of benefiting-Qi,nourishing-kidney and activating-blood prescription in the treatment of refractory membranous nephropathy(RMN)of spleen and kidney deficiency,and blood stasis obstructing collaterals pattern.Methods:A prospective,single-group target-value clinical trial was adopted to choose 34 RMN patients,and they took the prescription orally,and basic therapy of Western medicine,for 24 weeks in a row.To observe the main index of clinical effects(total effective rate),the secondary indexes of clinical effects containing blood albumin,anti-PLA2R antibody,serum creatinine,total cholesterol,triglyceride and low density lipoprotein(LDL),and safety indicator(hemoglobin)after 12 weeks and 24 weeks of the treatment.Results:After 12 weeks of the treatment,hemoglobin,anti-PLA2R antibody,serum creatinine,total cholesterol,triglyceride and LDL reduced,and the difference had no statistical meaning(P>0.05),while the difference had statistical meaning when the levels of total cholesterol were compared with these before treating(P<0.05).After treating for 24 weeks,the difference had statistical meaning in anti-PLA2R antibody,total cholesterol,triglyceride and LDL when compared with before the treatment(P<0.05).After 12 weeks and 24 weeks of the treatment,the levels of hemoglobin were lower than before the treatment,and the difference had no statistical meaning(P>0.05).Conclusion:Benefiting-Qi,nourishing-kidney and activating-blood prescription could improve clinical effects of RMN patients of spleen and kidney deficiency,and blood stasis obstructing collaterals pattern,it could lower the levels of anti-PLA2R antibody,lift the levels of serum albumin and improve blood lipid metabolism with better safety.
作者
申子龙
孙雪艳
赵文景
SHEN Zilong;SUN Xueyan;ZHAO Wenjing(Beijing Hospital of TCM Affiliated to Capital Medical University,Beijing 100010,China)
出处
《西部中医药》
2025年第6期134-137,共4页
Western Journal of Traditional Chinese Medicine
基金
国家重点研发计划项目(2018YFC1704102)
北京市属医院科研培育计划项目(PZ2018012)。
关键词
难治性膜性肾病
单组试验目标值法
抗磷脂酶A2受体抗体
益气滋肾活血方
refractory membranous nephropathy
single-group target-value clinical trial
anti-PLA2R antibody
benefiting-Qi,nourishing-kidney and activating-blood prescription
