摘要
目的:分析活血通络方联合免疫抑制方案治疗特发性膜性肾病的效果。方法:选择2022年1月~2024年10月96例特发性膜性肾病患者,采用前瞻性分析法进行研究,应用随机数字表法进行分组,分为西医组(单纯采取免疫抑制方案治疗)及中西医组(采取活血通络方联合免疫抑制方案治疗),各48例。两组均治疗6 m后,比较其临床疗效,治疗前后中医证候积分、基础实验室指标及血脂水平变化。结果:中西医组总有效率高于西医组(χ^(2)=5.897,P=0.015);治疗后,2组主症、次症相关中医证候积分均降低,中西医组低于西医组(t=7.613,11.086;P均<0.001);治疗后,2组白蛋白升高,中西医组高于西医组(t=5.934,P<0.001),24 h尿蛋白定量(24-Hour urinary protein quantity,24 h-UTP)、血尿酸、血肌酐、尿素氮均降低,中西医组低于西医组(t=7.940,2.943,2.590,7.482;P均<0.001);治疗后,2组总胆固醇(Total cholesterol,TC)及甘油三酯(Triglyceride,TG)均降低,中西医组低于西医组(t=4.834,5.989;P均<0.001)。结论:活血通络方联合免疫抑制方案治疗特发性膜性肾病疗效更优,可减轻患者症状,促进白蛋白升高,24h-UTP降低,改善患者肾功能水平,且可辅助降低血脂水平。
Objective:To analyze the efficacy of the combination of Huoxue Tongluo Formula and immunosuppressive regimen in the treatment of idiopathic membranous nephropathy.Methods:A prospective analysis was conducted on 96 patients with idiopathic membranous nephropathy from January 2022 to October 2024.The patients were randomly divided into two groups using a random number table:a Western medicine group(treated with immunosuppressive therapy alone)and a Chinese Western medicine group(treated with a combination of blood activating and meridian unblocking formula and immunosuppressive therapy),with 48 cases in each group.After 6 months of treatment,the clinical efficacy,TCM syndrome scores,basic laboratory indicators,and changes in blood lipid levels were compared between the two groups before and after treatment.Results:The total effective rate of the traditional Chinese and Western medicine group was higher than that of the Western medicine group(χ^(2)=5.897,P=0.015);After treatment,the scores of TCM syndromes related to the main and secondary symptoms in both groups decreased,and the scores in the TCM and Western medicine groups were lower than those in the Western medicine group(t=7.613,11.086;P<0.001 for both groups);After treatment,albumin levels increased in both groups,with the Western medicine group being higher than the Western medicine group(t=5.934;P<0.001).24-hour urinary protein quantification(24-hour UTP),blood uric acid,blood creatinine,and urea nitrogen all decreased,with the Western medicine group being lower than the Western medicine group(t=7.940,2.943,2.590,7.482 P<0.001);After treatment,both groups showed a decrease in total cholesterol(TC)and triglycerides(TG),with the Western medicine group being lower than the Western medicine group(t=4.834,5.989;P<0.001 for both groups).Conclusion:The combination of Huoxue Tongluo Formula and immunosuppressive regimen has a better therapeutic effect on idiopathic membranous nephropathy,which can alleviate patient symptoms,promote elevated albumin,reduce 24-hour UTP,improve renal function levels,and assist in reducing blood lipid levels.
作者
赵秋扬
田帅
张磊
王红军
Zhao Qiu-yang;Tian Shuai;Zhang Lei;Wang Hong-jun(Department of Nephrology,Zhumadian Hospital of Traditional Chinese medicine,Zhumadian 463000,Henan,China)
关键词
活血通络方
免疫抑制
特发性膜性肾病
肾功能
血脂
白蛋白
Huoxue Tongluo Formula
Immune suppression
Idiopathic membranous nephropathy
Renal function
Blood lipids
albumin
