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      中醫中藥

      槐杞黃顆粒治療IgA腎病的臨床研究

      孟慶陽

      [文章下載]

      【摘要】  【摘要】目的 研究槐杞黃顆粒治療IgA腎病的臨床效果。方法 選取我院2017年6月至2019年9月收治的60例IgAN患者進行研究,隨機分為對照組與研究組,每組各30例患者,對照組選用厄貝沙坦進行常規西醫治療,研究組在對照組的治療基礎之上增加使用槐杞黃顆粒進行治療。兩組均治療8周后,對比兩組用藥前后的Alb、BUN、Scr以及24 h尿蛋白定量的變化,對比兩組用藥后的治療效率和不良反應情況。

      【關鍵字】  槐杞黃顆粒,IgA腎病,治療效果

      中圖分類號:文獻標識碼:文章編號:

      [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腎?。↖gA nephropathy,IgAN)是指腎小球系膜區以IgA沉積或IgA沉積為主,同時還可能存在其他的免疫球蛋白沉積的一種原發性的腎小球疾病[1],是導致我國慢性腎衰竭的主要腎臟疾病之一[2]。該病的病變類型多樣,有系膜增生性腎小球腎炎、毛細血管內增生性腎小球腎炎、新月體腎小球腎炎、局灶節段性腎小球硬化和增生硬化性腎小球腎炎等[3]。臨床癥狀常常表現為鏡下血尿或肉眼血尿,同時可帶有一定程度的蛋白尿,甚至可能發生腎功能嚴重不全或高血壓[4-5]。該病的臨床治療多為服用常規西藥來保護腎臟,減少血尿和蛋白尿。近年來,槐杞黃顆粒治療IgAN的臨床效果明顯,我院在IgAN的常規治療中使用槐杞黃顆粒協同治療,取得了較為理想的效果,現具體報道如下。 1 資料與方法 1.1 一般資料:選取我院收治的IgAN患者60例作為研究對象,選取時間范圍是2017年6月至2019年9月,隨機均分為兩組,分別是對照組和研究組,每組各30例。對照組:男性有18例,女性有12例;年齡在20~58歲,平均年齡為(39.43±6.28)歲。研究組:男性有19例,女性有11例;年齡在22~59歲,平均年齡為(40.05±5.89)歲。選取標準:①經過腎活檢診斷為IgAN的患者;②24 h尿蛋白定量為0.15~1 g;③估算腎小球濾過率(e GFR)≥60 mL/(min?1.73 m2);④知情本研究且簽署過同意書者。排除標準:①病理顯示需進行激素或免疫抑制劑治療;②伴精神障礙;③資料不完整者。對比兩組上述基線資料,P值>0.05,差異不具備統計學意義,可進行統計學分析。 1.2 方法:兩組患者均給予飲食管理,限制食鹽攝入量等治療。對照組選用厄貝沙坦(生產企業:浙江華海藥業股份有限公司,國藥準字:H20030016)150 mg每日1次口服。研究組在對照組的常規治療基礎之上加用槐杞黃顆粒(生產企業:啟東蓋天力藥業有限公司,國藥準字:B20020074),開水沖服,每次劑量為10 g,每天2次。治療時間為8周。 1.3 觀察指標:對比兩組用藥前后的血清白蛋白(Alb)、血尿素氮(BUN)、血肌酐(Scr)以及24 h尿蛋白定量變化,對比兩組用藥后的治療效果和不良反應的發生率。治療效果分為完全緩解、基本緩解、部分緩解和無緩解,其中完全緩解指的是患者24 h尿蛋白定量低于200 mg,高倍鏡檢查無紅細胞,腎功能恢復正常;基本緩解指的是者24 h尿蛋白定量降低一半,高倍鏡檢查出紅細胞的數量不超過3個,腎功能基本恢復正常;部分緩解指的是24 h尿蛋白定量至少降低25%,高倍鏡檢查紅細胞的數量不超過5個,腎功能得到明顯的改善;除此之外的均為無緩解[6]。(完全緩解人數+基本緩解人數+部分緩解人數)/總人數×100%=總有效率。 1.4 統計學處理:所有數據分析均采用SPSS22.0版本統計軟件進行分析。計量資料使用“均數±標準差”的格式表示,采用t檢驗;計數資料使用百分比的格式表示,采用卡方檢驗;若檢驗結果P值低于0.05,則兩組數據的差異具有統計學意義。

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