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目的:探讨茜根散加减联合西药对IgA肾病(气阴两虚证)血尿、蛋白尿及中医症候积分的影响。方法:选取2013年4月~2015年6月我院收治的气阴两虚型IgA肾病患者70例为研究对象,采用随机数表法分为观察组和对照组各35例,对照组给予控压、减少尿蛋白、降脂抗凝、保肾等常规西药治疗,观察组在对照组基础上采用茜根散加减治疗,对比两组治疗效果,记录治疗前后中医症候积分,并比较两组尿红细胞计数(RBC)、24小时尿蛋白定量(24UTP)、纤维蛋白原(Fib)、血肌酐(Scr)及尿素氮(BUN)等水平,同时观察不良反应。结果:观察组治疗有效率88.57%明显高于对照组65.71%(P<0.05);观察组治疗后面色无华(1.34±0.36)分、腰脊酸痛(1.15±0.33)分、手足心热(1.34±0.18)分、咽喉肿痛(1.45±0.46)分、舌红(1.24±0.56)分、脉细弱(1.35±0.16)分症状积分较对照组低(P<0.05);治疗后观察组RBC(10.29±1.88)107/L、24UTP(0.55±0.16)g、Fib(3.65±1.11)g/L、Scr(72.32±1.14)μmol/L与对照组比较明显减少(P<0.05),两组BUN比较无显著差异(P>0.05);两组不良反应发生率8.57%、5.71%比较无显著差异(P>0.05)。结论:茜根散加减联合西药可明显减少气阴两虚型IgA肾病患者血尿、蛋白尿及肾损伤,改善其中医症候积分,且不良发应轻,值得在临床推广应用。
Objective: To investigate the effect of Qianqisan combined with Western medicine on hematuria, proteinuria and TCM symptom score of IgA nephropathy (Qi and Yin Deficiency Syndrome). Methods: From April 2013 to June 2015, 70 cases of IgA nephropathy with deficiency of both qi and yin admitted to our hospital were selected as research objects. 35 cases in observation group and control group were randomly divided into control group and control group Pressure, reducing urinary protein, lipid-lowering anticoagulation, kidney and other conventional Western medicine treatment group in the control group on the basis of the use of Qian Gesan addition and subtraction treatment, the two groups were compared, the treatment of TCM symptom scores, and compared two groups RBC, 24UTP, Fib, Scr and BUN were observed. Adverse reactions were also observed. Results: The effective rate of observation group was 88.57%, which was significantly higher than that of control group (65.71%, P <0.05). In the observation group, 1.34 ± 0.36, 1.49 ± 0.33, 1.14 (1.45 ± 0.46) points, red tongue (1.24 ± 0.56) points and pulse weakness (1.35 ± 0.16) points lower than the control group (P <0.05). After treatment, the RBC (P < 10.29 ± 1.88 107 / L, 24UTP 0.55 ± 0.16 g, Fib 3.65 ± 1.11 g / L and Scr 72.32 ± 1.14 μmol / L, respectively, compared with the control group (P <0.05) (P> 0.05). There was no significant difference between the two groups in the incidence of adverse reactions (8.57% vs 5.71%, P> 0.05). Conclusion: Qiangan San combined with western medicine can significantly reduce hematuria, proteinuria and renal injury in patients with Qi-Yin Deficiency-type IgA nephropathy, improve their TCM symptom scores, and the incidence of adverse reactions should be light, worthy of clinical application.