益气养阴方联合蚓激酶胶囊防治IgA肾病气阴两虚型临床观察.docVIP

益气养阴方联合蚓激酶胶囊防治IgA肾病气阴两虚型临床观察摘 要：目的：观察益气养阴方联合蚓激酶胶囊治疗IgA肾病气阴两虚型的临床疗效。方法：经肾穿刺活检确诊IgA肾病和中医辨证为气阴两虚型患者50例，对照组（n=25例）用益气养阴方，蚓激酶组（n=25例）用益气养阴方联合蚓激酶胶囊，均治疗6个月。观察临床症状和血液流变学、纤维蛋白原、D-二聚体、u-PA、PAI-1，血清肌酐(Scr)，尿红细胞计数、24h尿蛋白量治疗前后的变化情况。结果：两组患者血浆黏度、血小板聚集率、纤维蛋白原、血清肌酐、尿红细胞计数、24h尿蛋白量与治疗前比较均有统计学差异（P＜0.05或P＜0.01），且两组间临床症状积分、血液流变学、纤维蛋白原的结果比较有统计学差异（P＜0.05），蚓激酶组总有效率达96%。结论：益气养阴方联合蚓激酶胶囊能显著改善IgA肾病患者血液流变、降低血尿、蛋白尿，缓解临床症状，对IgA肾病有较好地防治作用。 关键词：蚓激酶；IgA肾病；中医；益气养阴方 中图分类号：R692文献标识码：B文章编号：1673-7717(2011)12-2822-03 Effect of Yiqi Yangyin Decoction United Lumbrokinase Capsule with Qi and Yin Deficiency Type of IgA Nephropathy JIN Zhouhui1，CHEN Yueqing1，PENG Wen2，YAO Weiguo2 (1.Shanghai Liqun Hospital，Putuo Distract，Shanghai 200333，China; 2.Shanghai University of TCM affiliated Putuo Hospital, Department of Nephropathy Shanghai 200062, China) Abstract:Objective:To observe the effect of Yiqi Yangyin Decoction united lumbrokinase capsules on patients with Qi and Yin Deficiency type of IgA nephropathy. Methods: The renal biopsy confirmed 50 cases of IgA nephropathy and traditional Chinese physician identified the type of qi and yin deficiency. They were divided into control group (n= 25 patients), which were treated by Yiqi Yangyin Decoction, and lumbrokinase group (n= 25 patients), which were treated by Yiqi Yangyin Decoction united lumbrokinase capsules. All were treated in 6 months and observed the changes of the clinical symptoms, hemorheology, fibrinogen, D-dimer, u-PA, PAI-1, serum creatinine (Scr), urinary red blood cell count, 24-hour urine protein in pre-therapy and post-therapy. Results: There were significantly different in plasma viscosity, platelet aggregation rate, fibrinogen, Scr, urine red cell count, 24-hour proteinuria compare with those before treatment (P0.05)。 1.1.1 纳入标准 全部病例均经肾穿刺活检并常规作光镜及免疫组化检查,确诊为IgA肾病\[3\]。 中医辨证按照2007年中华中医药学会制定的《IgA肾病的诊断、辨证分型和疗效评定(试行方案)》，气阴两虚型辨证\[4\]。 1.1.2 排除标准 过敏性紫癜、系统性红斑狼疮、肝硬化等所致继发性IgA肾病；有心、肝功能损害或神经病变者；以单纯蛋白尿为临床表现者；孕妇。 1.2 分组