益气活血法治疗慢性肾炎60例临床观察

【目的】探讨益气活血法对慢性肾炎的疗效。【方法】选择110例患者,随机分为2组,治疗组60例在对症治疗的基础上给予益气活血中药(基本方为黄芪、党参、茯苓、淮山药、山萸肉、仙灵脾、泽兰、丹参、桃仁、红花)治疗,对照组50例在对症治疗的基础上给予百令胶囊(主要成分为发酵虫草菌粉,有补肺肾、益精气作用)口服治疗,两组疗程均为 8周。观察两组临床总疗效及治疗前后临床症状、免疫功能、血液流变学和尿常规指标的变化情况。【结果】治疗组的总有效率为90．00％,优于对照组的68．00％(P<0．01);在改善症状方面,治疗组也优于对照组(P<0．05)。在尿常规的检测方面,治疗组的24h尿蛋白定量、纤维蛋白原降解产物(FDP)和尿红细胞位相的改善也优于对照组((均P<0．05)。在免疫功能方面,两组的淋巴细胞亚群CD3 、CD4 、CD8 、CD4 与CD8 比值等细胞免疫指标,以及免疫球蛋白IgG、补体C3和 CH50等体液免疫指标均有改善(P<0．05或P<0．01),且治疗组在改善体液免疫指标方面优于对照组(P<0．05)。【结论】益气(包括肺、脾、肾之气)活血中药对慢性肾炎的治疗作用优于单纯补肺肾的百令胶囊,说明益气活血法能切中大多数慢性肾炎的病机,是治疗该病的大法。

Effect of Qi-strengthening and Blood-activating Method for Chronic Nephritis: An Observation of 60 Cases

[Objective] To observe the effect of Qi-strengthening and blood-activating method for chronic nephritis (CN). [Methods] One hundred and ten patients with CN were randomized into 2 groups. Group A (n = 60) was treated with symptomatic treatment combined with Qi-strengthening and blood-activating herbs including Radix Astragali, Radix Codonopsis, Poria, Rhizoma Dioscorease, Fructus Corni, Rhizoma Curculiginis, Herba Lycopi, Radix Salviae Miltiorrhizae, Semen Persicae and Flos Carthami. Group B (n = 50) was treated with symptomatic treatment combined with oral use of Bailing Capsule, the principal ingredient of which is fermented Cordyceps powder with the actions of tonifying lung and kidney and invigorating essence and Qi. The treatment course lasted 8 weeks. Total therapeutic effect, and the changes of symptoms, immune function, hemorrheology indexes and urine routine indexes before and after treatment were observed. [Results] The total therapeutic effect was 90.00% in group A, higher than 68.00% in group B (P < 0.01) . The symptoms were much relieved in group A than that in group B (P < 0.05) . As for the urine routine indexes, the improvement of 24-hour urine protein, fibrin degradation products (FDP) and blood red cells in urine in group A was obvious than that in group B (P < 0.05). Humoral immunity indexes such as CD4 and CD8 percentage and the ratio of CD4 and CD8 in lymphocyte subgroup, as well as cellular immunity indexes of immunoglobulin G (IgG), complements C3 and CH50 levels were improved in the two groups (P < 0.05 or P < 0.01) , the improvement of humoral immunity indexes in group A being obvious than that in group B (P < 0.05) . [Conclusion] The herbs for strengthening Qi of the lung, spleen and kidney and activating blood have a better effect than Bailing Capsule, which has the only action of strengthening lung Qi and kidney Qi. Qi-strengthening and blood-activating method is considered as the principal therapeutic method for chronic nephritis.