不同时间点观察肝肾同治IgA肾病的临床疗效

目的:多点观察通过补益肝肾中西医结合优化治疗Ig A肾病的临床疗效。方法:选取2016年6月至2018年6月多中心收集Ig A肾病患者80例作为研究对象,按照随机对照原则分为观察组和对照组,每组40例,观察组采用中药颗粒剂+氯沙坦的治疗方案,对照组采用中药模拟剂+氯沙坦的治疗方案,每8周测定患者24 h尿蛋白定量、尿微量白蛋白/肌酐(MA/Cr)、血肌酐(Scr)、肾小球滤过率(e GFR)并做疗效评估,共观察24周。结果:观察组总有效率为80. 0%,对照组为35. 0%,2组患者比较差异有统计学意义(P 0. 05)。观察组24 h尿蛋白定量、MA/Cr、Scr随治疗时间延长逐渐下降,与对照组比较差异有统计学意义(P 0. 05); e GFR随治疗时间延长逐渐上升,与对照组比较差异有统计学意义(P 0. 05)。结论:中西医联合优化治疗方案组在降低蛋白尿、保护肾功能方面明显优于单纯西药观察组,并随时间延长优势进一步显现。

Observing Clinical Effects of Treatment of Liver and kidney in Treatment of IgA Nephropathy at Different Time Points

To multi-point observe the clinical effect of IgA nephropathy in the optimized treatment by tonifying and replenishing liver and kidney integration traditional Chinese and western medicine.Methods:A total of 80 patients with IgA nephropathy admitted to mutil-centers from June 2016 to June 2018 were selected as subjects.According to the principle of randomized control,they were divided into an observation group and a control group,with 40 cases in each group.The observation group was treated by traditional Chinese medicine granules+Losartan,and the control group was treated by traditional Chinese medicine mimicking agent+Losartan.The 24 hours urinary protein quantitation,urinary albumin/creatinine(MA/Cr),serum creatinine(Scr)and glomerular filtration rate(eGFR)were measured every 8 weeks and perform a therapeutic evaluation,for a total of 24 weeks of observation.Results:The total effective rate was 80.0% in the observation group and 35.0% in the control group,and the difference between the 2 groups was statistically significant(P<0.05).The 24-hour urine protein quantitation,MA/Cr and Scr in the observation group were decreased gradually with extension of the treatment time,which was statistically different compared with the control group(P<0.05).eGFR in the observation group was gradually increased with the extension of treatment time,which was statistically significant compared with the control group(P<0.05).Conclusion:The integration traditional Chinese and western medicine optimized treatment group is significantly better than the western medicine alone observation group in reducing proteinuria and protecting renal function,and the advantages are further revealed with extension over time.