知韦地黄汤治疗肾虚火旺型IgA肾病疗效观察

目的:观察知韦地黄汤治疗肾虚火旺型IgA肾病的临床疗效。方法:选取河南中医药大学第一附属医院2018年9月至2020年9月收治的肾虚火旺型IgA肾病97例,随机分为对照组48例和观察组49例,对照组采用替米沙坦片治疗,观察组在对照组治疗的基础上加用知韦地黄汤治疗,比较两组患者肾功能指标、肾脏纤维化指标等。结果:治疗后两组患者尿红细胞计数、尿蛋白定量及IgA水平均降低,与治疗前比较,差异有统计学意义(P<0.05);组间比较,差异有统计学意义(P<0.05)。治疗后两组患者血肌酐(serum creatinine,Scr)、尿素氮(urea nitrogen,BUN)均明显降低,肾小球滤过率(glomerular filtration rate,GFR)明显升高,与治疗前比较,差异有统计学意义(P<0.05);组间比较,差异有统计学意义(P<0.05)。治疗后两组患者Ⅳ型胶原(typeⅣcollagen,C-Ⅳ)、层黏连蛋白(laminin,LN)、基质金属蛋白酶组织抑制剂-1(tissue inhibitor of matrix metalloproteinase-1,TIMP-1)均明显降低,与治疗前比较,差异有统计学意义(P<0.05);组间比较,差异有统计学意义(P<0.05)。结论:知韦地黄汤能显著减轻IgA患者血尿、蛋白尿症状,改善肾功能。

Observation of Therapeutic Effect of Zhiwei Rehmannia Decoction on IgA Nephropathy with Syndrome of Kidney Deficiency with Effulgent Fire

Objective:To observe the clinical curative effect of Zhiwei Rehmannia Decoction(知韦地黄汤,ZWRD)on IgA nephropathy with syndrome of kidney deficiency with effulgent fire.Methods:A total of 97 patients IgA nephropathy with syndrome of kidney deficiency with effulgent fire treated in The First Affiliated Hospital of Henan University of CM from September 2018 to September 2020 were randomly divided into the control group and the observation group,with 48 and 49 cases respectively.The control group was treated with Telmisartan Tablets,while the observation group was additionally treated with ZWRD on the basis of the treatment of the control group.Then the renal function indexes and renal fibrosis indexes of the two groups were compared.Results:After treatment,the urinary red blood cell,urinary protein and IgA levels in the two groups decreased significantly compared with those before treatment,and all the differences were statistically significant(P<0.05)there were also significant differences between the two groups(P<0.05).After treatment,serum creatinine(SCR)and urea nitrogen(BUN)were significantly decreased,and glomerular filtration rate(EGFR)was significantly increased in the two groups.Compared with before treatment,the differences were statistically significant(P<0.05);the differences between the two groups were also statistically significant(P<0.05).After treatment,the levels of Type IV collagen(C-Ⅳ),laminin(LN)and tissue inhibitor of matrix metalloproteinase-1(TIMP-1)in the two groups were significantly lower than those before treatment,and all the differences were statistically significant(P<0.05);there were also significant differences between the two groups(P<0.05).Conclusion:ZWRD can significantly reduce the symptoms of hematuria and proteinuria in IgA patients and improve renal functions.