芪地固肾方治疗特发性膜性肾病的临床分析

目的:回顾性分析芪地固肾方治疗特发性膜性肾病(IMN)的临床疗效与安全性。方法:选取2014年1月至2017年6月陕西中医药大学附属医院肾病科门诊及住院IMN患者141例,根据用药方案分为西药组(西药标准疗法)、中西药结合组(芪地固肾方+西药标准疗法)和中药组(芪地固肾方)3组各47例,观察3组患者治疗后临床疗效、复发率及不良反应等。结果:治疗6个月后,中西药结合组和西药组总有效率72.34%、68.09%高于中药组,治疗12个月时3组有效率比较差异无统计学意义,治疗18个月后中药组和中西药结合组总有效率75.76%、78.72%高于西药组。中药组和中西药结合组在治疗12个月和18个月后较西药组在提高中医证候疗效、减少中医证候积分上更具优势。中药组和中西药结合组复发率更低,3组均未出现严重不良反应。结论:芪地固肾方能提高IMN缓解率,在提高中医证候疗效、降低复发率上更具优势,远期疗效可观,值得进一步推广应用。

Clinical Analysis of Qidi Gushen Recipe in The Treatment of Idiopathic Membranous Nephropathy

Obiective:To retrospectively analyze the clinical efficiency and safety of Qidi Gushen Recipe in the treatment of idiopathic membranous nephropathy(IMN).Methods:The research collected 141 patients with IMN,who visited Department of Nephrology in the Affiliated Hospital of Shaanxi University of Traditional Chinese Medicine from January 2014~June 2017,these patients were grouped three parts according to the drug regimen—respectively treated with‘Western medicine standard therapy’,‘Qidi Gushen Recipe+Western medicine standard therapy’and‘Qidi Gushen Recipe’,47 cases of each group.The clinical efficiency,recurrence rate and adverse events were observed.Results:(1)After 6 months of treatment,the effective rate that was 72.34%in the Chinese and Western medicine combined group and 68.09%in the Western medicine group.There was no significant difference after 12 months of treatment.After 18 months,the effective rate that was 78.72%in the Chinese and Western medicine combined group and 75.76%in the Chinese medicine group which was higher than the western.(2)After 12 and 18 months,the Chinese medicine group and the Chinese and Western medicine combined group were more advantageous than the western in TCM syndromes for efficiency.(3)The recurrence rate of the Chinese medicine group and the Chinese and Western medicine combined group was lower.(4)There is no serious adverse events occurred.Conclusion:Qidi Gushen Recipe can improve the remission rate of IMN,and it is more advantageous on improving the curative effect of TCM syndrome and reducing the recurrence rate.The long-term curative effect is considerable and it is worthy of further promotion and application.