中西医结合治疗脾肾气虚证型慢性肾小球肾炎研究

目的观察中西医联合治疗慢性肾小球肾炎脾肾气虚证的疗效。方法将慢性肾小球肾炎脾肾气虚证型患者随机分为治疗组(23例)与对照组(21例),两组均给予西医常规治疗,治疗组加用小剂量雷公藤多甙结合中药方剂治疗。以4周为1个疗程,2个疗程后比较两组疗效。检测患者治疗前后血肌酐、血尿素氮、24 h尿蛋白定量、尿红细胞计数、血清总蛋白和白蛋白变化情况。结果①治疗组疗效总有效率和中医证侯总有效率分别为86.96%、91.30%,显著高于对照组57.14%的疗效总有效率和71.43%的中医证侯总有效率(P<0.01)。②治疗后,CNG患者血肌酐、血尿素氮、24 h尿蛋白定量、尿红细胞计数均明显下降,其中以治疗组降低最为明显,与对照组间差异有统计学意义(P<0.01或0.05)。③相较于治疗前,治疗组患者血清总蛋白和白蛋白水平均显著增加,且改善程度优于对照组(P<0.01或0.05)。结论中西药联合治疗能明显缓解慢性肾小球肾炎脾肾气虚证患者的临床症状,改善肾功能,疗效优于单纯西医治疗。

A Clinical Study on Treatment of Chronic Glomerular Nephritis by Integrated Traditional and Western Medicine

Objective To study the effect of traditional Chinese medicine and western medicine on the deficiency syndromes of spleen and kidney in patients with chronic glomerular nephritis(CGN).Methods Forty four patients with CGN and c were divided into two groups,the control group(21 cases) was given regular western medicine,and the treatment group(23 cases) was added with low dose of Tripterygium Wilfordii Polyglycoside(TWP) and Chinese medicine.Before and after treatment,the serum creatinine(Scr),blood uria nitrogen(BUN),24h urinary protein quantitative(Upro),urine RBC count,serum total protein(TP) and albumin(Alb) were tested.Results ①The total efficiency and the clinical syndrome relief rate were 86.96% and 91.30% in the treatment group,which were significantly higher than 57.14% and 71.43% in the control group(P<0.01).②After the treatment,the Scr,BUN,Upro and Urine RBC count all decreased in patients with CGN,especially in treatment group,showing significant difference between the two groups(P<0.01 or 0.05).③The treatment group has an improvement in serum total protein(TP) and albumin as compared with that of before treatment,and there was a better improvement than the control group(P<0.01 or 0.05).Conclusion The treatment of CGN and deficiency syndromes of spleen and kidney with traditional Chinese medicine and western medicine can obviously relieve the symptom,improve kidney functions,and has a more obvious effect than western medicine alone.