大黄虫丸延缓慢性肾小球疾病进展的临床分层研究

目的 :研究大黄虫丸延缓慢性肾小球疾病进展的临床疗效。方法 :以血肌酐 (Scr) <4 4 2 μmol/L的慢性肾小球疾病门诊患者为研究对象 ,分为对照组 (5 0例 )和治疗组 (5 2例 ) ,对照组按目前中西医常规治疗 ,治疗组在常规治疗的基础上加用大黄虫丸 3g/次 ,每日 3次口服。观察经治疗后患者的血、尿生化检查结果 ,根据血压及血脂的正常与否进行分层分析。结果 :治疗组及对照组的近期有效率治疗 3个月时分别为 4 0 4 %和 4 0 % ,治疗6个月时分别为 6 1 5 %和 4 6 %。分层分析显示 ,在目前综合治疗的基础上已能满意地控制血压和血脂的异常 ,血压和血脂对于Scr的疗效变化具有一定的影响 ,但治疗组的变化相对于对照组的变化不明显 ,显示大黄虫丸具有一定的减轻高血压、高血脂对肾功能损害影响的作用。结论 :在目前常规治疗基础上 ,加用大黄虫丸的长期治疗能够进一步降低蛋白尿 ,改善血脂变化和提高血浆白蛋白水平 ,明显延缓肾功能不全进展的速度。

Clinical Investigation on effect of Da Huang Zhe Chong Wan on theprogression of chronic glomerular disease

Objective:To investigate the preventive effect of Da Huang Zhe Chong Wan(DHZCW) on the progression of chronic glomerular disease.Methods:102 out-patients with serum creatinine (Scr) level below 442 μmol/L were divied into 2 groups(control group and treatment group).The control group(n=50) received current routine administration of modern medicine and TCM.The treatment group(n=52) received DHZCW(3g,3/d) in addition to the routine treatment.The data of blood and urine outcomes were analyzed separately according to different levels of blood pressure and blood fat.Results:After 3 months of treatment,the efficiency rates in the treatment and control groups were 40.4% vs 40%.After 6 months,the rates were 61.5% vs 46%.It is known that different level of blood pressure and lipid have effects on Scr.DHZCW could reduce their negative effects on the progression of chronic glomerular disease.Conclusions:DHZCW plus current routine combined treatment was effective in preventing the progression and improving prognosis of chronic glomerular disease by decreasing proteinuria,improving serum protein,regulating the disorder of the fat metabolism and retarding renal fibrosis.