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从虚、瘀、风湿论治IgA肾病123例临床分析——附69例5型辨治及65例本虚为主辨治的疗效对照
引用本文:王永钧,陈洪宇,周柳沙,朱彩凤. 从虚、瘀、风湿论治IgA肾病123例临床分析——附69例5型辨治及65例本虚为主辨治的疗效对照[J]. 中国中西医结合肾病杂志, 2008, 9(10): 879-882
作者姓名:王永钧  陈洪宇  周柳沙  朱彩凤
作者单位:浙江中医药大学附属广兴医院(杭州市中医院)肾内科,杭州,310007
基金项目:国家中医药管理局科研项目,浙江省中医药管理局科研项目,浙江省杭州市科技局资助项目
摘    要:目的:优化IgA肾病(IgAN)的中医辨治方案,验证从虚、瘀、风湿3型论治IgAN的临床疗效。方法:将123例IgAN患者按虚、瘀、风湿3型辨证论治,并与5型辨治方案及本虚为主辨治方案进行历史性对比。结果:3型辨治组治后中医证候总积分、24h尿蛋白定量及尿红细胞均较治前明显减少(P〈0.01),肾功能稳定。3型辨治组肾病理Lee’sⅠ~Ⅱ级的61例患者,临床缓解率明显优于65例本虚为主组(59.0% vs 20.0%,P〈0.01);甚至前者62例Lee’s≥Ⅲ级的患者,其缓解率亦优于后者Lee’sⅠ~Ⅱ级的患者(45.2% vs 20.0%,P〈0.01)。3型辨治组较之5型辨治组虽然缓解率略高(Lee’sⅠ~Ⅱ:59.0% vs 57.1%;≥Ⅲ级:45.2% vs 29.3%),但无统计学意义(P〉0.05)。结论:虚、瘀、风湿3型辨治方案更符合IgAN的证候谱、病机及其演变规律,具有执简御繁、实用有效的优点。

关 键 词:IgA肾病  中医辨治方案  3型辨治

Study on the therapy based on tonifying deficiency,resolving blood stasis,and dispelling wind-dampness of IgA nephropathy in 123 cases
Affiliation:WANG Yongjun , CHEN Hongyu , Zhou Liusha , et al ( Department of Nephrology, Hangzhou Hospital of TCM , Hangzhou (310007)
Abstract:Objective: To improve and testify the Traditional Chinese Medicine (TCM) treatment according to the syndrome manifestations of Deficiency, Blood Stasis, and Wind - dampness in IgA Nephropathy( IgAN). Methods: Group A ( 123 IgAN patients) were treated with the therapy according to three- types- syndromes analysis (deficiency, blood stasis, and wind- dampness) ;group B (69 patients) that were treated with the therapy according to the former five - types- syndromes analysis(deficiency, blood stasis, wind- dampness, wind - heat, and damp - heat) ;and group C (65 patients) were treated only by Tonifying Deficiency. Results:The scores of TCM syndromes index, proteinuria and hematuria levels in patients of group A decreased significantly, and renal function was stable. Sixty- one patients of this group, whose kidney pathological changes were in level Ⅰ-Ⅱ (Lee' s) ,obtained a better curative effect than the patients in group C( the clinical cure rate were 59.0 % vs 20.0 %, P〈 0.01 ). And other 62 patients in group A, whose kidney pathological changes even reached over level Ⅲ, also got a better clinical cure rate more than those patients whose pathological changes were only in level Ⅰ - Ⅱ in group C (the clinical cure rate were 45.2% vs 20.0% ,P〈0.01). Though the cure rate in group A was also higher than the rate in group B, it was insignificant in statistics. Conclusion: The therapy based on Tonifying Deficiency, Resolving Blood Stasis, and Dispelling Wind - dampness is more suitable to IgAN than other former TCM analysis and treatments. It is good for carrying out and getting efficiency.
Keywords:IgA nephropathy Treatments based on syndrome manifestations in TCM
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