肾炎康复片联合氯沙坦钾治疗原发性IgA肾病（气阴两虚证）的临床观察

目的观察肾炎康复片联合氯沙坦钾治疗原发性IgA肾病（气阴两虚证，IgAN）的临床疗效。方法回顾性分析62例IgAN患者，治疗组32例采用肾炎康复片联合氯沙坦钾治疗，对照组30例单纯应用氯沙坦钾治疗，观察时间为8周。分别监测治疗前0周、治疗后4周和8周的24h尿蛋白定量、IgA、Alb、SCr和中医主症积分，继而进行中西医疗效评价。结果对照组治疗4周后尿蛋白定量下降，Alb升高，SCr、IgA水平降低，中医主症积分减少，与治疗前相比无统计学差异（P〉0．05）；治疗8周后尿蛋白定量明显减少，SCr明显下降，Alb明显升高，与治疗前相比有统计学意义（P〈0．05）。治疗组治疗4周后尿蛋白定量明显下降（P〈0．05）。治疗8周后尿蛋白定量显著下降，Alb显著升高，SCr显著下降，与治疗前相比有统计学意义（P〈0．01）；IgA水平明显降低，中医主症积分明显减少，与治疗前相比有统计学差异（P〈0．05）。治疗组治疗后8周和对照组治疗后8周比较，尿蛋白定量显著下降，Alb显著升高，有统计学意义（P〈0．01）。IgA水平明显降低，中医主症积分明显减少，有统计学意义（P〈0．05）。在西医和中医总的疗效方面，治疗组比对照组有更加确切的疗效，经卡方检验有统计学意义（P〈0．05）。结论肾炎康复片联合氯沙坦钾治疗IgAN（气阴两虚证）疗效显著，与单用氯沙坦钾相比可更有效减少24h尿蛋白定量，提升Alb水平，降低IgA及SCr浓度，改善患者临床症状，从而保护肾功能，延缓IgAN的进展。

Therapeutic effect of Shenyankangfu tablet combined with losartan potassium on primary lgA nephropa-thy with qi-yin deficiency syndrome

Objective To observe the clinical effects of Shenyankangfu tablet combined wltn losartan potassium on primary IgA nephropathy with qi-yin deficiency syndrome. Methods Sixty-two patients were retrospectively analyzed and assigned into two groups： treatment group in which 32 cases were treated with Shenyankangfu tablet combined with losartan potassium, and control group in which 30 cases were treated with losartan potassium alone. The therapeutic course for both groups was 8 weeks. The indexes of efficacy, including 24-h urinary protein, Alb, IgA, SCr and qi-yin deficiency syn- drome scores before and 4 and 8 weeks after the treatment were evaluated. Results There was no sig- nificant difference between the two groups in aspects of base line （0 week） clinical figures. In control group, after treatment for 4 weeks, the contents of 24-h urinary protein, IgA and SCr, and the scores of TCM dominant syndromes were decreased,but Alb increased, but showing no significant difference in comparing with the baseline （P〉0. 05）. After treatment for 8 weeks, the contents of 24-h urinary protein and SCr were decreased apparently, and Alb increased apparently, showing significant differ- ence in comparing with the baseline （P〈0. 05）. In treatment group, after treatment for 4 weeks, thecontents of 24-h urinary protein were decreased （P〈0. 05）. At 8th week after treatment, the contents of 24-h urinary protein and SCr were decreased remarkably, and Alb increased remarkably, showing significant difference in comparing with the baseline （P〈0. 01）. The blood serum level of IgA and the scores of TCM dominant syndromes were decreased apparently （P%0. 05）. As compared with control group, at 8th week after treatment, the contents of 24-h urinary protein were decreased remarkably, and homologus Alb increased remarkably （P〈0. 01）. The blood serum level of IgA and the scores of TCM dominant syndromes were decreased apparently （P〈0. 05）. In both western medicine and traditional Chinese medicine,treatment group had more dependable therapeutic effect than control group by chi- square （P〈0. 05）. Conclusions Shenyankangfu tablet combined with losartan potassium can effective- ly decrease the contents of 24-h urinary protein, IgA, SCr, and the scores of TCM dominant syn- dromes, increase Alb, and alleviate the symptoms of patients with primary IgA nephropathy with qi-yin deficiency syndrome, consequently protect the kidney function and delay the progression of IgAN. She- nyankangfu tablet combined with losartan potassium has more effective therapeutic effectiveness on primary IgA nephropathy with qi- yin deficiency syndrome than losartan potassium alone.