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自拟通络祛白汤结合西医常规疗法治疗慢性肾小球肾炎蛋白尿肾络不通证临床研究

Clinical study of Tongluo-Qubai Decoction combined with routine western medicine therapy in the treatment of proteinuria in chronic glomerulonephritis with renal collaterals unsmooth

摘要:

目的:评价自拟通络祛白汤结合西医常规疗法治疗慢性肾小球肾炎(chronic glomerulonephritis, CGN)蛋白尿肾络不通证患者的疗效。方法:将符合入选标准的2016年1月-2018年12月本院124例CGN蛋白尿肾络不通证患者采用随机数字表法分为2组,每组62例。对照组在西医常规治疗基础上服用厄贝沙坦片、双嘧达莫片,观察组在对照组基础上服用自拟通络祛白汤。2组均连续治疗3个月。采用免疫散射比浊法检测24 h尿蛋白定量;采用全自动生化分析仪检测血浆黏度(plasma viscosity, PV)、TG;评价临床疗效及中医证候疗效。结果:观察组临床疗效总有效率为96.5%(60/62)、对照组为83.9%(52/62),2组比较差异有统计学意义( χ2=13.361, P=0.014)。观察组中医证候疗效总有效率为90.3%(56/62)、对照组为79.0%(49/62),2组比较差异有统计学意义( χ2=10.301, P=0.040)。治疗后,观察组24 h尿蛋白定量[(1.00±0.65)g比(1.48±0.71)g, t=4.998],PV[(1.46±0.30)Pa?s比(2.27±0.28)Pa?s, t=6.292]、TG[(2.18±0.68)mmol/L比(2.57±0.73)mmol/L, t=7.025]水平均低于对照组( P<0.01)。 结论:自拟通络祛白汤结合西医常规疗法可有效降低CGN蛋白尿肾络不通证患者的尿蛋白水平,缓解临床症状,提高疗效。

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Objective:To evaluate the clinical effect of Tongluo-Qubai Decoction combined with conventional western medicine on proteinuria of chronic glomerulonephritis (CGN) with renal collaterals unsmooth. Methods:124 patients with CGN proteinuria who met the inclusion criteria from January 2016 to December 2018 were randomly divided into two groups, 62 in each group. The control group took irbesartan tablets and dipyridamole tablets on the basis of conventional western medicine treatment; the observation group took Tongluo-Qubai Decoction on the basis of the control group. Both groups were treated for 3 months. The level of 24 h urinary protein quantification (24 h-Upro) was detected by immunoturbidimetry; plasma viscosity (PV) and TG were detected by automatic biochemical analyzer; to evaluate clinical therapeutic effect and TCM syndrome effect. Results:The total effective rate was 96.5% (60/62) in the observation group and 83.9% (52/62) in the control group. The total effective rate of TCM syndromes in the observation group was 90.3% (56/62) and that of the control group was 79.0% (49/62). The difference between the two groups was statistically significant ( χ2=10.301, P=0.040). After the treatment, 24 h-Upro (1.00 ± 0.65 g vs. 1.48 ± 0.71 g, t=4.998), PV (1.46 ± 0.30 mPa?s vs. 2.27 ± 0.28 mPa?s, t=6.292), TG (2.18 ± 0.68 mmol/L vs. 2.57 ± 0.73 mmol/L, t=7.025) in the observation group were lower than those of the control group ( P<0.01). Conclusions:Tongluo-Qubai Decoction combined with conventional western medicine can effectively improve the clinical symptoms of CGN proteinuria patients.

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