目的 观察加味健肾方治疗脾肾两虚型特发性膜性肾病(idiopathic membranous nephropathy,IMN)患者的疗效及对磷脂酶A2 受体(phospholipase A2 receptor,PLA2R)滴度的影响.方法 选取 2021 年 1 月至 2022 年 7 月在柳州市中医医院门诊或住院治疗的IMN患者 60 例,采用简单随机抽样法将其分为对照组和治疗组,每组各 30 例.对照组患者单纯给予基础治疗,治疗组患者给予加味健肾方+基础治疗.比较两组患者治疗前后的血尿素氮(blood urea nitrogen,BUN)、血清肌酐(serum creatinine,SCr)、血清白蛋白(albumin,ALB)、24h尿蛋白定量、PLA2R滴度,评价两组患者的治疗效果.结果 治疗组患者的治疗总有效率显著高于对照组(χ2=60.000,P<0.001);治疗后,治疗组患者的水肿、脘腹胀满、倦怠乏力、腰膝酸软评分均显著低于对照组(P<0.05);治疗组患者的 24h尿蛋白定量、PLA2R滴度均显著低于对照组,ALB显著高于对照组(P<0.05).结论 加味健肾方可显著改善脾肾两虚型IMN患者的临床症状,提高血清ALB水平,降低 24h尿蛋白定量及PLA2R滴度.
Objective To observe the effect of Jiawei Jianshen prescription on idiopathic membranous nephropathy(IMN)with spleen-kidney deficiency and its influence on phospholipase A2 receptor(PLA2R)titer.Methods A total of 60 patients with IMN who were hospitalized or outpatients in Liuzhou Traditional Chinese Medical Hospital from January 2021 to July 2022 were selected and divided into control group and treatment group by simple random sampling method,with 30 cases in each group.The control group was given basic treatment alone,and the treatment group was given Jiawei Jianshen prescription + basic treatment.Blood urea nitrogen(BUN),serum creatinine(SCr),serum albumin(ALB),24h urinary protein quantitative and PLA2R titer were compared between two groups before and after treatment.The therapeutic effect of two groups was evaluated.Results The total effective rate of treatment group was significantly higher than that of control group(χ2=60.000,P<0.001).After treatment,the scores of edema,abdominal distension,fatigue,soreness and weakness of waist and knees in treatment group were significantly lower than those in control group(P<0.05).24h urinary protein and PLA2R titer in treatment group were significantly lower than those in control group,and ALB was significantly higher than that in control group(P<0.05).Conclusion Jiawei Jianshen prescription can significantly improve the clinical symptoms of IMN patients with spleen-kidney deficiency,increase serum ALB level,reduce 24h urinary protein quantity and PLA2R titer.
刘朝业;黄荣贵;张威英;谢议凤;陈柱
柳州市中医医院(柳州市壮医医院)肾内科,广西柳州 545001
临床医学
特发性膜性肾病;脾肾两虚证;磷脂酶A2受体
Idiopathic membranous nephropathy;Spleen-kidney deficiency pattern;Phospholipase A2 receptor
《中国现代医生》 2024 (010)
52-55 / 4
广西中医药管理局自筹经费科研课题项目(GZZC2020402);广西中医药大学自然科学研究项目(面上项目)(2020MS054)
10.3969/j.issn.1673-9701.2024.10.013
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