【作者】 段学峰；

【导师】 刘建华；

【作者基本信息】 福建中医药大学 ， 中医内科学， 2011， 硕士

【摘要】 目的：观察自拟肾炎汤对IgA肾病(IgA nephropathy, IgAN)气阴两虚(夹湿热)证患者尿沉渣红细胞计数、尿微量白蛋白/肌酐比值、24h尿蛋白定量、血清IgA、补体C3及中医证候积分的影响。材料与方法：选择不同程度蛋白尿、血尿的IgA肾病患者60例,随机分为对照组(30例)和治疗组(30例),对照组给予(贝那普利+西医常规)治疗,治疗组在上述治疗的基础上加服自拟肾炎汤,两组共治疗3个月。观察两组治疗前后尿沉渣红细胞计数、尿微量白蛋白/肌酐比值、24h尿蛋白定量、血清IgA、补体C3及中医证候积分的变化情况。结果：(1)自拟肾炎汤对尿沉渣红细胞计数的影响：治疗组能够明显降低尿沉渣红细胞计数,治疗组疗效优于对照组,具有统计学意义(P<0.05)。(2)自拟肾炎汤对尿微量白蛋白/肌酐比值、24h尿蛋白定量的影响：两组治疗后均能降低尿微量白蛋白/肌酐比值、24h尿蛋白定量,治疗后组间比较差异无统计学意义(P>0.05)。(3)自拟肾炎汤对血清IgA、补体C3的影响：两组治疗前后无明显变化,治疗后组间比较差异无统计学意义(P>0.05)。(4)自拟肾炎汤对中医证候积分的影响：治疗组治疗后少气乏力、口干咽燥、手足心热、腰酸腰痛、浮肿症状改善明显,对照组仅在腰酸腰痛、浮肿症状方面有改善,均具有统计学意义(P<0.05)。治疗后组间比较：治疗组在少气乏力、口干咽燥、手足心热症状改善方面明显优于对照组,具有统计学意义(P<0.05)。(5)在总有效率上,治疗组疗效优于对照组,具有统计学意义(P<0.05)。结论：自拟肾炎汤能够明显降低IgA肾病患者的尿沉渣红细胞计数、尿微量白蛋白/肌酐比值、24h尿蛋白定量,从而减轻肾组织损害,延缓肾脏疾病进展；能够明显改善患者的中医症状,提高患者生活质量。更多还原

【Abstract】 Objective:To observe the clinical effects of the Zini Shenyan decoction on IgA-nephropathy (syndrome deficiency of Qi and Yin) urine erythrocyte count, urinary albumin/creatinine, urine protein of 24 hours, serum immunoglobulin IgA, complement C3 and the clinical symptom score of TCM.Materials and methods:60 IgAN patients with different degree gross hematuria and proteinuria were chosen and divided into contrast group (30 cases) and treatment group (30 cases) at random. Patients of contrast group took the modern medicine conventional therapy and Benazepril. Patients of treatment group took the Zini Shenyan decoction and add modern medicine conventional therapy.Both groups were treated for 3 months. Before and after therapy, test the change of urine erythrocyte count, urinary albumin/creatinine, urine protein of 24 hours, serum immunoglobulin IgA, complement C3 and the clinical symptom score of TCM.Results:(1) Zini Shenyan decoction on the treatment of urine erythrocyte count:The treatment group could remarkably reduce the urine erythrocyte count. It was obviously superior to the contrast group(P<0.05). (2) Zini Shenyan decoction on the treatment of urinary albumin/creatinine and urine protein of 24 hours:They could be significantly decreased in the two groups.There was no significant difference in efficacy(P>0.05).(3)Zini Shenyan decoction on the treatment of serum immunoglobulin IgA and complement C3:It is no significant changes in both groups before and after treatment. There was no significant difference in efficacy(P>0.05). (4) Zini Shenyan decoction on the treatment of the clinical symptom score of TCM:The TCM symptoms had been distinctly improved after treatment in the two groups. There was distinctive difference between the two groups, and the treatment group was better than the control group(P<0.05). (5) The clinical effects of treatment group was obviously superior to those of contrast group(P<0.05).Conclusion:Zini Shenyan decoction can remarkably reduce the urine erythrocyte count and urinary albumin/creatinine and urine protein of 24 hours,so it can reduce the damage of kidney and delay the deterioration of kidney disease.It also can improve clinical symptoms of the patients and improve their quality of life.更多还原