益气养阴方联合蚓激酶胶囊防治IgA肾病气阴两虚型临床观察(1)
摘 要：目的：观察益气养阴方联合蚓激酶胶囊治疗IgA肾病气阴两虚型的临床疗效。方法：经肾穿刺活检确诊IgA肾病和中医辨证为气阴两虚型患者50例，对照组(n=25例)用益气养阴方，蚓激酶组(n=25例)用益气养阴方联合蚓激酶胶囊，均治疗6个月。观察临床症状和血液流变学、纤维蛋白原、D-二聚体、u-PA、PAI-1，血清肌酐(Scr)，尿红细胞计数、24h尿蛋白量治疗前后的变化情况。结果：两组患者血浆黏度、血小板聚集率、纤维蛋白原、血清肌酐、尿红细胞计数、24h尿蛋白量与治疗前比较均有统计学差异(P<0.05或P<0.01)，且两组间临床症状积分、血液流变学、纤维蛋白原的结果比较有统计学差异(P<0.05)，蚓激酶组总有效率达96%。结论：益气养阴方联合蚓激酶胶囊能显著改善IgA肾病患者血液流变、降低血尿、蛋白尿，缓解临床症状，对IgA肾病有较好地防治作用。
关键词：蚓激酶；IgA肾病；中医；益气养阴方
中图分类号：R692文献标识码：B文章编号：1673-7717(2011)12-2822-03
, 百拇医药
Effect of Yiqi Yangyin Decoction United Lumbrokinase Capsule with
Qi and Yin Deficiency Type of IgA Nephropathy
JIN Zhouhui1，CHEN Yueqing1，PENG Wen2，YAO Weiguo2
(1.Shanghai Liqun Hospital，Putuo Distract，Shanghai 200333，China;
2.Shanghai University of TCM affiliated Putuo Hospital, Department of Nephropathy Shanghai 200062, China)
, 百拇医药
Abstract:Objective:To observe the effect of Yiqi Yangyin Decoction united lumbrokinase capsules on patients with Qi and Yin Deficiency type of IgA nephropathy. Methods: The renal biopsy confirmed 50 cases of IgA nephropathy and traditional Chinese physician identified the type of qi and yin deficiency. They were divided into control group (n= 25 patients), which were treated by Yiqi Yangyin Decoction, and lumbrokinase group (n= 25 patients), which were treated by Yiqi Yangyin Decoction united lumbrokinase capsules. All were treated in 6 months and observed the changes of the clinical symptoms, hemorheology, fibrinogen, D-dimer, u-PA, PAI-1, serum creatinine (Scr), urinary red blood cell count, 24-hour urine protein in pre-therapy and post-therapy. Results: There were significantly different in plasma viscosity, platelet aggregation rate, fibrinogen, Scr, urine red cell count, 24-hour proteinuria compare with those before treatment (P<0.05 or P<0.01), and the results of two groups of clinical symptom score, hemorheology, fibrinogen were statistically significant (P<0.05). Lumbrokinase group total effective rate was 96%. Conclusion: Yiqi Yangyin Decoction united lumbrokinase capsule can improve blood rheology, reduce hematuria and proteinuria, remission clinical symptoms and there are better preventive roles on patients with Qi and Yin Deficiency type of IgA nephropathy.
, 百拇医药
Key words:lumbrokinase, IgA nephropathy, Traditional Chinese Medicine(TCM), Yiqi Yangyin Decoction
IgA肾病(IgA nephropathy, IgAN)是指肾组织经免疫荧光检查有大量IgA或以IgA为主的免疫复合物沉积在肾小球系膜区的一种原发性肾小球疾病，其临床表现及病理类型多变，但绝大多数患者均伴有镜下或肉眼血尿\[1\]。IgAN因其血液流变学异常导致肾内微循环障碍，加重蛋白尿，甚至导致肾小球纤维化\[2\]。目前对于IgAN的治疗尚无满意的方案，因此，积极探寻合理、有效的治疗方案，延缓疾病的进展,改善预后,具有重要的临床意义。近年来，笔者以益气养阴方联合蚓激酶胶囊治疗IgA肾病，临床取得了较好的疗效，现报道如。
1 材料与方法
1.1 一般资料
, http://www.100md.com
收集我院中医肾病专科门诊2009年1月-2010年6月随访经肾穿刺确诊的IgA肾病患者50例。随机分蚓激酶组和对照组各25例。其中蚓激酶组男15例，女10例，年龄18～56岁，平均年龄(36.72±10.91)，病程2个月～1年；对照组男17例，女8例，年龄17～58岁，平均年龄(34.52±11.49)岁，病程1个月～1.5年。所有患者Scr<133mol/L，24h尿蛋白定量<2.0g/24h。两组性别、年龄、病情,经统计学处理无明显组间差异(P>0.05)。
1.1.1 纳入标准 全部病例均经肾穿刺活检并常规作光镜及免疫组化检查,确诊为IgA肾病\[3\]。
中医辨证按照2007年中华中医药学会制定的《IgA肾病的诊断、辨证分型和疗效评定(试行方案)》，气阴两虚型辨证\[4\]。
1.1.2 排除标准 过敏性紫癜、系统性红斑狼疮、肝硬化等所致继发性IgA肾病；有心、肝功能损害或神经病变者；以单纯蛋白尿为临床表现者；孕妇。, 百拇医药(金周慧 陈月琴 彭文 姚卫国)
关键词：蚓激酶；IgA肾病；中医；益气养阴方
中图分类号：R692文献标识码：B文章编号：1673-7717(2011)12-2822-03
, 百拇医药
Effect of Yiqi Yangyin Decoction United Lumbrokinase Capsule with
Qi and Yin Deficiency Type of IgA Nephropathy
JIN Zhouhui1，CHEN Yueqing1，PENG Wen2，YAO Weiguo2
(1.Shanghai Liqun Hospital，Putuo Distract，Shanghai 200333，China;
2.Shanghai University of TCM affiliated Putuo Hospital, Department of Nephropathy Shanghai 200062, China)
, 百拇医药
Abstract:Objective:To observe the effect of Yiqi Yangyin Decoction united lumbrokinase capsules on patients with Qi and Yin Deficiency type of IgA nephropathy. Methods: The renal biopsy confirmed 50 cases of IgA nephropathy and traditional Chinese physician identified the type of qi and yin deficiency. They were divided into control group (n= 25 patients), which were treated by Yiqi Yangyin Decoction, and lumbrokinase group (n= 25 patients), which were treated by Yiqi Yangyin Decoction united lumbrokinase capsules. All were treated in 6 months and observed the changes of the clinical symptoms, hemorheology, fibrinogen, D-dimer, u-PA, PAI-1, serum creatinine (Scr), urinary red blood cell count, 24-hour urine protein in pre-therapy and post-therapy. Results: There were significantly different in plasma viscosity, platelet aggregation rate, fibrinogen, Scr, urine red cell count, 24-hour proteinuria compare with those before treatment (P<0.05 or P<0.01), and the results of two groups of clinical symptom score, hemorheology, fibrinogen were statistically significant (P<0.05). Lumbrokinase group total effective rate was 96%. Conclusion: Yiqi Yangyin Decoction united lumbrokinase capsule can improve blood rheology, reduce hematuria and proteinuria, remission clinical symptoms and there are better preventive roles on patients with Qi and Yin Deficiency type of IgA nephropathy.
, 百拇医药
Key words:lumbrokinase, IgA nephropathy, Traditional Chinese Medicine(TCM), Yiqi Yangyin Decoction
IgA肾病(IgA nephropathy, IgAN)是指肾组织经免疫荧光检查有大量IgA或以IgA为主的免疫复合物沉积在肾小球系膜区的一种原发性肾小球疾病，其临床表现及病理类型多变，但绝大多数患者均伴有镜下或肉眼血尿\[1\]。IgAN因其血液流变学异常导致肾内微循环障碍，加重蛋白尿，甚至导致肾小球纤维化\[2\]。目前对于IgAN的治疗尚无满意的方案，因此，积极探寻合理、有效的治疗方案，延缓疾病的进展,改善预后,具有重要的临床意义。近年来，笔者以益气养阴方联合蚓激酶胶囊治疗IgA肾病，临床取得了较好的疗效，现报道如。
1 材料与方法
1.1 一般资料
, http://www.100md.com
收集我院中医肾病专科门诊2009年1月-2010年6月随访经肾穿刺确诊的IgA肾病患者50例。随机分蚓激酶组和对照组各25例。其中蚓激酶组男15例，女10例，年龄18～56岁，平均年龄(36.72±10.91)，病程2个月～1年；对照组男17例，女8例，年龄17～58岁，平均年龄(34.52±11.49)岁，病程1个月～1.5年。所有患者Scr<133mol/L，24h尿蛋白定量<2.0g/24h。两组性别、年龄、病情,经统计学处理无明显组间差异(P>0.05)。
1.1.1 纳入标准 全部病例均经肾穿刺活检并常规作光镜及免疫组化检查,确诊为IgA肾病\[3\]。
中医辨证按照2007年中华中医药学会制定的《IgA肾病的诊断、辨证分型和疗效评定(试行方案)》，气阴两虚型辨证\[4\]。
1.1.2 排除标准 过敏性紫癜、系统性红斑狼疮、肝硬化等所致继发性IgA肾病；有心、肝功能损害或神经病变者；以单纯蛋白尿为临床表现者；孕妇。, 百拇医药(金周慧 陈月琴 彭文 姚卫国)