益气活血、通络消癥法治疗pfsgs气虚血瘀证的临床研究

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1、提要目的：在西医治疗基础上，予益气通络饮为主方随症加减，治疗原发性局灶节段性肾小球硬化（pFSGS），观察其临床疗效，探讨中西医结合治疗本病的优势和可行性，为进一步改良及推广配方打下基础。方法：本研究收集pFSGS患者(经肾活检病理诊断为局灶节段性肾小球硬化，排除继发性疾病。)符合中医气虚血瘀型患者60例，并随机分为2组，试验组、对照组各30例。对照组予以控制血压、抗凝、降蛋白尿等西医基础治疗，试验组在西医基础治疗上加用益气通络饮并随症加减，疗程为二个月。观察两组临床症状、体征及实验室检查指标的变化情况。结果：pFSGS

2、气虚血瘀型中医量化评分：试验组总有效率96.67%，对照组总有效率56.66，两组比较有显著统计学意义（p＜0.01）。试验组用药后积分与用药前积分相比具有显著的统计学意义（p＜0.01）。临床缓解率实验组总有效率86.67％，对照组总有效率80.00％，两组比较差异无统计学意义(P>0．05)：两组治疗前后血脂、血浆白蛋白、24h尿蛋白定量比较差异均有明显统计学意义(P<0.01)，且两组组治疗后比较差异均有明显统计学意义(P<0．01)。结论：益气通络饮随证加减配合西医基础治疗pFSGS气虚血瘀型，能显著改善患者身倦

3、乏力、颜面或肢体浮肿、腰痛固定或刺痛等临床表现，降低24h尿蛋白定量，升高血浆白蛋白，纠正脂质代谢紊乱，从而显示出中西医结合治疗本病的优势。关键词益气通络饮；pFSGS；气虚血瘀型；ClinicalStudyonPrimaryFocalSegmentalGlomerulosclerosis(FSGS)ofbloodstasisduetoqideficiencywithmethodsoftonifyingqiandinvigoratingthecirculationofblood,dredgingcollateralsan

4、ddissipatingagglomerateSpecial:InternalMedicineofIntegratedTCMandWesternMedicineStudent:LiuYanTutor:Prof.GuoZhaoanAbstractObjective:Toinvestigatetheeffectofyi-qi-tong-luo-yin（YQTLY）treatingpFSGSofbloodstasisduetoqideficiencyonthebasisofwesternmedicinetreatment.To

5、exploretheadvantagesandfeasibilityofcombiningtraditionalChineseandwesternmedicinetreatingpFSGSandlaythefoundationforfurtherimprovement.Methods:60patientswithpFSGSofbloodstasisduetoqideficiencywererandomlydividedinto2groups,experimentalgroupandcontrolgroup,eachgro

6、upwas30cases.Patientsincontrolgroupweretreatedbyroutinetherapy,whilepatientsinexperimentalgroupweretreatedbycombinationofYQTLYandroutinetherapy.Thecourseoftreatmentis2months.Thecurativeeffectandtherelatedindexesweredeterminedbeforeandaftertreatment,thechangeofpat

7、ients'clinicalsymptomswasrecorded.Results:Thetotaleffectiverateintheexperimentalgroup(96.67%)washigherthanthatinthecontrolgroup(56.66%,p<0.01).Itissignificantlydifferentbetweenthescoresofpro-treatmentandpost-treatment(p<0.01)intheexperimentalgroup.Thereisnosignif

8、icantdifferenceintheremissionofpFSGSbetweenthecontrolgroupandtheexperimentalgroup.Thereweresignificantdifferencebetweentwogroupson24hurineprotein,ALB,TCHandTGa