中西医结合综合治疗原发性慢性肾小球肾炎36例临床观察

目的]探讨中西医结合综合治疗原发性慢性肾小球肾炎的临床疗效.方法]采用随机数字表法将72例患者随机分为两组.对照组36例给予西药常规治疗（根据病情需要使用降压药、利尿药、激素等）;治疗组36例在西药常规治疗基础上加服复方雷公藤多甙片、金水宝胶囊、复方三七胶囊等中成药,静脉滴注黄芪注射液,同时给予中药辨证治疗（主要分肺肾气虚、气阴两虚、脾肾阳虚和肝肾阴虚4型）.治疗60d后观察两组临床疗效,并检测两组治疗前后的24h尿蛋白定量,血清总蛋白（TP）、白蛋白（Alb）、胆固醇（TC）、甘油三酯（TG）和免疫球蛋白IgA、IgG的含量变化.结果]治疗组的总有效率为94.44%,对照组为66.67%,两组比较,治疗组的疗效优于对照组（P＜0.05）.治疗后两组的24h尿蛋白定量均有降低（P＜0.01）,且治疗组降低更明显（与对照组比较,P＜0.01）;治疗后治疗组的血清总蛋白、白蛋白和免疫球蛋白IgA、IgG含量均有所升高,血清总胆固醇、甘油三酯含量均有所降低（P＜0.05或P＜0.01）,而对照组的降脂作用和对血清总蛋白、白蛋白和免疫球蛋白IgA、IgG含量的升高作用均不明显（P＞0.05）.结论]中西医结合综合治疗原发性慢性肾小球肾炎疗效优于单纯西药治疗.

Effect of Traditional Chinese and Western Medicine for Primary Chronic Glomerular Nephritis: An Observation of 36 Cases

Objective] To explore the therapeutic effect of traditional Chinese and western medicine for the treatment of primary chronic glomerular nephritis. Methods] Seventy-two cases were randomized into two groups by using random number table. Group A ( n = 36) was treated with compound Glucosidorum Tripterygll Totorum Tablets, Jinshuibao Capsules, Compound Sanqi Capsules for oral use, as well as intravenous injection of Huangqi injection apart from routine western medicines, and at the same time given herbal medicine on the basis of syndrome differentiation. Group B ( n = 36) was treated with routine western medicines such as drugs resisting hypertension, diuretics and hormones when necessarily. After a 60-day treatment, the therapeutic effect in the two groups was observed as well as the changes of 24-hour urinary protein, serum total protein (TP) , albumin (Alb), total cholesterol (TC ) , triglyceride (TG) and immunoglobulins (Ig) A and G. Results] The total effective rate was 94.44% in group A, and 66.67% in group B, the difference being significant (P < 0.05) . After treatment, 24-hour urinary protein decreased in the two groups and the effect of group A was superior to that of group B (P < 0.01). Serum TP, Alb, IgA and IgG increased, and serum TC and TG decreased in group A after treatment (P < 0.05 or P < 0.01). However, the effect on decreasing serum lipid and increasing TP, Alb, IgA and IgG was not obvious in group B (P > 0.05). Conclusion] The effect of traditional Chinese and western medicine for the treatment of primary chronic glomerular nephritis is better than that by using western medicine only.