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目的:探讨益肾化湿颗粒联合来氟米特治疗无症状尿检异常型IgA肾病(IgAN)的临床效果。方法:选取我院于2014年1月~2015年12月收治的确诊为无症状尿检异常型IgAN患者共84例,随机分为对照组与治疗组,每组各42例,两组患者均给予来氟米特片口服,治疗组患者在此基础上加用口服益肾化湿颗粒,每2个月为一疗程,治疗3个疗程,每个疗程后观察两组患者尿红细胞(RBC)计数、24 h尿蛋白定量的变化,同时比较两组患者的治疗有效率及不良反应发生率。结果:治疗组患者在治疗2个月时疗效显著,尿RBC计数和24 h尿蛋白定量较治疗前均显著下降(P<0.05);随着疗程的延长,至6个月时,治疗组患者的尿RBC计数和24 h尿蛋白定量较治疗前进一步显著下降(P<0.05);与治疗前比较,在治疗2个月时,对照组患者的尿RBC计数和24 h尿蛋白定量差异均无统计学意义(P>0.05),在治疗4个月时才显著下降(P<0.05);与同期对照组比较,在治疗2月、4月和6月时,治疗组患者的尿RBC计数和24 h尿蛋白定量均显著下降(P<0.05),治疗总有效率均显著升高(P<0.05);治疗组患者不良反应发生的总频数比对照组显著降低(7.1%vs 23.8%,P<0.05);所有患者治疗前后肾功能均保持稳定。结论:益肾化湿颗粒联合来氟米特对无症状尿检异常型IgAN有显著疗效,可有效减轻血尿和蛋白尿,稳定肾功能,且不良反应少。
Objective: To investigate the clinical effects of Yishen Huashi granule combined with leflunomide in treating asymptomatic urinary abnormal IgA nephropathy (IgAN). Methods: A total of 84 patients with abnormal IgAN in asymptomatic urinalysis admitted to our hospital from January 2014 to December 2015 were randomly divided into control group and treatment group, 42 cases in each group, and both groups were given Leflunomide tablets orally, the treatment group patients on this basis with oral Yishen Huashi particles, every 2 months for a course of treatment for three courses of treatment after each treatment were observed in two groups of patients with red blood cells (RBC) count , 24 h urine protein quantitative changes, while comparing the two groups of patients treated with the efficiency and adverse reactions. Results: In the treatment group, the curative effect was significant at 2 months of treatment, urinary RBC count and 24 h urinary protein quantitation were significantly lower than those before treatment (P <0.05); with the prolongation of treatment, by 6 months, the patients in the treatment group (P <0.05). Compared with those before treatment, the urinary RBC count and 24 h urinary protein in the control group had no statistical difference between the two groups The statistical significance (P> 0.05) was not significantly decreased at 4 months (P <0.05). Compared with the control group at the same time, urinary RBC count and (P <0.05), and the total effective rate was significantly increased (P <0.05). The total frequency of adverse reactions in the treatment group was significantly lower than that in the control group (7.1% vs 23.8%, P <0.05). The renal function of all patients remained stable before and after treatment. Conclusion: YISHENHUOGU granules combined with leflunomide have a significant effect on the abnormal type IgAN in asymptomatic urine test, which can effectively reduce hematuria and proteinuria and stabilize renal function, with less adverse reactions.