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目的:观察益肾化湿颗粒治疗IgA肾病的疗效。方法:选取东莞康华医院2012年1月至2015年12月收治确诊为IgA肾病的患者(24 h蛋白尿<3.5 g)40例,按临床随机数表法分为两组,氯沙坦钾组(20例)应用氯沙坦钾治疗100 mg/次,1次/d,联合治疗组(20例)在上述治疗的基础上加用益肾化湿颗粒1包治疗,3次/d。治疗时间为12周,观察两组患者临床症状、血肌酐、血钾、24 h尿蛋白定量。结果:治疗12周后比较,两组患者治疗前24 h蛋白尿、血压、血肌酐、血钾比较,差异均无统计学意义(P>0.05)。两组患者治疗后,血压、24 h蛋白尿与治疗前比较,差异具有统计学意义(P<0.05);血肌酐、血钾与治疗前比较,差异均无统计学意义(P>0.05)。治疗后,联合治疗组24 h蛋白尿(1.28±0.46)g较氯沙坦钾组(1.35±0.42)g下降,差异具有统计学意义(P<0.05)。结论:单用氯沙坦钾及联合应用氯沙坦钾和益肾化湿颗粒均能减少尿蛋白,联合应用益肾化湿颗粒疗效更显著。
Objective: To observe the therapeutic effect of Yishen Huashi granule on IgA nephropathy. Methods: Forty patients with IgA nephropathy diagnosed as IgA nephropathy (24 h proteinuria <3.5 g) were selected from Kang Hua Hospital of Dongguan from January 2012 to December 2015. The patients were divided into two groups according to randomized clinical trial: losartan potassium Group (n = 20) were treated with losartan potassium 100 mg once daily. The combination therapy group (n = 20) was treated with Yishen Huatuo Granule (1 package) three times a day. The treatment time was 12 weeks. Clinical symptoms, serum creatinine, serum potassium and urinary protein in 24 hours were observed in two groups. Results: After 12 weeks of treatment, there was no significant difference in proteinuria, blood pressure, serum creatinine and potassium between the two groups before treatment (P> 0.05). After treatment, blood pressure and 24 h proteinuria were significantly different from those before treatment (P <0.05). There was no significant difference in serum creatinine and serum potassium between the two groups before and after treatment (P> 0.05). After treatment, 24 h proteinuria (1.28 ± 0.46) g in the combined treatment group decreased compared with losartan potassium group (1.35 ± 0.42) g, the difference was statistically significant (P <0.05). CONCLUSION: Losartan alone and combination of losartan potassium and Yishen Huashi granule can reduce urinary protein, and Yishen Huashui Granule can be used more effectively.