任 桐 杨洪涛天津中医药大学第一附属医：肾病科，天津300381

    系膜增生性肾炎与特发性膜性肾病的中医证型特点及中医诊治优化方案疗效研究

    任桐杨洪涛

    天津中医药大学第一附属医：肾病科，天津300381

    目的探讨系膜增生性肾炎与特发性膜性肾病的中医证型分布特点，对比中医诊治优化方案对系膜增生性肾炎尧特发性膜性肾病的治疗效果。方法选取2013年1月耀2015年12月于天津中医药大学第一附属医：肾病科就诊的符合慢性肾脏病(CKD)3期且经肾活检确诊的患者，根据病理类型分为系膜增生性肾炎组(肾炎组)48例尧特发性膜性肾病组(肾病组)30例。两组患者均经基础治疗和中医辨证治疗24周，观察治疗前后各项生物学指标及中医证候评分情况。结果治疗后，两组血脂均稳定，肾炎组尿相差镜检红细胞尧尿蛋白定量尧血肌酐(Scr)和肾小球滤过率(eGFR)得到了明显改善(P约0.05)，尿素氮(BUN)尧尿酸(UA)尧白蛋白(ALB)稳定曰肾病组尿相差镜检红细胞尧尿蛋白定量尧肾功能和ALB明显改善(P约0.05)曰证候有不同程度改善。两组均未见明显不良反应。结论CKD3期患者经中医辨证诊治收到满意的疗效，为构建中医个体化诊疗模式提供了临床依据。

    中医曰CKD3期曰系膜增生性肾炎曰膜性肾病

    [Abstract]Objective To investigate the distribution characteristics of TCM syndrome types ofmesangial proliferative glomerulonephritis and membranous nephropathy,and to compare the effect of optimized Chinese medicine treatment for mesangial proliferative glomerulonephritis and membranous nephropathy.M ethods The patients diagnosed with stage 3 of chronic kidney diseases(CKD)by biopsy were chosen from Department of Nephrology of First Teaching Hos—pital of Tianjin University of Traditional Chinese Medicine from January 2013 to December 2015.According to the pathological type,they were divided into two groups:48 cases of mesangial proliferative glomerulonephritis group (nephritis group),30 cases ofmembranous nephropathy group(nephrosis group).Two groups of patientswere treated by basic treatment and TCM treatment for 24 weeks.The changes of biological indicators and TCM symptom scores before and after treatment were observed.Results After treatment,blood lipid were stable in the two groups.In nephritis group,red cells by urine phase contrastmicroscopy,urine protein,serum creatinine(Scr)and glomerular filtration rate (eGFR)had been significantly improved(P约0.05),blood urea nitrogen(BUN),uric acid(UA),albumin(ALB)were sta—ble.In nephrosis group,red cells by urine phase contrastmicroscopy,urine protein,renal function,and ALB had been significantly improved(P约0.05).All patients'symptoms had been improved in varying degrees.No obvious adverse reactions were observed in the two groups.Conclusion Through treatment based on syndrome differentiation, Chinese medicine receives satisfactory effect in treat—ment of CKD3 patients,which provides clinical evidence to construct individualized treatmentof Chinesemedicine mode. ......