楚旭　楚修林

[摘要] 目的 评价活血益肾汤联合西药治疗慢性肾小球肾炎的临床效果。 方法 选择2014年7月～2016年8月在河北省保定市徐水区人民医院接受治疗的86例慢性肾小球肾炎患者作为研究对象，按随机数字表法将其分为两组，对照组43例实施常规治疗，联合组43例接受常规治疗+活血益肾汤治疗。于治疗前、治疗2个月后，将两组中医证候评分及血肌酐（Scr）、尿素氮（BUN）水平进行对比，并评价两组临床疗效。 结果 与治疗前比较，两组治疗后中医证候评分均显著下降，且联合组治疗后中医证候评分显著低于对照组，差异有统计学意义（P < 0.05）。与治疗前比较，两组治疗后Scr、BUN水平均显著下降，且联合组治疗后Scr、BUN水平显著低于对照组，差异有统计学意义（P < 0.05）。联合组临床总有效率显著高于对照组，差异有统计学意义（P < 0.05）。 结论 活血益肾汤联合西药治疗慢性肾小球肾炎患者可显著提高临床疗效，缓解患者临床症状，促进肾功能恢复。

[关键词] 慢性肾小球肾炎；活血益肾汤；中医证候；临床疗效

[中图分类号] R277.523.1；R692.31 [文献标识码] A [文章编号] 1673-7210（2017）09（c）-0153-04

[Abstract] Objective To evaluate the clinical curative effect of Huoxue Yishen Decoction combined with western medicine in the treatment of chronic glomerulonephritis. Methods Eighty-six patients with chronic glomerulonephritis treated in Xushui People's Hospital of Baoding City from July 2014 to August 2016 were selected as research objects， and they were divided into two groups according to random number table method. 43 patients in the control group were treated with conventional therapy， and 43 patients in the combined group received conventional therapy + Huoxue Yishen Decoction. Before treatment and after treatment for 2 months， the TCM syndrome scores and the levels of serum creatinine （Scr） and blood urea nitrogen （BUN） between the two groups were compared， and the therapeutic effects of the two groups were evaluated. Results Compared with before treatment， the TCM syndrome scores in the two groups after treatment were decreased significantly， and the TCM syndrome score of combined group after treatment was significantly lower than that of control group， the differences were statistically significant （P < 0.05）. Compared with before treatment， the levels of Scr and BUN in the two groups after treatment were decreased significantly， and the levels of Scr and BUN in combined group after treatment were significantly lower than those in control group， the differences were statistically significant （P < 0.05）. The total effective rate of combined group was higher than that of control group， the difference was statistically significant （P < 0.05）. Conclusion Huoxue Yishen Decoction combined with western medicine in the treatment of chronic glomerulonephritis can significantly improve the clinical efficacy， relieve the clinical symptoms of patients， and promote the recovery of renal function.

[Key words] Chronic glomerulonephritis； Huoxue Yishen Decoction； TCM syndrome； Clinical efficacy

慢性腎小球肾炎在我国肾脏疾病的发病中占据较大比例，具有病情反复、病程长、起病隐匿等临床特点[1]。该类患者在发病时多伴有不同程度的蛋白尿、水肿等表现，严重者可引发贫血、高血压等，对患者机体损害较大，若治疗不彻底，随着肾功能逐渐恶化而发展至慢性肾衰竭，影响预后[2-3]。故如何改善患者生活质量、抑制病情进展是慢性肾小球肾炎的研究重点[4]。西医疗法以缓解症状为主，注重药效的时效性；而中医学理论则重点强调辨证论治，认为本病发病的内在因素在于正气不足，主张治疗应以调理脏腑、扶正祛邪为原则[5]。本研究通过对照试验的研究方法，从中医证候评分、临床疗效及肾功能指标三方面观察并评价中西……