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目的:观察杞菊地黄丸辅助治疗肝肾阴虚型慢性肾盂肾炎(CPN)的疗效及对复发的影响。方法:将128例肝肾阴虚型CPN患者随机分为对照组和观察组各64例,2组均采用西医常规对症治疗及抗生素序贯抑菌疗法,观察组加服杞菊地黄丸,疗程12周,并随访6月。记录主要症状评分,检测尿N-乙酰-β-氨基葡萄糖苷酶(NAG)、24h SIgA、视黄醇结合蛋白(R BP)、β2-微球蛋白(β2-MG)及微量白蛋白(Alb),测定治疗前后肝肾功能,记录6月随访期内急性发作例数。结果:总有效率观察组100%,高于对照组的84.4%(P<0.05)。治疗后,2组各项症状评分及总分均较治疗前下降(P<0.01);观察组各项评分与总分均低于对照组(P<0.01)。治疗后,2组尿Alb、β2-MG、NAG及R BP均较治疗前下降(P<0.01),尿24h SIgA较治疗前升高(P<0.01);观察组各指标与对照组比较,差异均有显著性意义(P<0.01)。治疗后,2组肌酐(SCr)和尿素氮(BUN)水平均较治疗前下降(P<0.01),观察组SCr和BUN均低于对照组(P<0.01)。复发率对照组54.68%,观察组为26.56%。2组复发率比较,差异有显著性意义(P<0.05)。结论:在常规用药基础上加用杞菊地黄丸治疗,对肝肾阴虚型CPN疗效显著,能减少复发,值得临床使用。
Objective: To observe the curative effect of Qiju Dihuang Pill on adjuvant treatment of chronic pyelonephritis (CPN) with liver-kidney-yin deficiency and its effect on relapse. Methods: 128 cases of CPN patients with liver-kidney yin deficiency were randomly divided into control group and observation group of 64 cases. The two groups were treated with routine western medicine symptomatic treatment and antibiotic sequential antibacterial therapy. The observation group received Qi Ju Di Huang Wan, treatment group 12 Week, and follow-up in June. The main symptom scores were recorded. Urinary N-acetylglucosaminidase (NAG), 24h SIgA, retinol binding protein (R BP), β2-microglobulin (β2-MG) and microalbumin ), Before and after treatment of liver and kidney function, record the number of acute attacks in June follow-up period. Results: The total effective rate in observation group was 100%, which was higher than 84.4% in control group (P <0.05). After treatment, the symptom score and total score of 2 groups decreased compared with those before treatment (P <0.01). The score and total score of observation group were lower than that of control group (P <0.01). After treatment, the urinary Alb, β2-MG, NAG and R BP of the two groups were significantly lower than those before treatment (P <0.01), while the SIgA of 24 h urine was higher than that before treatment (P0.01); Compared with the control group, The difference was significant (P <0.01). After treatment, the levels of creatinine (SCr) and blood urea nitrogen (BUN) were decreased in both groups (P <0.01). The SCr and BUN in the observation group were lower than those in the control group (P <0.01). The recurrence rate was 54.68% in the control group and 26.56% in the observation group. There was significant difference between the two groups (P <0.05). Conclusion: The addition of QJD on the basis of routine medication has significant curative effect on CPN of liver-kidney-yin deficiency type, which can reduce recurrence and is worth clinical use.