Objective To observe the efficacy and safety of Yiqiyangyinliangxue method combined with telmisar -tan in treating primary IgA nephropathy patients of Qi -Yin deficiency syndrome (QYDS).Methods Randomized and controlled trial was conducted in 61 IgA nephropathy patients of QYDS , who were randomly assigned to two groups treated with traditional Chinese medicine (TCM) combined with Telmisartan (treatment group, n =31) and telmisartan alone (control group, n=30) for 8weeks.The changes of TCM syndrome score , 24-hour urine protein quantity (UP), urina-ry red blood cell (uRBC), serum creatinine (Scr), blood urea nitrogen (BUN), IgA concentration were recorded .Re-sults According to the curative criteria of TCM and Western medicine , the total effective rates were 80.6%and 71.0%, respectively, in treatment group, which were higher than control group (40.0%, P<0.001;63.3%, P>0.05).Com-pared with those before treatment ) , The UP and TCM syndrome scores were significantly improved in both groups after 4-week treatment (P<0.01), which was significantly more prominent in treatment group (P<0.05).The levels of uRBC, Scr and IgA were also significantly reduced in treatment group compared with control group 8 weeks after treatment ( P<0.05).Conclusion Yiqiyangyinliangxue method combined with telmisartan can more effectively reduce UP , uRBC, Scr, IgA and the TCM syndrome scores .%目的：以血管紧张素Ⅱ转化酶抑制剂替米沙坦作为阳性对照，观察益气养阴凉血法联合替米沙坦治疗原发性IgA肾病（气阴两虚型）的临床效果。方法采用随机对照的设计方案，将61例气阴两虚型IgA肾病患者分为对照组30例（采用替米沙坦治疗）和观察组31例（采用中药联合替米沙坦治疗），治疗8周，观察4周和8周时24 h尿蛋白定量、尿红细胞定量、血肌酐（Scr）、血尿素氮（BUN）、血清IgA含量、中医证候积分等疗效指标及肝功能和不良事件等安全性指标。结果观察组中西医总有效率分别为80.6％和71.0％，均高于对照组的40.0％（P＜0.001）和63.3％（P＞0.05）。治疗4周后，观察组患者24 h尿蛋白和中医证候积分与治疗前相比显著降低（P＜0.01， P＜0.001），与同期对照组相比差异有统计学意义（P＜0.05， P＜0.01）；两组尿红细胞计数与本组治疗前相比也显著下降（ P＜0.05）。治疗8周后，除了BUN，观察组尿红细胞计数、Scr、血IgA含量也开始明显低于同期对照组，差异有统计学意义（ P＜0.01， P＜0.001，P＜0.05）。结论益气养阴凉血法联合替米沙坦治疗原发性气阴两虚型IgA肾病疗效显著，与单用替米沙坦相比可更有效减少24 h尿蛋白定量及尿红细胞计数，降低IgA及Scr 水平，改善患者临床症状，从而保护肾功能，延缓IgA肾病的进展，并提高患者生活质量。
展开▼
