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目的评价活血散(自拟经验方)治疗有高凝状态的原发性肾病综合征患者的疗效和安全性。方法 90例伴高凝表现的原发性肾病综合征患者,随机分为2组,分别接受肾病综合症常规治疗和常规加活血散治疗,持续用药至少8周,治疗前后检测凝血指标三项(PT、APTT、FIB)、血小板、胆固醇、三酰甘油、血浆白蛋白、血肌酐、血尿素氮、24h尿蛋白定量等,比较临床疗效、不良反应发生率以及血凝学指标改善程度。结果活血散治疗组完全缓解率显著高于对照组,而不良反应率、总有效率比较无显著差异,表明活血散可促进病情缓而明显提高疗效,而不增加不良反应发生;两组各自治疗前后比较,各项指标均有显著改善(P<0.01),活血散治疗组治疗后各项指标明显优于对照组治疗后(P<0.01),提示活血散可促进各项血凝学及生化指标的恢复。结论活血散可能通过改善微循环,抑制凝血因子及凝血酶活性,降血酯,有效改善了患者血液高凝状态,促进细胞再生和组织修复,减少蛋白尿,从而促进了病情缓解。
Objective To evaluate the efficacy and safety of Huoxue San (self-experience formula) in the treatment of primary nephrotic syndrome patients with hypercoagulable state. Methods Ninety patients with primary nephrotic syndrome with hypercoagulability were randomly divided into two groups. They were treated with conventional nephrotic syndrome and conventional hemodialysis respectively. The patients were treated for at least 8 weeks, and three indexes of coagulation index PT, APTT, FIB), platelet, cholesterol, triglyceride, serum albumin, serum creatinine, blood urea nitrogen, 24h urinary protein, etc. The clinical efficacy, the incidence of adverse reactions and the improvement of hemagglutination index were compared. Results The complete remission rate of Huoxue Powder treatment group was significantly higher than that of the control group, while the adverse reaction rate and total effective rate showed no significant difference, indicating that Huoxue San can promote the disease slowly and significantly improve the efficacy without increasing adverse reactions; (P <0.01). After treatment, the indexes of Huoxue Powder treatment group were significantly better than those of the control group (P <0.01), suggesting that Huoxue San can promote the development of various hematocrit and biochemical Recovery of indicators. Conclusion Huoxue Powder may improve the microcirculation, inhibit the coagulation factor and thrombin activity, lower blood lipid, improve blood hypercoagulability state, promote cell regeneration and tissue repair, reduce proteinuria, thus contributing to the remission.