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[目的]观察辨证分型联合西药治疗紫癜性肾炎疗效。[方法]使用前瞻性设计方法,将50例门诊及住院患者强的松,1mg/d·kg,最大剂量不超过80mg,清晨顿服,连续8周后减量,每周减量10%。辨证分型:风热搏结-疏风清热,凉血止血,银翘散(连翘、金银花各30g,薄荷20g,牛蒡子、桔梗各18g,竹叶、荆芥穗各12g,生甘草、淡豆豉各15g);湿瘀互结证-化瘀止血、清热除湿,三仁汤合桃红四物汤(薏苡仁20g,当归、熟地各15g,杏仁12g,白芍、桃仁各10g,川芎、豆蔻仁各8g,红花6g);气阴两虚-滋阴益气,参芪地黄汤(黄芪、熟地各30g,党参、茯苓、山药各15g,甘草、山茱萸、泽泻各10g);肝肾阴虚证-滋补肝肾,知柏地黄丸合二至丸(熟地黄25g,山药、山茱萸各12g,丹皮、泽泻、墨旱莲、女贞子各10g,黄柏、知母各6g);1剂/d,水煎200m L,早晚口服。连续治疗7d为1疗程。观测临床症状、尿常规、不良反应。连续治疗4疗程,判定疗效。[结果]显效29例,有效19例,无效2例,总有效率96.00%。[结论]辨证分型联合西药治疗紫癜性肾炎疗效满意,无严重不良反应,值得推广。
[Objective] To observe the curative effect of syndrome differentiation and western medicine on purpuric nephritis. [Methods] Using prospective design method, 50 outpatients and inpatients prednisone, 1mg / d · kg, the maximum dose of not more than 80mg, Dayton morning suits, after 8 consecutive weeks of reduction, 10% reduction per week. Syndrome Differentiation: wind and heat stroke - Shufeng heat, cooling blood to stop bleeding, Yinqiaosan (forsythia, honeysuckle 30g, mint 20g, burdock, Campanulaceae 18g, bamboo leaves, Nepeta each 12g, raw licorice, (15g Coix Seed, Angelica, Rehmannia each 15g, almonds 12g, peony root, peach 10g, Chuanxiong, peony root, peony root, Cardamom each 8g, safflower 6g); Qi and Yin Deficiency - Yin and Qi, Shenqi Di Huang Tang (Astragalus, Rehmannia each 30g, Codonopsis, Poria, Chinese yam each 15g, licorice, dogwood, Kidney yin deficiency - nourishing the liver and kidney, Zhibai Dihuang Wan combined two to the pill (Rehmannia 25g, yam, dogwood 12g, Dan, Alisma, Eclipta, Ligustrum seed each 10g, Treats, Anemarrhena each 6g) ; 1 agent / d, decoction 200m L, morning and evening oral. Continuous treatment 7d for a course of treatment. Observation of clinical symptoms, urine, adverse reactions. Continuous treatment of 4 courses to determine the efficacy. [Result] 29 cases were markedly effective, 19 cases were effective, 2 cases were ineffective and the total effective rate was 96.00%. [Conclusion] Syndrome differentiation combined with Western medicine in the treatment of purpuric nephritis with satisfactory results, no serious adverse reactions, it is worth promoting.