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[目的]观察小蓟饮子与六味地黄汤联合西药治疗急性肾小球肾炎疗效。[方法]使用随机平行对照方法,将100例门诊患者按随机数字表法分为两组。对照组50例卧床休息,低盐饮食,限制水和蛋白质的摄入;感染者控制感染,青霉素10~20万IU?kg-1+0.9%氯化钠100mL,1次/d,静滴;过敏者可选用阿奇霉素500mg+0.9%氯化钠100mL,1次/d,静滴;少尿水肿者双氢克尿噻25mg/次,1次/d,口服;水肿严重时速尿1mg?kg-1,静滴/肌注;血压高者利血平降压,首剂可按0.07mg?kg-1口服/肌注,首剂后0.02~0.03mg?kg-1,2次/d,口服。治疗组50例小蓟饮子与六味地黄汤(小蓟20g,生地15g,滑石、炒蒲黄、藕节各10g,淡竹叶、当归、栀子、熟地各15g,山药20g,山茱萸、丹皮各15g,泽泻10g,茯苓15g),水煎200mL,1剂/次,早晚温服;西药治疗同对照组。连续治疗7d为1疗程。观测临床症状、1h尿红细胞排泄率、24h尿蛋白定量、血尿素氮(BUN)和血肌酐(SCr)、不良反应。连续治疗2疗程,判定疗效。[结果]治疗组治愈29例,好转18例,未愈3例,恶化0例,总有效率94.00%。对照组治愈21例,好转20例,未愈9例,恶化0例,总有效率82.00%。治疗组疗效优于对照组(P<0.05)。两组症状、体征积分均有改善(P<0.05),治疗组优于对照组(P<0.05)。两组生化指标均有改善(P<0.05),治疗组优于对照组(P<0.05)。[结论]小蓟饮子与六味地黄汤联合西药治疗急性肾小球肾炎疗效显著,值得推广。
[Objective] To observe the therapeutic effect of Jixi Yinzi and Liuwei Dihuang Decoction combined with western medicine on acute glomerulonephritis. [Methods] Using randomized parallel method, 100 outpatients were divided into two groups according to random number table. Control group, 50 cases of bed rest, low-salt diet, limiting water and protein intake; Infection control infection, penicillin 10 200 000 IU? Kg? 1 0.9% sodium chloride 100mL 1 times / Patients with allergies may choose azithromycin 500mg + 0.9% sodium chloride 100mL, 1 times / d, intravenous drip; oliguric edema were hydrochlorothiazide 25mg / times, 1 time / d, oral; severe edema furosemide 1mg? Kg- 1, intravenous infusion / intramuscular injection; high blood pressure and reserpine hypotensive, the first dose can be 0.07mg? Kg-1 oral / intramuscular injection, the first dose of 0.02 ~ 0.03mg? Kg-1,2 times / d, . The treatment group of 50 cases of small thistle drink and Liu Wei Di Huang Tang (Artichoke 20g, habitat 15g, talc, fried Puhuang, lotus root each 10g, light bamboo leaves, Angelica, gardenia, Rehmannia each 15g, yam 20g, dogwood, Each 15g, Alisma 10g, Poria 15g), decoction 200mL, 1 / time, morning and evening warm clothes; western medicine treatment with the control group. Continuous treatment 7d for a course of treatment. Clinical symptoms were observed, urinary excretion rate of urinary 1h, urinary protein excretion of 24h, blood urea nitrogen (BUN) and serum creatinine (SCr), adverse reaction. Continuous treatment of 2 courses to determine the efficacy. [Results] In the treatment group, 29 cases were cured, 18 cases improved, 3 cases were unhealed, 0 cases deteriorated, and the total effective rate was 94.00%. In the control group, 21 cases were cured, 20 cases improved, 9 cases unhealed, 0 case worse, and the total effective rate was 82.00%. The treatment group was better than the control group (P <0.05). Symptoms and signs improved in both groups (P <0.05), and the treatment group was better than the control group (P <0.05). The two groups of biochemical indicators were improved (P <0.05), the treatment group than the control group (P <0.05). [Conclusion] Si Ji Yin Zi and Liu Wei Di Huang Decoction combined with Western medicine in the treatment of acute glomerulonephritis significant effect, it is worth promoting.