目的 观察滋阴活血方治疗阴虚血瘀型IgA肾病的临床疗效。方法 将60例IgA肾病阴虚血瘀证患者随机分为治疗组（40例）和对照组（20例），对照组患者给予血管紧张素转化酶抑制剂或血管紧张素受体阻滞剂类药物等治疗，治疗组在对照组基础上加服自拟滋阴活血方，两组疗程均为12周。治疗后观察并比较两组IgA临床疗效及中医证候疗效，治疗前后分别检测两组尿红细胞（urine red blood cell，URBC）计数、24 h尿蛋白定量（24-hour urinary protein，24hUP）、血清肌酐（serum creatinine，SCr）水平及估算肾小球滤过率（estimated glomerular filtration rate，eGFR）。结果 治疗组临床总有效率显著高于对照组（72.50％ vs 45.00%，P=0.037），治疗组中医证候疗效显著优于对照组（P=0.015）；治疗组治疗后URBC、24hUP、SCr均较治疗前显著降低（P<0.05），而eGFR显著升高（P＜0.05），治疗组在降低URBC、24hUP、SCr及升高eGFR方面显著优于对照组（P＜0.05，或P＜0.01）。结论 滋阴活血方对阴虚血瘀型IgA肾病具有较好的临床疗效，适用于中轻度蛋白尿、早中期肾功能损害的患者。
Objective To observe the clinical efficacy of yin-nourishing and blood-activating prescription (YNBAP) in IgA nephropathy patients with yin-deficiency and blood-stasis syndrome. Methods Sixty IgA nephropathy patients with yin-deficiency and blood-stasis syndrome were randomly divided into treatment group (n=40) and control group (n=20). The control group was given angiotensin-converting enzyme inhibitor or angiotensin receptor blocker, while the treatment group received self-made YNBAP in addition to the angiotensin-converting enzyme inhibitor or angiotensin receptor blocker. The course of treatment was 12 weeks in both groups. After treatment, the two groups were compared in terms of improvements in IgA nephropathy and traditional Chinese medicine (TCM) syndrome. Before and after treatment, urine red blood cell (URBC) count, 24-hour urinary protein (24hUP) excretion, and serum creatinine (SCr) level were determined, and estimated glomerular filtration rate (eGFR) was calculated. Results Compared with the control group, the treatment group had a significantly higher overall response rate (72.50% vs 45.00%, P=0.037) and a significantly more improvement in TCM syndrome (P=0.015). After treatment, the treatment group showed significant decreases in URBC count, 24hUP excretion, and SCr level (P<0.05) and a significant increase in eGFR (P<0.05); compared with the control group, the treatment group had significantly higher decreases in URBC count, 24hUP excretion, and SCr level and a significantly higher increase in eGFR (P<0.05 or P<0.01). Conclusion YNBAP has good clinical efficacy in IgA nephropathy patients with yin-deficiency and blood-stasis syndrome and is suitable for those with mild or moderate proteinuria and early- or middle-stage renal impairment.