【摘要】 目的:评估黄葵胶囊治疗IgA肾病、膜性肾病及糖尿病肾病的疗效差异。方法:基于多中心、前瞻性、单臂、开放式队列研究(NCT02231138)数据进行二次分析，倾向性评分匹配平衡基线差异后，比较IgA肾病、膜性肾病及糖尿病肾病临床疗效。以尿蛋白下降率≥30%定义为治疗有效，尿蛋白下降率<30%定义为无效，分析影响黄葵胶囊降低尿蛋白的危险因素。结果:共纳入964例患者，其中IgA肾病患者745例，膜性肾病患者96例，糖尿病肾病患者123例。IgA肾病、膜性肾病和糖尿病肾病组黄葵胶囊治疗后尿蛋白水平均较基线显著降低，但6个月尿蛋白降低率和有效率3组间无明显差别；基线尿蛋白、体重指数、血肌酐和血清白蛋白是黄葵胶囊降低尿蛋白的独立危险因素，尿蛋白每增加100 mg,尿蛋白降低率增加3.6%;血清白蛋白每增加1 g/L,尿蛋白降低率增加5.9%;而血肌酐每增加1μmmol/L,尿蛋白降低率减少0.7%,体重指数每升高1 kg/m~2,尿蛋白降低率减少6.7%。结论:黄葵胶囊治疗6个月，降低IgA肾病、膜性肾病和糖尿病肾病尿蛋白的疗效无明显差别；合理选择黄葵胶囊为治疗慢性肾脏病患者提供了参考。更多还原

【Abstract】 Objective:To evaluate the difference of curative effect of Huangkui capsule on IgAN(IgA nephropathy), MN(membranous nephropathy) and DN(diabetic nephropathy). Methods:Secondary analysis was conducted based on the data of multicenter, prospective, single-arm and open cohort study(NCT02231138). After the propensity score matched the balanced baseline difference, the clinical efficacy of IgAN, MN and DN was compared. The treatment was defined as effective with the decrease rate of urine protein≥30%, and ineffective with the decrease rate of urine protein <30%. The risk factors affecting the decrease of urine protein in Huangkui capsule were analyzed. Results:A total of 964 patients were included, including 745 patients with IgAN, 96 patients with MN and 123 patients with DN. The urine protein level of IgA, MN and DN groups after treatment with Huangkui Capsule was significantly lower than that of baseline, but there was no significant difference in the urine protein reduction rate and effective rate among the three groups at 6 months. 24 h baseline urinary protein, body mass index(BMI), serum albumin(Alb), and serum creatinine(Scr) were the independent influencing factors of Huangkui capsule in reducing urinary protein. After 6 months of Huangkui capsule treatment, the decrease rate of urine protein increased by 3.6% for every 100 mg increase of 24 h urinary protein and 5.9% for every 1 g/L increase of Alb, while decreased by 0.7% and 6.7% respectively, for every 1 μmmol/L increase of Scr and 1 kg/m~2 increase of BMI. Conclusion:Huangkui capsule has no significant difference in reducing urinary protein of IgAN, MN and DN after 6 months of treatment. The research results provide a reference for the rational selection of Huangkui capsule in the treatment of patients with chronic kidney disease.更多还原