摘要
目的观察中药健脾益气清热活血法分别联合环磷酰胺(cyclophos-phamide,CTX)及环孢素A治疗特发性膜性肾病(idiopathic membranous nepropathy,IMN)的疗效及安全性。方法选取我院及合作单位肾内科2015年7月～2017年7月符合入选标准的IMN患者80例,平均分为4组,A1组为中药联合环磷酰胺组、A2组为环磷酰胺组、B1组为中药联合环孢素A组、B2组为环孢素A组。观察A1、A2两组及B1、B2两组患者治疗前后的血清白蛋白、24 h尿蛋白定量、血肌酐等疗效性指标以及肝功能、血常规等安全性指标。结果治疗3个月后,A1组在24 h尿蛋白、血清白蛋白、总胆固醇水平改善情况较治疗前及A2组明显(P<0.05);治疗6个月后,A1组24 h尿蛋白定量、总胆固醇较治疗前明显下降(P<0.01),血清白蛋白水平高于治疗前(P<0.01),较A2组相关指标改善更为显著(P<0.05),A1组6个月总有效率高于A2组(P<0.05);治疗3个月后,B1组在24 h尿蛋白定量、总胆固醇、血清白蛋白改善情况较治疗前及B2组明显(P<0.05);治疗6个月后,B1组上述指标改善情况显著高于B2(P<0.01),B1组6个月总有效率高于B2组(P<0.05)。结论中药健脾益气清热活血法联合免疫抑制剂临床疗效优于单纯使用免疫抑制剂,且安全性良好。
Objective To observe the efficacy and safety of traditional Chinese medicine Jianpi Yiqi Qingre Huoxue decoction combined with cyclophosphine-phamide(CTX)or cyclosporine A in the treatment of idiopathic membranous nephropathy(IMN).Methods 80 patients with IMN who met the inclusion criteria from July 2015 to July 2017 in the Department of Nephrology in our hospital and partner unit were enrolled.The patients were divided into 4 groups.The A1 group was Chinese medicine combined with cyclophosphamide group and the A2 group was cyclophosphamide group.B1 group was Chinese medicine combined with cyclosporine A group,and B2 group was cyclosporine A group.The serum albumin,24h urine protein quantitation,serum creatinine and other therapeutic indicators,as well as liver function,blood routine,CRP,endogenous creatinine clearance and other safety indicators were observed before and after treatment in the group A1,A2,B1 and B2.Results After 3 months of treatment,the improvement of urine protein,serum albumin and total cholesterol in the A1 group was significantly higher than that in the A2 group and that before treatment(P<0.05).After 6 months of treatment,the 24 hour urine protein quantitation and the total cholesterol in the A1 group was significantly lower than that before treatment(P<0.01),and the serum albumin level was higher than that before treatment(P<0.01),which was more significant than that of the A2 group(P<0.05).The 6 months total efficiency in the A1 group was higher than that of A2 group(P<0.05).After 3 months of treatment,the improvement of 24h urine protein,total cholesterol and serum albumin in B1 group was significantly higher than that before treatment and B2 group(P<0.05).And after 6 months of treatment,the improvement of the above indicators in the B1 group was significantly higher than that in the B2 group(P<0.01),and the total effective rate in the 6 months in the B1 group was higher than that in the B2 group(P<0.05).Conclusion The clinical efficacy of traditional Chinese medicine Jianpi Yiqi Qingre Huoxue decoction ccombined with immunosuppressive agent is better than that of immunosuppressive agent alone,and the safety is good.
作者
娄成利
徐业
黄科
赵俊
王力勇
何立群
LOU Chengli;XU Ye;HUANG Ke;ZHAO Jun;WANG Liyong;HE Liqun(Department of Nephrology,Jiaxing Traditional Chinese Medicine Hospital in Zhejiang Province,Jiaxing 314000,China;Department of Nephrology,Shuguang Hospital Affiliated to ShanghaiUniversity of Traditional Chinese Medicine,Shanghai 200021,China)
出处
《中国现代医生》
2019年第9期124-127,130,共5页
China Modern Doctor
基金
浙江省中医药科研基金项目(2016ZB126)
关键词
健脾益气清热活血法
特发性膜性肾病
免疫抑制剂
安全性
Jianpi Yiqi Qingre Huoxue method
Idiopathic membranous nephropathy
Immunosuppressive agent
Safety
