摘要
目的 :评估中西医结合治疗狼疮性肾炎 (LN)的疗效和副作用 ,旨在进一步寻求对狼疮性肾炎副作用小、完全缓解率高、复发率低的治疗方案。方法 :4 6例LN患者随机分为两组 ,单纯激素组 (2 0例 ) :单纯选用强的松标准疗程 ;联合治疗组 (2 6例 ) :环磷酰胺 (CTX)冲击 +激素标准疗程 +中药治疗。根据中医对LN的分型进行辨证施治。中药治疗对CTX冲击与大量激素治疗所产生的不良反应针对性用药。同时对肾衰竭、血液高凝状态给予血透、抗凝对症治疗。结果 :单纯激素组完全缓解率为 5 5 .5 5 % ,总有效率为 80 %。联合治疗组完全缓解率为 73.0 7% ,总有效率为 92 %。 5年复发率比较 ,单纯激素组为 2 5 % ,联合治疗组为 15 .3%。结论 :从完全缓解率、总有效率、复发率及不良反应几方面分析研究表明 ,联合方案治疗LN明显优于单用激素。加用中药可保证CTX冲击与激素等主要用药的顺利实施 ,减少不良反应 ,提高缓解率 ,降低复发率。
Objective:To investigate the effects of integrated Chinese traditional medicine and western medicine regimen on lupus nephritis.Methods:46 cases of LN were included in this study. The treatment programme is composed of pulse therapy of cyclophosphamide(CTX) plus standard prednisone regimen and Chinese Traditional Medicine(CTM).26 cases were included in this combined therapy group,while 20 cases treated with simple standard prednisone regimen were taken as control group.Chinese Traditional Medicine was focused on the side effect of CTX and prednisone, given dialectically according to the classification of LN with the theory of CTM. Hemodialysis was performed for renal failure and anti-coagulation was for high coagulative state. Results:For the simple prednisone group,the complete remission rate was 55.55%,the total efficacy rate was 80%,the relapse rate in 5 years was 25%.For the combined therapy group,the complete remission rate was73.07%, the total efficacy rate was 92%,the relapse rate in 5 years was 15.3% .There were more side effect in simple prednisone group than that in combined therapy group.Conclusion:The combined therapy programme for LN was remarkablely more effective than the simple prednisone treatment in respect to complete remission rate ,total efficacy rate,relapse rate and side effect. CTM can guarantee the tolerance to pulse therapy of CTX and prednisone.This combined therapy programe for LN seems to be safe and effective with high complete remisson rate , low replase rate and little side effect.
出处
《中国中西医结合肾病杂志》
2003年第6期336-338,共3页
Chinese Journal of Integrated Traditional and Western Nephrology
