摘要
目的:探讨环磷酰胺冲击疗法联合参芪地黄汤治疗成人难治性肾病综合征的方法、临床疗效和安全性。方法:选取成人难治性肾病综合征患者140例,以随机数字表法分为观察组与对照组,每组各70例。对照组给予泼尼松、潘生丁和雷公藤多苷等进行基础治疗和对症处理,并行环磷酰胺冲击治疗。观察组在对照组的基础上,辅以参芪地黄汤加减治疗。于治疗前、治疗6个月后观察两组患者的临床表现和肾功能指标,记录治疗过程中的不良反应。结果:两组患者治疗前,尿蛋白定量、血浆白蛋白、血肌酐、内生肌酐清除率、尿素氮水平比较,差异均无统计学意义(P>0.05)。治疗后,除对照组血浆白蛋白外,两组其他肾功能指标均有不同程度的改善,差异具有统计学意义(P<0.05或P<0.01);观察组与对照组尿蛋白定量、血浆白蛋白、血肌酐、内生肌酐清除率、尿素氮水平比较,差异均具有统计学意义(P<0.05)。观察组与对照组的总缓解率分别为87.14%、65.71%,不良反应发生率分别为17.14%和28.57%,差异均具有统计学意义(P<0.05)。结论:环磷酰胺冲击疗法联合参芪地黄汤治疗成人难治性肾病综合征具有较高的临床缓解率,显著改善了肾功能指标,且有效降低了药物的不良反应,具有较高的临床安全性,不失为一种治疗成人难治性肾病综合征的推荐方法。
Objective：To explore the measurement, clinical effect and safety of cyclophosphamide stosstherapy with Shenqi Dihuang Decoction in the treatment of adult patients with refractory nephrotic syndrome （RNS）. Methods： 140 adult patients with RNS were selected and randomly divided into observation group and control group,70 cases per group. Patients in control group were given routine treatment and symptomatic treatment,including prednisone, dipyridamole and tripterygium glycosides, also with cyclophosphamide stosstherapy, and patients in observation group were given Shenqi Dihuang Decoction based on control group. Two groups clinical manifestations, renal function indicators and adverse reactions were observed before and 6 months later after treatment. Results：Before treatment,there were no statistical differences on urinary protein, plasma albumin, serum creatinine, endogenous creatinine clearance rate and urea nitrogen between two groups （ P 〉 0.05 ）. Except for plasma albumin plasma albumin in control group, there were statistical differences on other indicators of two groups before and after treatment （P 〈 0.05 or P 〈 0. 01 ）. There were statistical differences on urinary protein, plasma albumin, serum creatinine, endogenous creatinine clearance rate and urea nitrogen between two groups after treatment （P 〈0.05）. The total remission rate in observation group and control group were 87.14% and 65.71% and the adverse reaction rate were 17.14% and 28.57% and there were statistical differences between two groups （P 〈 0. 05 ）. Conclusion： Cyclophosphamide stosstherapy with Shenqi Dihuang Decoction has higher clinical remission rate on adult patients with RNS, and obviously improves renal function, effectively reduces drugs＇ adverse reactions, and also has higher clinical security. Therefore,it may be one recommended method on treatment of adult RNS.
出处
《中华中医药学刊》
CAS
2014年第2期435-437,共3页
Chinese Archives of Traditional Chinese Medicine
关键词
难治性肾病综合征
成人
环磷酰胺
冲击疗法
参芪地黄汤
refractory nephrotic syndrome （RNS）
adult
cyclophosphamide
stosstherapy
Shenqi Dihuang Decoction
