摘要
目的探讨血府逐瘀口服液治疗狼疮性肾炎的临床疗效,以及对患者免疫学指标的影响。方法选取河北北方学院附属第二医院2021年10月至2022年10月收治的狼疮性肾炎患者60例,按随机数字表法分为对照组和观察组,各30例。两组患者均予常规药物治疗,观察组患者加用血府逐瘀口服液,两组患者均治疗3个月。结果治疗后,观察组患者的系统性红斑狼疮疾病活动指数(SLEDAI)评分、白细胞计数(WBC)、红细胞沉降率(ESR)、C反应蛋白(CRP)、24 h尿蛋白定量、尿红细胞计数、血肌酐(SCr)、血尿素氮(BUN)、免疫球蛋白A(IgA)、免疫球蛋白G(IgG)水平及CD_(8)^(+)T细胞、滤泡辅助性T细胞(Tfh)百分率均显著低于对照组(P<0.05),补体C3、白蛋白(Alb)、胸腺肽β4、活性E玫瑰花结形成细胞百分数、淋巴细胞计数、CD_(4)^(+)T细胞、CD_(4)^(+)/CD_(8)^(+)均显著高于对照组(P<0.05);两组患者的抗双链DNA抗体阳性发生率均较治疗前显著降低(P<0.05),但组间无显著差异。观察组患者的感染发生率显著低于对照组(3.33%比26.67%,P<0.05),总有效率显著高于对照组(86.67%比63.33%,P<0.05),不良反应发生率与对照组相当(6.67%比13.33%,P>0.05)。Pearson相关性分析结果显示,胸腺肽β4水平与SLEDAI评分、WBC、ESR、CRP、24 h尿蛋白定量、尿红细胞计数、SCr、BUN、IgA、IgG、CD_(8)^(+)T细胞、Tfh细胞百分率均呈负相关(r=-0.729,-0.418,-0.674,-0.785,-0.651,-0.512,-0.684,-0.676,-0.499,-0.513,-0.624,-0.631,P<0.05),与补体C3、Alb、活性E玫瑰花结形成细胞百分数、淋巴细胞计数、CD_(4)^(+)T细胞、CD_(4)^(+)/CD_(8)^(+)均呈正相关(r=0.475,0.452,0.619,0.626,0.633,0.645,P<0.05)。结论血府逐瘀口服液治疗狼疮性肾炎的临床疗效良好,可提升患者机体的免疫水平,改善肾功能,减少感染的发生,促进病情恢复,其作用机制可能与血府逐瘀口服液能促进胸腺肽β4的合成相关。
Objective To investigate the clinical efficacy of Xuefuzhuyu Oral Liquid in the treatment of lupus nephritis,and its effect on immunological indicators.Methods Sixty patients with lupus nephritis admitted to the Second Affiliated Hospital of Hebei North University from October 2021 to October 2022 were selected and divided into the control group and the observation group by the random number table method,with 30 cases in each group.The patients in the two groups were given conventional medication treatment,on this basis,the patients in the observation group were additionally treated with Xuefuzhuyu Oral Liquid.Both groups were treated for three months.Results After treatment,the systemic lupus erythematosus disease activity index(SLEDAI)score,the levels of white blood cell count(WBC),erythrocyte sedimentation rate(ESR),C-reactive protein(CRP),24 h urine protein quantification,urine red blood cell count,blood creatinine(SCr),blood urea nitrogen(BUN),immunoglobulin A(IgA),immunoglobulin G(IgG),and the CD_(8)^(+)T cells and the percentage of T follicular helper cells(Tfh)in the observation group were significantly lower than those in the control group(P<0.05),while the levels of complement C3,albumin(Alb),and thymosinβ4,the percentage of active E rosette-forming cells,lymphocyte count,CD_(4)^(+)T cell and CD_(4)^(+)/CD_(8)^(+)in the observation group were significantly higher than those in the control group(P<0.05).The incidence of anti-double stranded DNA antibody positivity in the two groups was significantly lower than those before treatment(P<0.05),but there was no statistically significant difference between the two groups.The incidence of infection in the observation group was significantly lower than that in the control group(3.33%vs.26.67%,P<0.05),and the total effective rate in the observation group was significantly higher than that in the control group(86.67%vs.63.33%,P<0.05).The total incidence of adverse reactions in the observation group was comparable to that in the control group(6.67%vs.13.33%,P>0.05).Pearson correlation analysis showed that thymosinβ4 level was negatively correlated with SLEDAI score,WBC,ESR,CRP,24 h urine protein quantification,urine red blood cell count,SCr,BUN,IgA,IgG,CD_(8)^(+)T cells,and percentage of Tfh cells(r=-0.729,-0.418,-0.674,-0.785,-0.651,-0.512,-0.684,-0.676,-0.499,-0.513,-0.624,-0.631,P<0.05),while it was positively correlated with complement C3,Alb,percentage of active E rosette-forming cells,lymphocyte count,CD_(4)^(+)T cell,and CD_(4)^(+)/CD_(8)^(+)(r=0.475,0.452,0.619,0.626,0.633,0.645,P<0.05).Conclusion Xuefuzhuyu Oral Liquid in the treatment of patients with lupus nephritis has significant clinical efficacy,it can enhance the patient's immune level,improve renal function,reduce the incidence of infection,and promote disease recovery,and its mechanism may be related to Xuefuzhuyu Oral Liquid promoting the synthesis of thymosinβ4.
作者
徐娜
韩梅
封锦慧
孙垚
任占芬
贾军利
XU Na;HAN Mei;FENG Jinhui;SUN Yao;REN Zhanfen;JIA Junli(The Second Affiliated Hospital of Hebei North University,Zhangjiakou,Hebei,China 075100;The First Affiliated Hospital of Hebei North Uni-versity,Zhangjiakou,Hebei,China 075100)
出处
《中国药业》
CAS
2024年第9期130-135,共6页
China Pharmaceuticals
基金
河北省张家口市重点研发计划项目[2121133D]。
