摘要
目的 探讨百令胶囊联合常规西药治疗免疫球蛋白A(Immunoglobulin A,IgA)肾病患者的临床疗效及对其炎性因子的影响。方法 选取2019年6月—2021年6月期间自贡市第一人民医院收治的IgA肾病患者94例,按照随机数字表法分为对照组和观察组,每组各47例。对照组采用他克莫司和甲泼尼龙片等常规治疗方案,观察组在对照组基础上加用百令胶囊治疗。均治疗3个月。观察比较两组患者肾功能指标[血浆白蛋白(Albumin,ALB)、血肌酐(Serum creatinine,SCr)、血尿素氮(Blood urea nitrogen,BUN)、24 h尿蛋白(24 hours urine protein,TUP)]和血脂指标[甘油三酯(Triglyceride,TG)、高密度脂蛋白(High-density lipoprotein,HDL-C)、低密度脂蛋白(Low-density lipoprotein,LDL-C)、总胆固醇(Cholesterol total,TC)]水平,炎性因子[干扰素-γ(Interferon γ,IFN-γ)、白细胞介素17(Interleukin 17,IL17)、转化生长因子β1(Transforming growth factor-β,TGF-β1)]水平、外周血细胞免疫水平(T细胞亚群CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+))、临床疗效及不良反应情况。结果 治疗后观察组总有效率93.62%(44/47)明显高于对照组74.47%(35/47),差异有统计学意义(P<0.05)。治疗后两组患者SCr、BUN、24 h TUP和LDL-C、TG、TC水平均较治疗前降低,ALB、GFR和HDL-C水平均较治疗前升高,差异有统计学意义(P<0.05);且观察组BUN、SCr、24 h TUP和LDL-C、TG、TC水平均明显低于对照组,ALB、GFR、HDL-C均明显高于对照组,差异有统计学意义(P<0.05)。治疗后两组患者炎症因子TGF-β1、IL-17、IFN-γ水平均较治疗前降低,差异有统计学意义(P<0.05);观察组炎症因子TGF-β1、IL-17、IFN-γ水平均明显低于对照组,差异有统计学意义(P<0.05)。治疗后两组患者免疫指标CD4^(+),CD4^(+)/CD8^(+)水平均较治疗前升高,CD8^(+)水平均较治疗前降低,差异有统计学意义(P<0.05);且观察组免疫指标CD4^(+),CD4^(+)/CD8^(+)均明显高于对照组,CD8^(+)水平明显低于对照组,差异有统计学意义(P<0.05)。治疗期间,两组患者不良反应发生率比较,差异无统计学意义(χ^(2)=0.617,P=0.432)。结论 在他克莫司和甲泼尼龙片基础上联合百令胶囊治疗IgA肾病有助于改善肾功能、血脂指标,提高临床有效率,降低炎性因子水平,且安全性良好。
Objective To explore the clinical efficacy of Bailing Capsule in combination with conventional Western medicine for the treatment of patients with Immunoglobulin A(IgA)nephropathy and its impact on inflammatory factors.Methods Ninety-four patients diagnosed with IgA nephropathy at Zigong First People′s Hospital from June 2019 to June 2021 were selected and divided into a control group and an observation group by random number table,with 47 in each group.The control group received conventional treatment with tacrolimus and methylprednisolone tablets,while the observation group was given Bailing Capsule on the basis of the control group.Both groups were treated for three months.The study compared renal function indexes(albumin[ALB],serum creatinine[SCr],blood urea nitrogen[BUN],24-hour urine protein[TUP])and blood lipid indexes(triglycerides[TG],high-density lipoprotein cholesterol[HDL-C],low-density lipoprotein cholesterol[LDL-C],total cholesterol[TC]),inflammatory factors(interferon-γ[IFN-γ],interleukin 17[IL-17],transforming growth factor-β1[TGF-β1]),cell immune levels in peripheral blood(T-cell subgroups CD4^(+),CD8^(+),CD4^(+)/CD8^(+)),clinical efficacy,and adverse reactions in the two groups.Results After treatment,the total effective rate in the observation group was 93.62%(44/47),higher than 74.47%(35/47)in the control group(P<0.05).Both groups showed a significant reduction in SCr,BUN,24-h TUP,LDL-C,TG,and TC,and an increase in ALB,GFR,and HDL-C(P<0.05),and the observation group had more reduction or increase than the control group(P<0.05).Additionally,decreased TGF-β1,IL-17,and IFN-γ,as well as elevated immune indexes CD4^(+),CD4^(+)/CD8^(+) and lowered CD8^(+) were observed in both groups after treatment,with more pronounced changes in the observation group(all P<0.05).There was no difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion The addition of Bailing Capsule to conventional treatment with tacrolimus and methylprednisolone tablets for patients with IgA nephropathy can enhance the improvement in renal function and blood lipid,increase the clinical efficacy,and reduce inflammatory factors,with high safety.
作者
袁一孟
郑戈
YUAN Yi-meng;ZHENG Ge(Department of Nephrology,Zigong First People′s Hospital,Zigong Sichuan 643000)
出处
《世界中西医结合杂志》
2024年第4期817-821,共5页
World Journal of Integrated Traditional and Western Medicine
基金
四川省卫生厅科研基金资助项目(120342)。
关键词
百令胶囊
他克莫司
甲泼尼龙片
免疫球蛋白A肾病
炎症因子
Bailing Capsule
Tacrolimus
Methylprednisolone tablets
Immunoglobulin A nephropathy
Inflammatory factors
