雷公藤多甙片对肾性蛋白尿的作用

The Effect of Nephrotic proteinuria with Tripterygium wilfordii Therapy

目的:探讨雷公藤多甙片在原发性和继发性肾病综合征治疗中的价值及降低肾性蛋白尿的作用。 方法:选择本院肾内科近3年来27例病人,全部经肾活检确定病理类型。口服雷公藤多甙片1.5 mg·kg^(-1)·d^(-1)共4周,观察浮肿消退,尿量增减及消化道反应,定期检查24 h尿蛋白定量、肝肾功能、外周血象及血浆蛋白变化。 结果:27例中12例得到缓解,11例改善,有效共23例,占85％,其中治疗1周后有效6例,2周后有效8例,故2周内尿蛋白明显减少而显效14例。占有效组60.8％,4周后无效4例,占15％,27例中仅有个别轻度消化道症状,少数病人治疗初期ALT轻度上升,继续治疗后恢复,有2例在整个治疗过程中白细胞降至3.0～3.5×10~9/L,但均未影响疗程,所有病人肾功能均正常。结论:雷公藤多甙能有效降低肾性蛋白尿,明显改善原发性及继发性肾脏病的临床症状。

Objective: To investigate the value and the effect of dexreasing proteinuria in the primary and secondary nephropathy Syndrome with Tripterygium Wilfordii therapy. Methods: Selecting 27 patients in the department of kidney in our hospital, all the patients have been confirmde the pathology classification, and given Tab Tripterygium Wilfordii by 1. 5 mg· kg -1· d -1 for 4 weeks, observing term, 24 - hour urine volume and gastrointextinal reaction, examine negularly the 24 - hour proteinuria quantity, liver and renal function, peripheral bioob and serum albumin. RestultS: 12 of 27 patients were recovery, 11 patients were improved, totally 85 % , 6 patients effective after 1 -week therapy, 8 patients effective after 2 - week therapy, therefore, 14 patients (60. 8% in effective group) have significantly proteinuria decrease. 4 patients(15% ) ineffective after 4 - week therapy, a small number of patients in all the 27 patients had moderate gastrointestinal disorders, a eatfraction of patients had modest ALT increase in early therapy, all recoved after continuance treatment, The WBC decteased to 3. 0 - 3. 5 × 109 /L, 2 patients in the whole therapy, however, the therapy continue was not affected. All patients had normal renal faction. Conclusion: Tripterygium Wilfordii can decrease proteinuria effectively, improve the symptom of primary and secondary nephropathy Syndrome.