抗氧化中药治疗狼疮性肾炎25例临床观察

Clinical Observation on 25 Cases of Lupus Nephritis Treated by Chinese Medicines with the Function of Antioxidation

目的观察具有抗氧化作用的中药治疗狼疮性肾炎(LN)的临床疗效。方法LN患者共25例,治疗以黄芪、熟地黄等作为主药,持续6个月。观察肾功能不全组和肾功能正常组患者治疗前后临床症状,SLE疾病活动指数(SLEDAI)、AI评分,血中脂质过氧化物(LPO)、红细胞超氧化物歧化酶(SOD)、谷胱甘肽(GSH)、谷胱甘肽过氧化物酶(GSH-Px)、脂质过氧化物丙二醛(MDA)、一氧化氮(NO),血常规、尿常规、24小时尿蛋白定量、肝肾功能、抗ds-DNA、补体C_3、C_4的变化。结果两组SLEDAI及AI评分较治疗前差异有统计学意义(P<0.01),治疗后NO、MDA及抗ds-DNA明显下降,SOD、GSH-Px和GSH明显升高(P<0.05或P<0.01);肾功能正常组LPO、尿蛋白较治疗前显著下降,C_3升高(P<0.05)。结论抗氧化中药对SLE缓解和延缓LN肾功能恶化有一定疗效,但对已经进入肾功能不全的LN疗效差,对肾脏组织学病理分型为Ⅴ型的LN几乎无效。

Objective To observe the effect of Chinese Medicines with the function of antioxidation on lupus nephritis （LN） patients. Methods The 25 LN patients consisting of renal function normal group（15 cases） and renal failure group（10 cases） were treated with Huang Qi （Radix Hedysari） and Shu Dihuang （Radix Rehmanniae Praeparata） as main ingredients for 6 months in succession. Changes of symptom, systemic lupus erythematosus disease activity index （SLEDAI）, activity index （AI）, lipid peroxide （LPO） ,superoxide dismutase （SOD） ,glutathione peroxide （GSH-Px） ,malondialchehyche （MDA） ,nitric oxide （NO） ,blood and urine routine examination,24-hour urine protein quantity,liver and kidney function,anti-double-stranded DNA （anti ds-DNA）,complement 3 （C3） and complement 4（C4）, after treatment were observed. Results SLEDAI and AI scores were remarkably different from those before treatment （P〈0.01）. After treatment,NO,MDA and anti-ds-DNA of both groups were extremely decreased, SOD,GSH：Px and reduced GSH were extremely increased （P〈0.05 or P〈0.01）. LPO and urine protein of the renal function normal group were greatly decreased and C3 increased （P〈0.05）. Conclusion The effect of Chinese Medicines with the function of antioxidation is effective in relieving SLE and delaying renal function failure, but is less effective for LN patients with renal failure and they are ineffective for those with V-type of LN in histopathology.