来氟米特联合雷公藤多甙治疗过敏性紫癜性肾炎的临床观察

Clinical Observation of Leflunomide and Glucosida Tripterygii TOTA on Nephritis of Schonlein-henoch Purpura

目的探讨来氟米特联合雷公藤多甙治疗过敏性紫癜性肾炎的疗效和安全性。方法按入院先后顺序将过敏性紫癜性肾炎患者69例随机分配到A组、B组、C组,每组23例。每组均给予泼尼松口服[1mg(/kg·d)],氯苯拉敏(8mg,每日3次),每日静脉注射维生素C4～6g及10%葡萄糖酸钙10mL;除此之外,A组、B组分别给予常规剂量的来氟米特和雷公藤多甙口服,而C组联合使用小剂量来氟米特和雷公藤多甙口服。观察过敏性紫癜复发次数、尿红细胞、尿蛋白、血常规、肝功能、肾功能、药物不良反应。观察周期6个月。结果小剂量联合治疗组(C组)尿红细胞及尿蛋白减少幅度明显高于A组和B组(P<0.05或P<0.01),而且C组疾病的复发率低于A组、B组,有统计学意义(P<0.05),同时C组不良事件发生率也低于A组、B组。结论小剂量来氟米特和雷公藤多甙联合治疗紫癜性肾炎疗效显著、复发率低、不良事件发生率低。

Objective To evaluate the efficacy and safety of leflunomide and glucosida tripterygii TOTA being coapplied to treat nephritis of Schonlein-henoch purpura. Methods Sixty-nine HSPN patients were randomly divided into 3 groups according to admission time： group A, group B and group C. Three groups received routine treatment：taking orally prednisone [1mg/ （kg·d）], chlorphenamine（8mg,three times each day）, and infusing vitamin C（3-6g,one time each day） and 10% calcium gluconate（10mL,one time each day）. Besides this routine treatment, group A and group B received routine dosage leflunomide and glucosida tripterygii TOTA respectively,and in group C, low dose leflunomide and low dose glucosida tripterygii TOTA were coapplied. We observed the relapse rate of HSPN,and measure parameters as following： red blood cell in urine,quantitation of urine protein, liver function,renal function,white blood cell,prothrombin time and activated partial thromboplastin time,drug adverse reaction. It was 6 months for observation timing. Results Compared with the control group（group A and group B）, proteinuria and red blood cell in urine were all significantly decreased in low dose leflunomide and glucosida tripterygii TOTA therapeutic alliance group （C group）, moreover, the relapse rate of purpura nephritis in C group was lower than group A and group B（P〈O.05）, incidence of adverse reaction was also lower than group A and group B. Conclusion While low dose leflunomide and glucosida tripterygii TOTA being coapplied to treat purpura nephritis,it is evident in curative effect,and it is lower in relapse rate and incidence of adverse reaction.