中药配合腹膜透析治疗狼疮肾炎尿毒症的疗效观察

Observation on curative effects of traditional Chinese medicine combined with peritoneal dialysis for patients with uremia of lupus nephritis

目的：探讨中药配合腹膜透析（腹透）治疗狼疮肾炎尿毒症患者的疗效。方法：随机设置３７例中西医结合治疗组（治疗组）与３５例对照组，２组均采用连续不卧床腹透及激素标准疗程治疗。治疗组并加用中药治疗。结果：治疗半年后治疗组完全缓解率３５．１％，复发率８．１％，不良反应率３７．８％，脱离透析率８１．１％；对照组分别为１４．２％、２２．９％、７４．３％和４５．７％。治疗组总蛋白（ＴＰ）、血红蛋白（Ｈｂ）均较对照组明显升高〔（６８．３±３．９）ｇ／Ｌ比（５７．９±４．２）ｇ／Ｌ，（８１．３±９．９）ｇ／Ｌ比（７２．１±６．３）ｇ／Ｌ〕，Ｐ均＜０．０５；血尿素氮（ＢＵＮ）、血肌酐（ＳＣｒ）和尿蛋白均明显降低〔分别为（１６．１±７．５）ｍｍｏｌ／Ｌ比（２４．５±９．６）ｍｍｏｌ／Ｌ，（２６９．３±８７．３）μｍｏｌ／Ｌ比（４５７．０±９３．５）μｍｏｌ／Ｌ，（０．６±４．９）ｇ／２４ｈ比（３．５±５．７）ｇ／２４ｈ〕，Ｐ均＜０．０５。结论：中药配合腹透治疗狼疮肾炎尿毒症优于单纯西医治疗。

Objective :To investigate the curative effects of traditional Chinese medicine (TCM) combined peritoneal dialysis (PD) on patients with uremia of lupus nephritis. Methods :The integrated traditional Chinese and western medicine therapy group (treatment group,n=37) and the control group (n=35) were randomly established.Both two groups were treated with continuous ambulatory peritoneal dialysis (CAPD) and steroid in standard therapeutic course.The TCM was added into treatment group. Results :After half a year the rates of complete remission,recurrences,harmful reactions,and withdrawing dialysis were 351%,81%,378% and 811% in treatment group but 142%,229%,743% and 457% respectively in control group.Otherwise the total protein volume and hemoglobin were significantly increased in treatment group compared with control group (68339)g/L vs.(57942)g/L and (81399)g/L vs. (72163)g/L respectively (all P<005),meantime the blood urea nitrogen (BUN),serum creatinine (SCr),and proteinuria volume were significantly decreased (16175)mmol/L vs.(24596)mmol/L,(2693873)mol/L vs.(4570935)mol/L,and (0649)g/24 h vs.(3557)g/24 h,all P<005. Conclusions :The TCM combined with PD is superior to western medicine alone in treatment for patients with uremia of lupus nephritis.