芪蛭汤联合激素和环磷酰胺治疗肾病综合征临床观察

Observation of Qizhi Decoction combined with Hormone Therapy and Cyclophosphamide for Nephritic Syndrome

目的观察芪蛭汤联合激素和环磷酰胺治疗肾病综合征的临床疗效。方法患者75例随机分为芪蛭组和阿魏酸哌嗪组。两组均给予一般对症治疗和泼尼松加环磷酰胺治疗,不用任何抗凝药;芪蛭组服加味芪蛭汤水煎剂,阿魏酸哌嗪组服阿魏酸哌嗪片1月。比较两组治疗前后24 h尿蛋白定量、血浆白蛋白、总胆固醇、纤维蛋白原、谷丙转氨酶、血肌酐等。结果两组治疗后24 h尿蛋白定量、纤维蛋白原、总胆固醇降低,血浆白蛋白增高,谷丙转氨酶、血肌酐增高;芪蛭组较阿魏酸哌嗪组24 h尿蛋白定量、纤维蛋白原、总胆固醇、血肌酐降低,血浆白蛋白、谷丙转氨酶增高。芪蛭组总有效率为92.11%,高于阿魏酸哌嗪组的59.46%;芪蛭组阴虚火旺症、Cushing综合征、血栓形成及感染发生率较阿魏酸哌嗪组低。结论泼尼松和环磷酰胺联合芪蛭汤可增强肾病综合征患者疗效,同时降低不良反应和并发症的发生。

Objective： To investigate the clinical effects of Qizhi Decoction for nephritic syndrome.Methods： In terms of minimum allocation principle of the imbalance index,75 cases with nephritic syndrome were randomly divided into the Qizhi Decoction group and the cyclophosphamide group according to the course of the disease,the patient＇s conditions and the primary or recurrent cases.Besides normal symptomatic treatment,the Qizhi Decoction were added the Modified Qizhi Decoction orally 3 times one day with one dose for 1 month.The cyclophosphamide group was used the cyclophosphamide tablet orally 3 time with 0.2 g for 1 month.These indices were compared before and after treatment including 24 h urine protein,serum albumin（Alb）,fibrinogen（Fib）,total cholesterol（TC）,alanine aminotransferase（ALT） and serum creatinine（Scr）.Results： After treatment,the levels such as 24 h urine protein,Fib and TC were significantly decreasted.Meanwhile,the Alb was significantly increased.However,ALT and Scr were slightly increased in 2 groups.After treatment,in the Qizhi Decoction group,24 h urine protein,Fib and TC were significantly decreased.Also,the plasma albumin was increased remarkably.Alb was increased and Scr was decreased slight.The total effective rate in the treatment group was higher than that in the control group.Adverse reactions including Yinxuhuowang syndrome,Cushing syndrome,thrombosis rate and infection incidence in the treatment group were significantly lower than those in the control group.Conclusion： Qizhi Decoction combined with cyclophosphamide can strengthen curative effects and reduce the side effects and complications.