贞莲益肾片联合来氟米特治疗慢性肾病蛋白尿的临床回顾性研究

Retrospective Study of the Curative Effect of Combination use of Zhen Lian Yi Shen Pian and Leflunomide in the Treatment of Nephrotic Proteinuria

目的观察贞莲益肾片与来氟米特联合治疗对慢性肾病蛋白尿的临床疗效和安全性,探讨治疗肾性蛋白尿的有效方案。方法采用回顾性病例对照研究,200例慢性肾病患者分为A组(对照组)82例和B组(研究组)118例,两组常规治疗相同:低盐、低蛋白饮食、控制感染、控制血压等。A组口服厄贝沙坦,B组联合贞莲益肾片与来氟米特治疗。治疗期间及治疗前后,监测血常规、24h尿量、24h尿蛋白定量、血浆白蛋白和肝肾功能的变化等方面的差异及药物治疗的不良反应发生情况,6个月后行疗效和安全性的评价。结果 B组治疗后24h尿量明显增加,有统计学差异(P<0.01);24h尿蛋白减少有统计学差异(P<0.01);血浆白蛋白增加有统计学差异(P<0.05);研究组临床总有效率高于对照组(P<0.05)。结论贞莲益肾片联合来氟米特治疗慢性肾病蛋白尿能明显减少尿蛋白。

Objective To observe the efficacy and safety of combination use of Zhen Lian Yi Shen Pian and leflunomide in initial treatment of nephrotic proteinuria, and evaluate the value of the therapy for the treatment of nephrotic proteinuria. Methods Two hun- dred patients with chronic kidney disease were divided into groups A（contrast group） and B（ treatment group）. The conventional treatment of the two groups was the same ： low - salt,low - proeit dies, controlling infection and controlling blood pressure, et al. Group A, consisting of 82 patients were treated with Irbesartan, and group B, consisting of 118 patients were treated with Zhen Lian Yi Shen Plan and lefluno- mide treatment everyday. During the treatment,before and after treatment,the blood,24h urine excretion,24h urine protein quantity, serum albumin levels,hepatic and renal functions were detected,and the efficacy and safety were evaluated six monks later. Results 24h urine excretion was significantly increase （P 〈 0.01 ） ,24h urine protein excretion was significantly reduced（ P 〈 0.01 ） and albumin was signifi- cantly increase （ P 〈 0.05 ） by Zhen Lian Yi Shen Pian and leflunomide treated. The total remission rates of the treated group were signifi- cantly superior to those of the controlled group（P 〈 0.05）. Conclusion Proteinuria could be reduced in glomerular disease by Zhen Lian Yi Shen Pian and leflunomide treated.