雷公藤多苷联合糖皮质激素治疗难治性肾病综合征疗效观察

Tripterginum Wilfordii Polyglycoside Combined with Glucocorticoid Treatment of Refractory Nephrotic Syndrome

目的:探讨雷公藤多苷联合糖皮质激素治疗难治性肾病综合征临床疗效,为肾病综合症患者提供较好的治疗方法。方法:选取2008年12月—2012年12月收治的96例难治性肾病综合征患者进行研究。按照随机对照的方法将患者随机分为两组,每组48例,对照组在基础治疗(低盐低蛋白饮食、利尿、降压、抗凝、保肾等综合治疗)的基础上采用糖皮质激素进行治疗,观察组在对照组的基础上联合雷公藤多苷治疗,观察两组患者治疗的有效性及安全性,以及两组患者治疗前后肾功能的情况,并对相关数据进行统计分析。结果:观察组完全缓解17例,部分缓解26例,无效5例,总有效率为89.58%;对照组完全缓解11例,部分缓解20例,无效17例,总有效率为64.58%,两组相比,差异具有统计学意义,P<0.05。经过治疗,难治性肾病综合症患者24h尿蛋白定量逐渐下降,而血清总蛋白和白蛋白水平逐渐增加,与治疗前比较差异均有显著性,P<0.05,其中观察组各指标变化显著优于对照组,两组相比,差异有统计学意义,P<0.05。两组在治疗过程中均未出现严重不良反应。结论:雷公藤多苷联合糖皮质激素明显缓解肾病综合症患者的临床症状,改善肾功能,减少蛋白尿的产生,且不良反应较少。

Objective： To study the effect of Tripterginum Wilfordii Polyglycoside Combined with glucocorticoid treat-ment of refractory nephrotic syndrome. It could provide a better way to treat refractory nephritic syndrome. Methods ：96 pa- tients with refractory nephritic syndrome from December 2008 to December 2012 in our hospital were to be studied. They were divided into two groups by randomly. Each group had 48 patients. Basic treatment in the control group （ low - salt low - protein diet, diuretic, antihypertensive, anticoagulant, and kidneys, and other comprehensive treatment） based on the use of corticosteroids for treatment, observation group were based on the combined treatment TWP were observed in pa- tients with treatment efficacy and safety, as well as two groups of patients before and after renal function in the case, and related data for statistical analysis. Results： Observation group, 17 cases of complete remission, partial remission in 26 cases, 5 cases, the total effective rate was 89.58% ;control group 11 cases of complete remission, partial remission in 20 cases, ineffective in 17 cases, total effective rate was 64.58%, compared to the two groups , a statistically significant difference, P 〈 0.05. After treatment, patients with nephrotic syndrome, 24h urinary protein decreased, while serum total protein and albumin levels gradually increased, compared with before treatment differences were statistically significant, P 〈 0.05, which changes each index observation group was significantly superior in the control group, two groups, the difference was statistically significant, P 〈 0.05. Both groups during treatment no serious adverse reactions. Conclusions ： TWP combined with glucocorticoids significantly alleviate clinical symptoms in patients with nephrotic syndrome and im- prove kidney function and reduce proteinuria produced fewer adverse reactions.