原发性局灶节段性肾小球硬化的中西医结合个体化治疗的疗效观察

Individualized Treatment with Western and Traditional Medicine in Primary Focal Segmental Glomerulosclerosis

目的 :研究中西医结合个体化治疗原发性局灶节段性肾小球硬化 (pFSGS)的疗效。方法 :对 30例经肾活检术确诊为 pFSGS的患者根据不同个体采用中西医结合个体化治疗方案 ,供选择药物有 :强的松 (Pred)、雷公藤多甙片 (T1)、血管紧张素转换酶抑制剂 (ACEI)、环磷酰胺 (CTX)、非甾体类消炎药 (NsAID)、益肾通络方 (黄芪、首乌、金樱子、积雪草、桃仁、制军 )等。以 15例未按上述正规治疗的患者作对照。结果 :治疗观察 (33.5 8± 2 0 .6 7)月 ,治疗组完全缓解 16例 (5 3.33% ) ,显效 8例 (2 6 .6 7% ) ,有效 5例 (16 .6 7% ) ,无效 1例 (3.33% ) ,其中 10例肾衰竭的患者 ,治后 8例恢复正常。对照组未见临床缓解或显效 ,仅 7例有效 ,差异显著 (P <0 .0 1)。结论

Objective:To study the individualized treatment with western and TCM on primary focal segmental glomerulosclerosis(pFSGS).Methods:In group 1,30 patients with pFSGS,being diagnosed by biopsy,received treatment with individualized western and traditional medicine treatment including predisone,T1,ACEI,CTX,NsAID,Chinese herbs(huangqi,shouwu,jinyingzi,jixuecao,taoren,zhijun)etc. In group 2,15 patients without receiving the above-mentioned treatment served as control.Results:The duration of follow-up was (33.58±20.67) months.In group 1,16 patients had complete remission(53.33%),8 had obvious effect(26.67%),5 had moderate effect(16.67%),and only 1 patient had no effect(3.33%).8 out of 10 patients with renal insufficiency had recovered renal function during treatment.In group2,there was no complete remission or obvious effect and only 7 patients had moderate effect.The difference between the two groups was significant(P<0.01).Conclusion:Individualized western and traditional medicine is effective for the treatment of primary FSGS.