四种祛风类中药治疗原发性肾小球肾炎的临床研究

EFFECTS OF FOUR KINDS OF ANTI-RHEUMATIC HERBS ON PRIMARY GLOMERULONEPHRITIS

目的 :评价口服火把花根、祖师麻、清风藤碱和雷公藤多甙单独与联合用药治疗原发性肾小球肾炎的效果。方法 :选择 6 5 6例经单味或两味祛风类中药治疗的原发性肾小球肾炎患者 ,观察不同治疗患者的临床表现、尿蛋白定量、尿常规、肝肾功能等指标变化。结果 :单味药治疗肾炎的缓解率为 2 4.0 %～ 44 .5 % ,两味药联合治疗肾炎的缓解率为 5 1.9%～ 5 9.2 % ;清风藤碱治疗的各种临床表现的肾炎缓解率均低于其他治疗组 ,单味药火把花根、祖师麻和雷公藤多甙对单纯性蛋白尿的缓解率为 5 0 .0 %～ 6 9.7% ,对单纯性血尿的缓解率为 36 .0 %～ 5 0 .0 % ,对蛋白尿合并血尿的缓解率为 19.5 %～ 2 2 .7% ,联合用药对各种表现的缓解率均高于单味药组 ,对单味药未缓解的部分病例两味药治疗仍有一定效果 ,复发率低于单味药组 ;联合用药组消化道反应、肾功能损害、停经和白细胞减少发生率与单味药组均无明显差别 ,转氨酶增高发生率增加 ,但谷丙转氨酶 >10 0 U /L者少见。结论 :四种祛风类单味药对肾小球肾炎均有一定疗效 。

Objective:To eval uate the therapeutic effects of oral Tri ptergium Hypoglaucum(TH),Daphne Gi raldii Nitsche(DGN),Sinomenine(SI) and Triptergium Wilfordii(TW) alone or combined on primary glomerulon ephritisMethods:656 patient s with primary glomerulonephritis treate d with above drugs were involved i n this study and their clinical ma nifestations,urine protein excret ion,urine and blood routine test,r enal and hepatic function and asso ciated parameters were monitoredR esults:The remission rates of abov e drugs alone were from 240% to 4 45%,those of two drugs combined from 519%to 592%The SI grou p had the lowest remission rateTh e remission rates of patients with sole proteinuria treated with TH, DGN and TW were 583%,500%and 69 7% respectively,those with sole ha maturia 40%,36% and 500% whi le those with both proteinuria and hematuria were 195%,205% and 22 7%The groups combined two drugs had higher remission rates and lower r ecurrent rates than one drugs alon eSome patients failed to response to one drug showed improvement fo llowing two drugs therapyThere we re marked differences in the in cidence of alimentary tract reacti ons,renal function damage,menostas is and leukopenia between one or two drug s groupsAlthough the inci dence of hepatic function abnormal ity was more common,obvious elevation of serum glutamic-pyruvic transam inase was seldomConclusions:The four kinds of anti-rheumatic herbs were effective on glomerulonephritisTwo he rbs combination exerted more power ful actions