中西医结合治疗难治性原发性肾病综合征20例

Clinical Analysis of the Integrated Treatment of 20 Refractory Primary Nephrotic Syndrome Cases

目的 :探讨难治性原发性肾病综合征 ( PNS)的中西医结合治疗途径。方法 :选择 PNS患者2 0例 ,逐步撤减激素至停用 ,停免疫抑制剂 ,酌情给予降压、利尿、降脂、提高血浆胶体渗透压 ,自拟“健肾汤”、辨证辨病加减 ,治疗前后分别测定 2 4 h尿蛋白定量、血浆白蛋白、胆固醇、Scr(血肌酐 )、Ccr(肌酐清除率 )。结果 :治疗 8周后 2 4 h尿蛋白、血浆胆固醇显著下降 ,血浆白蛋白显著上升 ,肾功能明显改善 ( P<0 .0 1 )。病情完全缓解 40 % ,部分缓解 45 % ,无效 1 5 % ,总有效率 85 %。结论 :中西医结合治疗 PNS取得一定疗效 ,值得临床和实验进一步研究。

Objective: To explore the integral treatment of refractory primary nephritic syndrome(PNS) cases. Methods:20 PNS cases were treated with Jian Shen Decoction after decreasing hormone and immune inhibiting drugs together with diuresis, lowering the blood pressure, serum lipid and colloid osmotic pressure. Detections were made before and after the treatment on the 24 hour protein in the urine, serum albumin level and colloid osmotic pressure, cholesterol, Scr, CCr and T test. Results: 8 weeks after the treatment, 24 hours protein in the urine and serum cholesterol levels were lowered greatly. Serum albumin was raised with improved kidney function( P <0.01). The disease was completely relieved at 40%; partial relieved at 45%, no relieved at 15 %. The total effective rate was 85.5%. Conclusion:The integrated treatment was effective in treating refractory PNS cases.