雷公藤多甙片联合半量激素治疗原发性膜性肾病30例

Treating 30 cases of membranous nephropathy by tripterygium wilfordii plus half amount of hormone

目的:观察探讨雷公藤多甙片(Tripterygium Wilfordii,TW)联合半量激素(泼尼松)治疗原发性膜性肾病(Idiopathic Membranous Nephropathy,IMN)的临床疗效与安全性。方法:选取明确诊断为IMN的患者30例,给予TW(120mg/d)和泼尼松(30mg/d),并逐渐减量,同时给予补钙、调脂、抗血小板聚集等对症治疗,记录患者3个月、6个月、12个月的24h尿蛋白、血浆白蛋白(ALB)、血胆固醇(TC)、甘油三酯(TG)、谷丙转氨酶(ALT)、血肌酐(Scr)等相关生化指标,动态观察其临床疗效。结果:3个月时24h尿蛋白、TC、TG均有所下降,ALB有所提升,ALT、Scr基本无变化,6个月时各项指标较3个月时明显好转,12个月时各项指标均基本正常。结论:运用TW和半量激素(泼尼松)治疗IMN效果良好,患者耐受性较好,不良反应较少,是一种比较有效的治疗方法。

Objective： To observe and explore clinical efficacy and security of tripterygium wilfordii plus half amount of hormones（prednisone） in treating idiopathic membranous nephropathy. Methods： 30 patients diagnosed with IMN were given TW（120mg/d） plus prednisone（30mg/d）,and slowly reducing the quantity, while giving calcium, lipid-lowering, anti-platelet aggregation and other symptomatic treatment, noted hydration therapy, recorded patients 3 months, 6 months,12 months＇ 24 h urinary protein, serum albumin（ALB）, blood cholesterol（TC）, triglycerides（TG）, alanine transaminase（ALT）, serum creatinine（Scr） and other biochemical markers while observing clinical efficacy dynamicly. Results： 3 months 24 h urinary protein？TC？TG were dropped,ALB were raised, ALT, Scr without changing, 6 months the indicators were significantly higher compared to 3 months, indicators of patients were basically normal in 12 months. Conclusion： TW plus half amount of hormone（prednisone） was effective in treating IMN, with better tolerance and seldom side effects,it was a more effective method of treatment.