肝肾双调法干预乙肝病毒相关性肾小球肾炎进程的临床研究

The Clinical Research on Liver and Kidney Double Adjustment Inhibit the Course of Hepatitis B Virus Associated Glomerulonephritis

目的观察以平补肝肾、清利湿热、活血散结为治疗大法的乙肝肾合剂对乙肝病毒相关性肾小球肾炎(HBV-GN)的临床疗效。方法 50例HBV-GN患者按随机数字表法随机分为治疗组组24例和对照组26例。对照组给予降压,纠正水/电解质、酸碱平衡紊乱、降脂、抗凝等对症治疗,治疗组在对照组治疗基础上加用乙肝肾合剂,于治疗前及治疗后1个月对患者丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)、白蛋白(ALB)、总蛋白(TP)等肝功能,血清病毒学(HBV-DNA)、24 h尿蛋白定量、T淋巴细胞亚群分析(CD4+、CD8+、CD4+/CD8+)等实验室结果进行分析研究,并观察临床症候积分变化。结果治疗组总有效率为79.17%,优于对照组的65.38%(P<0.05)。治疗后,两组肝功能指标、24 h尿蛋白定量、HBV-DNA定量、T淋巴细胞亚群分析以及主要症候体征积分均较治疗前明显好转(P<0.05),且治疗组优于对照组(P<0.05)。结论在常规治疗基础上联合应用乙肝肾合剂能够有效地控制HBV-GN患者蛋白尿、提高血浆白蛋白、改善肝功能,抑制乙肝病毒复制活跃度,改善患者临床症状,提高机体免疫功能,阻止病情进一步发展。

Objective： To observe the clinical effects of the B liver and kidney mixture on hepatitis B virus as- sociated glomerulonephritis （HBV-GN）. Methods： 50 observed cases were randomly divided into the treatment group with 24 and the control group with 26. The control group were given correct water,electrolyte acid-base balance disorder, hypertension, low salt, low fat, food with low quality protein such as symptomatic treatment. The treatment group,on the basis of the treatment for the control group,took the B liver and kidney mixture. One month before and after treatment,liver function （ALT, AST, ALB, TP）, serum virology in patients with HBV-de- signed（HBV-DNA） ,24 hours urine protein quantitative （UTP）,T lymphocyte subsets（CD4＋,CD8＋,CD4＋/CD8＋） and other laboratory results were studied, and the change of clinical symptoms integral was observed. Results： The total effective rate of the treatment group was 79.17% ,better than the control group 65.38%. The index of the patients,liver function, serum virology in patients with HBV-designed, 24 hours urine protein quantitativ,T lym- phocyte subsets and the clinical symptoms integral were obviously improved, and the treatment group was superior to the other. Conclusion： Based on the conventional therapy,the B liver and kidney mixture can reduce urinary protein quantitative, improve the blood plasma albumin, protection of liver function, inhibit the duplication of hep- atitis B virus,improve clinical symptoms of patients,increase immune function and prevent the development con- dition.