雷公藤多苷片联合糖皮质激素治疗肾病综合征患者临床疗效分析及对血清炎症因子的影响

Clinical Efficacy of Tripterygium Glycosides Tablet Combined with Glucocorticoid Therapy in Patients with Nephrotic Syndrome and Analysis on Serum Inflammatory Factors

目的探讨雷公藤多苷片联合糖皮质激素治疗肾病综合征患者临床疗效分析及对血清炎症因子的影响。方法将80例患者根据随机数字表法随机分为观察组和对照组,每组40例。两组患者均给予常规基础治疗,对照组给予泼尼松片治疗,观察组在对照组基础上结合雷公藤多苷片治疗。两组患者均以8周为1个疗程,共治疗3个疗程。疗程结束后对比分析两组临床疗效,治疗前后血清炎症因子水平、尿蛋白定量、血清白蛋白、总蛋白水平、血肌酐和尿素氮水平及治疗过程中不良反应发生情况。结果观察组总有效率显著高于对照组,且差异具有统计学差异(P<0.05)。治疗后观察组IL-1、TNF-α显著低于治疗前及同期对照组,差异具有统计学意义(P<0.05)。观察组治疗后尿蛋白定量显著低于对照组,而血清白蛋白和总蛋白显著高于治疗前及同期对照组,差异具有统计学差异(P<0.05)。两组患者治疗后血肌酐、尿素氮均较各组治疗前显著减少(P<0.05),但两组间治疗后比较差异无统计学意义(P>0.05)。观察组不良反应发生率显著低于对照组(P<0.05)。结论雷公藤多苷片联合糖皮质激素治疗肾病综合征患者临床疗效显著,可明显降低患者血清炎症因子水平,具有重要临床意义。

Objective To investigate the clinical efficacy of Tripterygium glycosides tablet combined with glucocorticoid therapy in patients with nephrotic syndrome and analysis on serum inflammatory factors. Methods A total of 80 patients were randomly divided into observation group（n = 40）and control group（n= 40）. Two groups of patients were given treatment on a regular basis. The control group received treatment with prednisone tablets. The observation group used Tripterygium glycosides tablets treatment except from the same therapy as the the control group. A course of treatment was eight weeks,and both groups took a total of three courses of treatment. The clinical efficacy after treatment,serum levels of inflammatory factors,urinary protein,serum albumin,total protein,serum creatinine and blood urea nitrogen levels after treatment and the adverse events were compared between the two groups. Results The total effective rate of the observation group was significantly higher,and there was a statistically significant difference（P ﹤ 0. 05）;after treatment, the level of IL - 1 and TNF - α in observation group were significantly lower than the same period before the treatment and control group,and there was statistically significant difference（P ﹤ 0. 05）;urinary protein ex-cretion in observation group was significantly lower than the control group,while serum albumin and total pro-tein were significantly higher than the same period before the treatment and control group,and there were sta-tistically significant difference（P ﹤ 0. 05）;after treatment in terms of serum creatinine,blood urea nitrogen compared between the groups before treatment,they were significantly reduced,and a statistically significance was found（P ﹤ 0. 05）;incidence of adverse reactions of the observation group was significantly lower than that of the control group,and there was a statistically significant difference（ P ﹤ 0. 05）. Conclusion Tripterygium glycosides tablet combined with glucocorticoid therapy in patients with nephrotic syndrome has a significant clinical effect,and it can significantly reduce serum levels of inflammatory cytokines in patients with clinical significance.