氯沙坦钾联合益肾化湿颗粒治疗慢性肾小球肾炎的临床疗效及安全性评价

Clinical efficacy and safety of losartan potassium combined with yishenhuashi in the treatment of chronic glomerulonephritis

目的观察氯沙坦钾联合益肾化湿颗粒治疗慢性肾小球肾炎的临床疗效及血清白细胞诱素1(LKN-1)、肿瘤坏死因子α(TNF-α)和白细胞介素^(-1)3(IL-13)的变化水平。方法将58例慢性肾小球肾炎患者随机分为试验组29例和对照组29例。对照组予以口服氯沙坦钾50 mg qd;试验组在对照组的基础上,加用益肾化湿颗粒10 g,tid。2组患者疗程均为12周。观察2组患者的临床疗效及治疗前后LKN-1、TNF-α、IL-13、血清肌酸酐、尿素氮和24 h尿蛋白定量(Up)的变化水平,以及不良反应发生率。结果试验组的总有效率82.76%显著高于对照组62.07%(P<0.05)。治疗后,2组患者的LKN-1、TNF-α、IL-13、血清肌酸酐、尿素氮、Up水平较治疗前明显下降(P<0.05),且试验组的LKN-1、TNF-α、IL-13和UP下降水平较对照组更为显著(P<0.05)。治疗期间,2组患者均未出现肝肾功能损害、皮疹等其他严重不良反应。结论氯沙坦钾联合益肾化湿颗粒治疗慢性肾小球肾炎能有效地提高临床疗效,降低血清LKN-1、TNF-α和IL-13水平,减轻蛋白尿,临床应用安全可靠。

Objective To observe the clinical efficacy of losartan potassium particles joint yishenhuashi particles and leukotactin- 1（ LKN- 1）,tumor necrosis factor（ TNF- α）,interleukin- 13（ IL- 13） level changes in chronic glomerulonephritis. Methods Fifty- eight patients with chronic glomerulonephritis were randomly divided into treatment group and control group,29 cases in each group. Control group was treated with oral losartan potassium 50 mg,once a day. Treatment group was given yishenhuashi 10 mg,3 times a day. The course of two groups was12 weeks. Clinical efficacy, before and after treatment of leukocyte LKN- 1,TNF- α and IL- 13,serum creatinine（ Scr）,blood urea nitrogen（ BUN） and 24 h urine protein quantification（ Up） of varying levels were compared between two groups. Results The total efficiency of treatment group was 82. 76% higher than 62. 07% of control group,the difference was statistically significant（ P〈0. 05）. After treatment,LKN- 1,TNF- α,IL- 13,Scr,BUN,former Up levels significantly decreased in both groups（ P〈0. 05）. And LKN- 1,TNF- α,IL- 13 and UP levels in treatment group declined more significant than the control group,the difference was statistically significant（ P〈0. 05）. Noother serious adverse drug reactions such as liver and kidney dysfunction, skin rash were observed.Conclusion Losartan potassium joint yishenhuashi particles for the treatment of chronic glomerulonephritis can effectively improve the clinical efficacy and reduce serumLKN- 1,TNF- α and IL- 13 levels,decrease proteinuria.