中西医结合治疗乙肝病毒相关性肾炎的临床观察

Clinical Observation on Integrated Chinese-western Therapy in Treatment of Hepatitis B Virus-Associated Glomerulonephritis

目的观察阿德福韦酯联合中药治疗乙肝病毒相关性肾炎的临床疗效。方法 60例乙肝病毒相关性肾炎患者随机分为两组,两组均根据患者具体临床表现予以对症治疗,如降压、利尿、抗感染、输注人体血浆白蛋白等,肝功能有损害者,予以护肝治疗;对照组予阿德福韦酯,治疗组在对照组基础上加服自拟中药。治疗6个月后观察疗效。结果治疗组临床疗效明显优于对照组(P<0.05);两组治疗前后24h尿蛋白,谷丙转氨酶(ALT)、血浆白蛋白(ALB)、尿素氮(BUN)、肌酐(Scr)均得到了较明显的改善(P<0.05),且治疗组治疗后以上指标的改善明显优于对照组(P<0.05);治疗组治疗后HBV-DNA转阴率明显优于对照组(P<0.05)。结论阿德福韦酯联合中药治疗乙肝病毒相关性肾炎疗效显著。

Objective To observe the clinical efficacy of integrated Chinese- western therapy in treatment of Hepatitis B virus- associated glomerulonephritis（ HBV- GN）. Methods 60 patient of HBV- GN were divided into treatment group and control group. Both groups received symptomatic treatment according to patients＇ symptoms,such as anti- hypertension,diuresis,anti- infection,human plasma albumin infusion,and liver protection therapy to patients with abnormal liver functions. Control group took Hepsera tablets orally,10 mg per time,once per day. Treatment group took formula of self- made Chinese herbs on the basis of control group. After treating for 6 months,the efficacies of both groups were evaluated. Results The efficacy of treatment group were better than that of control group（ P〈0. 05）. 24 hour urinary protein,ALT,ALB,BUN,Scr in both groups were significantly improved after 1 course of treatment compared to those before treatment（ P〈0. 05）,the improvment of the indexes of treatment group were more obviously than those of control group（ P〈0. 05）. After 1 course of treatment,the negative conversion rate of HBV- DNA in treatment group was significantly higher than that of control group（ P〈0. 05）.Conclusions The effect of Hepsera combined with Chinese medicine on HBV- GN is better than using Hepsera alone.