中药对原发性肾病综合征糖皮质激素治疗的增效减毒作用分析

Synergistic and Attenuated Effect Analysis of Traditional Chinese Medicine for the Treatment of Primary Nephrotic Syndrome Treated with Glucocorticoid

目的:观察中药对原发性肾病综合征(PNS)糖皮质激素治疗的增效减毒效果,为临床治疗提供参考依据。方法:选取我院2014年1月~2016年1月收治的80例PNS患者作为研究对象,根据随机数字表法分为糖皮质激素组和中药组,每组各40例。糖皮质激素组给予泼尼松片治疗,中药组在糖皮质激素组治疗的基础上给予分阶段辨证治疗。治疗6个月后,比较2组患者的临床疗效、肾功能、纤维蛋白原(Fib)、血脂代谢及免疫功能和不良反应发生率。结果:治疗6个月后,中药组总有效率为92.50%,明显高于糖皮质激素组的72.50%(P<0.05);中药组24h UTP、Fib均明显低于糖皮质激素组,HDL-C、IgG、ALB均明显高于糖皮质激素组(P<0.05);中药组肝功能受损、血糖升高、痤疮、向心性肥胖发生率均明显低于糖皮质激素组(P<0.05)。结论:在不同糖皮质激素用药治疗阶段,同时给予中药辨证用药可明显提高PNS治疗效果,且明显改善了患者肾功能、血脂代谢和免疫功能,并减少了不良反应的发生,增效减毒作用显著。

Objective： To investigate the effect of traditional Chinese medicine （TCM） on the effect of glucocorticoid therapy on the treatment of primary nephrotic syndrome （PNS）, to provide reference for clinical treatment. Methods： From January 2014 to January 2016 in our hospital, 80 cases of PNS patients were selected as the research object, according to the random number table method were divided into glucoeortieoid group and TCM group, each group had 40 cases. The glucoeorticoid group was trea- ted with prednisone tablets, on the basis of the treatment of glucoeorticoid group, the TCM group was treated with phased dialecti- cal treatment. After 6 months of treatment, the clinical efficacy, renal function, fibrinogen （Fib）, blood lipid metabolism and immune function, and incidence of adverse reactions were compared between the two groups. Results： After 6 months of treat- ment, the total effective rate of the TMC group was 92. 50% , which was significantly higher than the glucocorticoid group （ P 〈 0. 05 ） which was 72. 50% ; The 24hUTP and Fib in the TCM group were significantly lower than those of the glucoeorticoid group, the HDL-C, IgG, and ALB wei＇e significantly higher than those of the glucocorticoid group （P 〈 0. 05） ; The incidence of liver function damage, blood sugar and acne in the TCM group was significantly lower than that in the glucocorticoid group （ P 〈 0. 05）. Conclusion： In different glucocorticoid treatment stage, given the Chinese traditional medicine TCM drugs can signifi- cantly improve the therapeutic effect of PNS, and significantly improve the renal function, lipid metabolism and immune function,and reduce the incidence of adverse reactions, synergistic effect.