他克莫司联合黄葵胶囊治疗难治性膜性肾病的临床疗效

Clinical Effects of Tacrolimus Combined with Okra Capsule in Treatment of Refractory Membranous Nephropathy

目的:探讨他克莫司联合黄葵胶囊治疗难治性膜性肾病疗效及安全性。方法:选取2014年3月-2015年10月我院收治的60例难治性膜性肾病患者,按随机数字表法分为观察组和对照组各30例,对照组给予泼尼松治疗,观察组在此基础上增加他克莫司联合黄葵胶囊口服,两组均治疗6个月,观察两组临床疗效,检测并对比两组治疗前后尿蛋白(uPRO)、血清白蛋白(sALB)、血清肌酐(sCr)、血谷丙转氨酶(sALT)、肿瘤坏死因子α(TNF-α)、转化生长因子β1(TGF-β1)以及不良反应情况。结果:观察组的有效率高于对照组(P<0.05);治疗后两组uPRO、TNF-α、TGF-β1均明显降低,sALB、sCr明显升高(P<0.05),且观察组uPRO、TNF-α、TGF-β1低于对照组(P<0.05);两组不良反应发生率比较差异无统计学意义(P>0.05)。结论:他克莫司联合黄葵胶囊治疗难治性膜性肾病具有较好的疗效,降低肾功能损伤,不良反应低,值得临床推广。

Objective：To investigate the effect and safety of tacrolimus combined with Okra capsule in treatment of the refractory membranous nephropathy.Methods：Selected 60 patients with refiactory membranous nephropathy who were treated in our hospital from March 2014 to October 2015,and they were divided into observation group and control group with 30 cases in each group according to the random number table method.The control group was treated with prednisone,and the observation group was treated with tacrolimus combined with Okra capsule on the basis of the control group,the courses of treatment were 6 months in two groups.The clinical effects were observed in two groups,the levels of urine protein （uPRO）,serum Albumin （sALB）,serum Creatinine （sCr）,serum Alanine aminotransferase （sALT）,tumor necrosis factor-α （TNF-α） and transforming growth factor-β 1 （TGF-β1） were detected and compared in two groups before and after treatment,and the adverse reactions were recorded in two groups.Results：The total effective rate of the ob-servation group was significantly higher than control group （P〈0.05）.Compared with before treatment,the levels ofuPRO,TNF-α,TGF-β1 in two groups were decreased after treatment,while sALB,sCr were increased （P〈0.05）,and uPRO,TNF-o,TGF-β1 in the observation group were lower than the control group （P〈0.05）.There was no significant difference in the incidence of adverse reactions between the two groups （P〉0.05）.Conclusion：Tacrolimus combined with Huangkui capsule in the treatment ofrefractory membranous nephropathy has good curative effect,reduce renal damage,and low adverse reaction,worthy of promotion.