地黄叶总苷治疗特发性膜性肾病Ⅱ期患者疗效观察

Total glucosides of yellow leaves in adjuvant treatment of idiopathic membranous nephropathy in phase Ⅱ efficacy

目的探讨地黄叶总苷辅助治疗特发性膜性肾病Ⅱ期患者的临床疗效。方法选取临床诊断为原发性肾病综合征且病理类型为特发性膜性肾病Ⅱ期的患者30例,随机分为两组。A组15例患者接受常规的糖皮质激素与环磷酰胺治疗,B组15例患者在A组用药基础上加用地黄叶总苷。治疗6个月后,比较两组疗效。结果治疗6个月后,两组患者24 h尿蛋白定量均较治疗前降低,B组患者24 h尿蛋白定量低于A组,差异有统计学意义(P<0.05);两组患者血浆白蛋白水平均较治疗前升高,B组患者血浆白蛋白水平高于A组,差异有统计学意义(P<0.05);两组患者胆固醇、甘油三酯水平均较治疗前降低,B组患者胆固醇、甘油三酯水平低于A组,差异有统计学意义(P<0.05);A组不良反应发生率为53.3%(8/15),明显高于B组的20.0%(3/15),差异有统计学意义(P<0.05)。结论地黄叶总苷在治疗特发性膜性肾病Ⅱ期患者中发挥积极作用,可控制蛋白尿、升高血浆白蛋白、降低血脂。

Objective To investigate the effect of total saponins extracted from leaves of rehmannia in the treatment of stage Ⅱ of idiopathic membranous nephropathy（IMN）.Methods A retrospective study was performed on 30 cases of patients who were diagnosed as primary nephrotic syndrome and the pathological type was membranous nephropathy Ⅱ.Patients were randomly divided into Group A and Group B,with 15 cases in each group.Patients in Group A were treated with glucocorticoid and cyclophosphamide,the others in Group B were added total saponins extracted from leaves of rehmannia on the base of treatment in Group A.The curative effect after6 months of treatment was compared between the two groups.Results After 6 months of treatment,the 24 hours urinary protein quantification was reduced in the two groups than that before the treatment,the 24 hours urinary protein quantification in Group B was lower than that in Group A（P0.05）.The plasma albumin levels in both groups were higher than those before the treatment,and the plasma albumin level in Group B was higher than that in Group A（P0.05）.The cholesterol and triglyceride in the two groups were lower than those before treatment,and the cholesterol and triglyceride in Group B were lower than that in Group A（P0.05）.The incidence of adverse reactions in Group A was 53.3%（8/15）,which was significantly higher than 20.0%（3/15） in Group B,and the difference was statistically significant（P0.05）.Conclusion The total saponins extracted from leaves of rehmannia can assist the treatment of idiopathic membranous nephropathy Ⅱ,reduce urinary protein,blood lipid and increase serum albumin.