白芍总苷辅助治疗老年狼疮性肾炎的疗效及对病人免疫应答与氧化应激的影响

Effect of total glucosides of paeony on the immune response and oxidative stress in elderly patients with lupus nephritis

目的探讨白芍总苷辅助治疗老年狼疮性肾炎(LN)的疗效,及其对病人免疫应答与氧化应激的影响。方法回顾性分析我院2015年3月至2017年5月收治的老年LN病人临床资料,根据治疗方案将92例病人分为常规组和观察组,常规组病人给予环磷酰胺、醋酸泼尼松方案治疗,观察组在常规组治疗的基础上给予联合白芍总苷治疗,2组均治疗3个月。比较2组的总有效率、免疫功能及氧化应激相关指标水平以及总不良反应率。结果观察组总有效率为93.48%,显著高于常规组的80.43%,差异有统计学意义(P<0.01); 2组治疗前Ig G、补体C3、C4、丙二醛(MDA)、超氧化物歧化酶(SOD)水平比较,差异无统计学意义(P>0.05);治疗后观察组Ig G、MDA水平均显著低于常规组,补体C3、C4及SOD水平均显著高于对照组,差异有统计学意义(P<0.05);观察组总不良反应发生率为13.04%,显著低于常规组(23.91%),差异有统计学意义(P<0.05)。结论白芍总苷辅助治疗LN可显著提高治疗总有效率,改善机体免疫功能及氧化应激状态,减少药物不良反应发生,具有一定临床价值。

Objective To investigate the effect of total glucosides of paeony on the immune response and oxidative stress in the elderly patients with lupus nephritis（LN）.Methods The clinical data of elderly LN patients admitted to our hospital from March 2015 to May 2017 were retrospectively analyzed.According to the patients＇ treatment method,92 elderly patients with LN were divided into the routine group and the observation group.The patients in routine group were given cyclophosphamide and prednisone acetate treatment.On the basis of the routine group,the patients in observation group were treated with total glucosides of paeony additionally.All the patients were treated for 3 months.The total effective rate,immune function,oxidative stress related index and total adverse reaction rate were compared between the two groups.Results The total effective rate of the observation group（93.48%）was significantly higher than that of the routine group（80.43%）（P〈0.01）.There were no significant differences in the levels of IgG,C3,C4,malonaldehyde（MDA） and superoxide dismutase（SOD）between the two groups before treatment（P〉0.05）.After treatment,the levels of Ig G and MDA were significantly lower and the levels of C3,C4 and SOD were significantly higher in the observation group than those in the routine group（P〈0.05）.The total adverse reaction rate of the observation group（13.04%）was significantly lower than that of the routine group（23.91%）（P〈0.05）.Conclusions Total glucosides of paeony can improve the total effective rate,immune function and oxidative stress state,and reduce the incidence of adverse drug reactions,which has a certain clinical value for LN in the elderly.