针刺配合坎地沙坦酯片治疗抗磷脂酶A_2受体抗体阳性轻度膜性肾病35例

Effect of acupuncture combined with candesartan tanatide tablets on anti-phospholipase A_2 receptor antibody-positive mild membranous nephropathy: An analysis of 35 cases

目的探讨针刺配合坎地沙坦酯片治疗抗磷脂酶A2受体(PLA_2R)抗体阳性轻度膜性肾病的效果。方法选择PLA_2R抗体阳性的轻度膜性肾病患者70例,按照随机数字表法分为两个组,对照组和治疗组,每组35例,所有患者给予常规对症治疗,对照组患者加用坎地沙坦酯片,治疗组患者在对照组治疗方法的基础上再加用针刺相关穴位的方法,对治疗的效果进行分析和评价。结果对照组与治疗组患者在不同时间点的PLA_2R抗体、24 h尿蛋白、血清白蛋白、三酰甘油、胆固醇、空腹血糖、肾小球滤过率(eGFR)、D-二聚体、血小板计数结果比较:(1)除空腹血糖外,其余项目在不同时间点间差异有统计学意义(P<0.05);(2)除空腹血糖外,对照组与治疗组的数据差异有统计学意义(P<0.05),其中PLA_2R抗体、24 h尿蛋白、三酰甘油、胆固醇、D-二聚体、血小板计数治疗组低于对照组,血清白蛋白、eGFR治疗组高于对照组;(3)除空腹血糖外,对照组与治疗组的数据随时间变化趋势差异有统计学意义(P<0.05),其中PLA_2R抗体,24 h尿蛋白,三酰甘油,胆固醇,D-二聚体,血小板计数随着时间的进展而逐渐下降,血清白蛋白、eGFR随着时间的进展而逐渐上升,两组不良反应发生率差异无统计学意义(P>0.05)。结论使用针刺配合坎地沙坦酯片治疗PLA_2R抗体阳性轻度膜性肾病的患者,可以显著改善患者的各项生理指标,提高治疗的效果,并未使不良反应的概率增加,是值得推广的一种治疗方法。

Objective To investigate the effect of acupuncture combined with western medicine on anti-phospholipase A 2 receptor antibody-positive mild membranous nephropathy.Methods Seventy cases of mild membranous nephropathy with PLA 2R antibody positive were chosen and assigned into two groups according to the random number method.There were respective 35 cases in the control group and the treatment group.All patients were given conventional symptomatic treatment.Meanwhile,patients in the control group were given candesartan tanatide tablets,while patients in the treatment group received acupuncture of related acupuncture points based on the therapy of the control group.The curative effects were analyzed and evaluated.Results There were significant differences in PLA 2R antibodies,24-hour urinary protein,serum albumin,triglycerides,cholesterol,glomerular filtration rate(eGFR),D-dimer,and platelet count at different time points between two groups,except for fasting plasma glucose(P<0.05).The PLA 2R antibody,24-hour urine protein,triglycerides,cholesterol,D-dimer,and platelet count were lower and serum albumin and evaluated glomerular filtration rate(eGFR)were higher in treatment group than in control group.Except for fasting glucose,there were significant difference in time-related data change between treatment group and control group(P<0.05).The PLA 2R antibody,24-hour urine protein,triglycerides,cholesterol,D-dimer and platelet count gradually decreased with time,while serum albumin and eGFR gradually increased with time.There was not statistically significant difference in adverse reactions between the two groups(P>0.05).Conclusions The use of acupuncture combined with western medicine treatment of anti-phospholipase A 2 receptor antibody-positive patients with mild membranous nephropathy can significantly improve the patients′physiological indicators,improve the treatment effect,and does not increase the probability of adverse reactions,which is worthy of popularization.