地黄叶总苷胶囊联合泼尼松治疗肾病综合征的临床研究

Clinical study on Dihuangye Zonggan Capsules combined with prednisone in treatment of nephrotic syndrome

目的探讨地黄叶总苷胶囊联合醋酸泼尼松片治疗肾病综合征的临床疗效。方法选取2017年3月-2018年5月深圳市龙华区人民医院收治的90例肾病综合征患者为研究对象,按照随机数字表法分为对照组和治疗组,每组各45例。对照组口服醋酸泼尼松片,首次剂量1 mg/(kg·d),每日晨起顿服,8周后逐步减量,每周递减初始剂量的10%,最后以0.4 mg/(kg·d)维持剂量。治疗组在对照组治疗的基础上口服地黄叶总苷胶囊,0.4g/次,3次/d。两组患者均治疗16周。观察两组临床疗效,比较两组炎症因子水平、肾功能指标。结果治疗后,对照组和治疗组的总有效率分别为75.56%、91.11%,两组比较差异有统计学意义(P<0.05)。治疗后,两组白细胞介素-1β(IL-1β)、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、尿单核细胞趋化因子-1(MCP-1)水平明显降低,同组治疗前后差异有统计学意义(P<0.05);且治疗后治疗组的炎症因子水平低于对照组,差异有统计学意义(P<0.05)。治疗后,两组的24 h尿蛋白定量(24 h UPQ)、胱抑素C(Cys-C)、血肌酐(Scr)水平均明显降低,ALB水平明显升高,同组治疗前后差异有统计学意义(P<0.05);且治疗后治疗组的肾功能指标优于对照组,差异具有统计学意义(P<0.05)。结论地黄叶总苷胶囊联合泼尼松治疗肾病综合征具有较好的临床疗效,可改善肾功能,降低炎症因子水平,具有一定的临床推广应用价值。

Objective To explore the clinical efficacy of Dihuangye Zonggan Capsules combined with Prednisolne Acetate Tablets in treatment of nephrotic syndrome. Methods Patients(90 cases) with nephrotic Syndrome in Shenzhen Longhua District People’s Hospital from March 2017 to May 2018 were randomly divided into control and treatment groups, and each group had 45 cases.Patients in the control group were po administered with Prednisolne Acetate Tablets, starting dosage 1 mg/(kg·d), after 8 weeks,reduced starting dosage by 10% every week, finally the dose was maintained at 0.4 mg/(kg·d). Patients in the treatment group were po administered with Dihuangye Zonggan Capsules on the basis of the control group, 0.4 g/time, three times daily. Patients in two groups were treated for 16 weeks. After treatment, the clinical efficacies were evaluated, and inflammatory factors and indicators of renal function in two groups were compared. Results After treatment, the clinical efficacies in the control and treatment groups were75.56% and 91.11%, respectively, and there was difference between two groups(P < 0.05). After treatment, the levels of IL-1β,TNF-α, IL-6, and MCP-1 in two groups were significantly decreased, and the difference was statistically significant in the same group(P < 0.05). And the inflammatory factors levels in the treatment group were significantly lower than those in the control group, with significant difference between two groups(P < 0.05). After treatment, the levels of 24 h UPQ, Cys-C, and Scr in two groups were significantly decreased, but the levels of ALB in two groups were significantly increased, and the difference was statistically significant in the same group(P < 0.05). And the indicators of renal function levels in the treatment group were significantly better than those in the control group, with significant difference between two groups(P < 0.05). Conclusion Dihuangye Zonggan Capsules combined with Prednisolne Acetate Tablets has clinical curative effect in treatment of nephrotic syndrome, can improve renal function, and reduce the level of inflammatory factors, which has a certain clinical application value.