肾炎康胶囊联合化痰袪瘀汤治疗特发性膜性肾病的临床观察

Clinical Observation of Shenyankang Capsule Combined with Huatan Quyu Decoction in Treatment of Idiopathic Membranous Nephropathy

目的探讨肾炎康胶囊联合化痰袪瘀汤治疗特发性膜性肾病的临床疗效。方法回顾性分析2013年4月至2017年4月京东誉美中西医结合肾病医院肾三病区收治的65例特发性膜性肾病患者的临床资料,根据治疗方法不同分为对照组(泼尼松联合环磷酰胺治疗,n=34)和观察组(泼尼松联合环磷酰胺+肾炎康胶囊联合化痰袪瘀汤治疗,n=31)。比较两组治疗效果,治疗前后中医证候积分、实验室指标变化以及不良反应发生率。结果观察组总有效率高于对照组[96.77%(30/31)比73.53%(25/34)](P<0.05),且观察组疗效优于对照组(P<0.05)。中医证候积分的组间和时点间存在交互作用(P<0.05),两组不同时点的变化趋势不同,均呈下降趋势,观察组降低更显著。24 h尿蛋白定量、血肌酐、血清白蛋白、三酰甘油和总胆固醇的组间和时点间存在交互作用(P<0.05),两组各指标不同时点间的变化趋势不同,两组24 h尿蛋白定量、血肌酐、三酰甘油和总胆固醇呈下降趋势,观察组降低更显著;两组血清白蛋白呈先升高后降低的趋势,观察组变化幅度更大。观察组不良反应发生率低于对照组[6.45%(2/31)比26.47%(9/31)](P<0.05)。结论肾炎康胶囊联合化痰袪瘀汤可提高特发性膜性肾病的治疗效果,并减少不良反应的发生。

Objective To explore the clinical effect of Shenyankang capsule combined with Huatan Quyu decoction in the treatment of idiopathic membranous nephropathy.Methods From Apr.2013 to Apr.2017,65 patients with idiopathic membranous nephropathy were included in the study.According to different treatment methods,they were divided into a control group(prednisone combined with cyclophosphamide,n=34)and an observation group(prednisone combined with cyclophosphamide+Shenyankang capsule combined with Huatan Quyu decoction,n=31).The therapeutic effect,TCM syndrome score,laboratory index change and incidence of adverse events were compared between the two groups.Results The total effective rate of the observation group was higher than that in the control group[96.77%(30/31)vs 73.53%(25/34)](P<0.05),and the efficacy of the observation group was better than that of the control group(P<0.05).There was interaction in TCM syndrome score between group and time point(P<0.05);the changing trend of different time points in the two groups was different:both showing a downward trend,and the decrease in the observation group was more significant.There were interactions in 24 h urine protein quantity,serum creatinine,serum albumin,triacylglycerol and total cholesterol between group and time point(P<0.05);the changing trends of different indexes of different time points in the two groups were different:a downward trend was observed in 24 h urine protein quantity,serum creatinine,triacylglycerol and total cholesterol in both groups,and the decreases in the observation group were more significant;a first upward then downward trend was observed in serum albumin in both groups,and the changing amplitude in the observation group was bigger.The incidence of adverse reactions in the observation group was lower than that in the control group[6.45%(2/31)vs 26.47%(9/31)](P<0.05).Conclusion Shenyankang capsule combined with Huatan Quyu decoction can improve the therapeutic effect of idiopathic membranous nephropathy and reduce the occurrence of adverse events.