加减参芪地黄汤联合泼尼松片对狼疮性肾炎肾功能的影响

Effect of modified Shenqi Dihuang decoction combined with prednisone tablets on renal function of patients with lupus nephritis

目的探讨加减参芪地黄汤联合泼尼松片对狼疮性肾炎肾功能的影响。方法选取2016年2月-2019年1月,黄石市爱康医院就诊的80例狼疮性肾炎患者,随机分为研究组与对照组,各40例。对照组采用泼尼松片治疗,研究组在此基础上联合加减参芪地黄汤治疗。比较两组临床疗效,评价两组患者的肾功能指标、补体C3恢复正常及抗双链DNA(ds-DNA)抗体转阴情况,血清高迁移率族蛋白B1(HMGB1)、糖基化终产物受体(RAGE)水平比较及不良反应发生率。结果治疗6个月后,研究组总有效率(90.00%)高于对照组(50.00%),差异有统计学意义(P<0.05);与治疗前比,治疗后两组血清肌酐(Scr)、谷丙转氨酶(ALT)、尿蛋白/24 h、C-反应蛋白(CRP)均降低,白蛋白(ALB)升高(P<0.05);与对照组比,研究组Scr、ALT、TP/24 h、CRP降低,ALB升高(P<0.05);与对照组比,研究组补体C3恢复正常率及抗ds-DNA抗体转阴率较高(P<0.05);与治疗前比,治疗后两组HMGB1、RAGE水平均降低,且研究组患者HMGB1、RAGE水平低于对照组(P<0.05);与对照组比,研究组患者不良反应发生率较低(P<0.05)。结论加减参芪地黄汤联合泼尼松片治疗狼疮性肾炎能明显改善患者肾功能,提高患者免疫力。

OBJECTIVE To explore the effect of modified Shenqi Dihuang decoction combined with prednisone tablets on renal function of the patients with lupus nephritis.METHODS A total of 80 patients with lupus nephritis who were treated in Huangshi Aikang Hospital from Feb.2016 to Jan.2019 were enrolled in the study and randomly divided into the study group and the control group,with 40 cases in each.The control group was treated with prednisone tablets,while the study group was given prednisone tablets combined with modified Shenqi Dihuang decoction.The clinical curative effect was compared between the two groups,the renal function indexes,return of complement C3 to normal and negative rate of anti-double-stranded DNA(ds-DNA)antibody were evaluated.RESULTS After the treatment for 6 months,the total effective rate of the study group was 90.00%,significantly higher than 50.00%of the control group(P<0.05).The levels of serum creatinine(Scr),alanine aminotransferase(ALT),urine protein/24 h and C-reactive protein(CRP)of the two groups were significantly lower after the treatment than before the treatment,while the albumin(ALB)level was significantly higher after the treatment than before the treatment(P<0.05).The levels of Scr,ALT,TP/24 h and CRP of the study group were significantly lower than those of the control group,while the ALB level of the study group was significantly higher than that of the control group(P<0.05).The rate of return of complement C3 to normal and the negative rate of anti-ds-DNA antibody were significantly higher in the study group than in the control group(P<0.05).The levels of HMGB1 and RAGE of the two groups were significantly lower after the treatment than before the treatment,and the levels of HMGB1 and RAGE of the study group were significantly lower than those of the control group(P<0.05).The incidence of adverse reactions of the study group was lower than that of the control group(P<0.05).CONCLUSION Modified Shenqi Dihuang decoction combined with prednisone tablets can remarkably improve the renal function of the patients with lupus nephritis and boost the immunity.