自拟益肾固元汤加减联合醋酸泼尼松片治疗肾病综合征临床效果

Clinical effect of self-made Yishenguyuan decoction combined with prednisone acetate tablets in the treatment of nephrotic syndrome

目的观察自拟益肾固元汤加减联合醋酸泼尼松片治疗肾病综合征的临床效果。方法选取2017年5月-2019年5月海南省昌江黎族自治县人民医院收治的肾病综合征患者107例,按照随机数字表法分为观察组和对照组。对照组53例采用醋酸泼尼松片治疗,观察组54例采用自拟益肾固元汤加减联合醋酸泼尼松片治疗。比较2组临床疗效,治疗前后肾功能指标、炎性因子水平、中医症状积分及不良反应。结果观察组总有效率为92.59%,高于对照组的75.47%(χ^(2)=5.867,P=0.015)。治疗后,2组血肌酐、尿素氮及24 h尿蛋白定量均低于治疗前,血浆白蛋白高于治疗前,且观察组优于对照组(P<0.01)。治疗后,2组患者血清TNF-α、IL-1β及IL-6水平均低于治疗前,且观察组低于对照组(P<0.01)。治疗后,2组中医症状积分均低于治疗前,且观察组低于对照组(P<0.01)。观察组不良反应总发生率为5.56%,低于对照组的18.87%(χ^(2)=4.441,P=0.035)。结论自拟益肾固元汤加减联合醋酸泼尼松片治疗肾病综合征可改善患者的临床症状和肾功能,减轻炎性反应,且安全性高,适合临床推广应用。

Objective To observe the clinical effect of self-made Yishenguyuan decoction combined with prednisone acetate tablets in the treatment of nephrotic syndrome.Methods Selected 107 patients with nephrotic syndrome admitted to the People’s Hospital of Changjiang Li Autonomous County,Hainan Province from May 2017 to May 2019,according to the random number table method,they were divided into observation group and control group.53 cases in the control group were treated with prednisone acetate tablets,and 54 cases in the observation group were treated with self-made Yishenguyuan decoction combined with prednisone acetate tablets.Compared the clinical efficacy,renal function indexes,inflammatory factor levels,TCM symptom scores and adverse reactions of the two groups before and after treatment.Results The total effective rate of the observation group was 92.59%,which was higher than the 75.47%of the control group(χ^(2)=5.867,P=0.015).After treatment,the serum creatinine,urea nitrogen,plasma albumin and 24-hour urine protein quantification of the two groups were better than those before treatment,and the observation group was better than the control group(P<0.01).After treatment,the serum levels of TNF-α,IL-1βand IL-6 in the two groups were lower than before treatment,and the observation group was lower than the control group(P<0.01).After treatment,the TCM symptom scores of the two groups were lower than those before treatment,and the observation group was lower than the control group(P<0.01).The total incidence of adverse reactions in the observation group was 5.56%,which was lower than 18.87%in the control group(χ^(2)=4.441,P=0.035).Conclusion The self-made Yishenguyuan decoction combined with prednisone acetate tablets in the treatment of nephrotic syndrome can reduce and improve the clinical symptoms and renal function of patients,with mild inflammation,and high safety,which is suitable for clinical application.