白芍总苷联合环磷酰胺和醋酸泼尼松治疗老年狼疮性肾炎患者的效果

Effects of total glucosides of paeony combined with Cyclophosphamide and Prednisone acetate in treatment of elderly patients with lupus nephritis

目的:观察白芍总苷联合环磷酰胺和醋酸泼尼松治疗老年狼疮性肾炎(LN)患者的效果。方法:选取106例老年LN患者为研究对象,按照随机数字表法分为对照组和观察组各53例。对照组采用注射用环磷酰胺联合醋酸泼尼松片治疗,观察组在对照组基础上联合白芍总苷胶囊治疗。治疗6个月后,比较两组临床疗效,治疗前后肾功能指标[血肌酐(Scr)、血尿素氮(BUN)、血清白蛋白(ALB)、24 h尿蛋白定量(24hUP)]水平、补体(C_(3)、C_(4))水平、T淋巴细胞亚群水平,以及不良反应发生率。结果:观察组治疗总有效率为98.11%(52/53),高于对照组的84.91%(45/53),差异有统计学意义(P<0.05);治疗后,观察组Scr、BUN、24hUP及CD8^(+)水平均低于对照组,血清ALB、C_(3)、C_(4)、CD3^(+)、CD4^(+)水平及CD4^(+)/CD8^(+)均高于对照组,差异有统计学意义(P<0.05);两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:白芍总苷联合环磷酰胺和醋酸泼尼松治疗老年LN患者效果显著,可改善患者肾功能指标和免疫功能指标水平,且无严重不良反应,效果优于环磷酰胺联合醋酸泼尼松治疗。

Objective:To explore effects of total glucosides of paeony combined with Cyclophosphamide and Prednisone acetate in treatment of elderly patients with lupus nephritis(LN).Methods:106 elderly patients with LN were selected as the research objects and were divided into control group and observation group according to the random number table method,53 cases in each group.The control group was treated with Cyclophosphamide for injection combined with Prednisone acetate tablets,while the observation group was treated with total glucosides of paeony capsules on the basis of those of the control group.After 6 months of treatment,the clinical effects,the renal function index levels[serum creatinine(Scr),blood urea nitrogen(BUN),serum albumin(ALB),24 h urine protein quantitative(24hUP)],the complement(C_(3),C_(4))levels,the T lymphocyte subset level and the incidence of adverse reactions were compared between the two groups.Results:The total effective rate in the observation group was 98.11%(52/53),which was higher than the control group of 84.91%(45/53),and the difference was statistically significant(P<0.05).After the treatment,the levels of Scr,BUN,24hUP,and CD8^(+)in the observation group were lower than those in the control group;the levels of serum ALB,C_(3),C_(4),CD3^(+),CD4^(+)and CD4^(+)/CD8^(+)were higher than those in the control group;and the differences were statistically significant(P<0.05).However,there was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusions:Total glucosides of paeony combined with cyclophosphamide and Prednisone acetate have significant effects in the treatment of the elderly LN patients,which can improve the renal function and immune function index levels without serious adverse reactions.Moreover,it is superior to Cyclophosphamide combined with Prednisone acetate treatment.