槐杞黄颗粒辅助治疗狼疮性肾炎的疗效及对患者血清铁蛋白的影响

Efficacy of Huaiqihuang Granules in the Adjuvant Treatment of Lupus Nephritis and Its Effects on Serum Ferritin

目的:探讨槐杞黄颗粒辅助治疗狼疮性肾炎的疗效及对患者血清铁蛋白的影响。方法:采用前瞻性研究,按随机数字表法将2018年11月至2020年4月该院84例狼疮性肾炎患者分为对照组(42例,泼尼松联合环磷酰胺治疗)和观察组(42例,在对照组的基础上辅以槐杞黄颗粒治疗)。比较两组患者治疗前及治疗3个月后血清抗核抗体(ANA)滴度阳性率,24 h尿蛋白定量、血清铁蛋白(SF)、B淋巴细胞刺激因子(BAFF)及炎症因子水平,统计治疗后的临床疗效及不良反应。结果:与治疗前相比,两组患者治疗3个月后ANA滴度阳性率、24 h尿蛋白定量,血清SF、BAFF水平均降低;与对照组相比,观察组患者上述指标水平明显降低,差异均有统计学意义(P<0.05)。与治疗前比较,两组患者治疗3个月后血清γ干扰素水平均明显升高,观察组患者明显高于对照组;两组患者治疗3个月后白细胞介素4、白细胞介素10 IL-4、IL-10水平均明显降低,观察组患者明显低于对照组,差异均有统计学意义(P<0.05)。治疗3个月后,观察组患者的总有效率为95.24%(40/42),高于对照组的80.95%(34/42),差异有统计学意义(P<0.05)。治疗期间,观察组、对照组患者的总不良反应(胃肠道症状、白细胞减少、脱发及肝功能异常)发生率分别为11.90%(5/42)、14.29%(6/42),两组的差异无统计学意义(P>0.05)。结论:在常规治疗基础上辅以槐杞黄颗粒可更明显地降低狼疮性肾炎患者24 h尿蛋白定量,缓解机体炎症状态,还可降低血清SF水平,安全有效。

OBJECTIVE:To probe into the efficacy of Huaiqihuang granules in the adjuvant treatment of lupus nephritis and its effects on serum ferritin.METHODS:Prospective study method was adopted,according to the random number table method,84 patients with lupus nephritis in the hospital from Nov.2018 to Apr.2020 were divided into the control group(42 cases,prednisone combined with cyclophosphamide)and the observation group(42 cases,on the basis of the control group supplemented with Huaiqihuang granules).The positive rate of serum antinuclear antibody(ANA)titer,24 h urine protein quantification,serum ferritin(SF),B lymphocyte stimulating factor(BAFF)and inflammatory factor levels before treatment and after 3 months of treatment were compared between two groups.Clinical efficacy and adverse drug reactions were recorded.RESULTS:After treatment of 3 months,the positive rate of ANA titer,24 h urine protein quantification,serum SF and BAFF levels in two groups were significantly lower than those before treatment,and the observation group was significantly lower than the control group,with statistically significant differences(P<0.05).Compared with before treatment,the serum interferon-γlevels in two groups increased significantly after treatment of 3 months,and the observation group was significantly higher than the control group;after treatment of 3 months,the IL-4 and IL-10 levels in two groups decreased significantly,and the observation group was significantly lower than the control group,the difference was statistically significant(P<0.05).After treatment of 3 months,the total effective rate of the observation group was 95.24%(40/42),higher than 80.95%(34/42)of the control group,the difference was statistically significant(P<0.05).The incidence of total adverse drug reactions(gastrointestinal symptoms,leukopenia,alopecia,and abnormal liver function)in the observation group and the control group were respectively 11.90%(5/42)and 14.29%(6/42),with no statistically significant difference(P>0.05).CONCLUSIONS:Huaiqihuang granules combined with conventional treatment can significantly reduce the 24 h urine protein quantification of patients with lupus nephritis,alleviate the inflammatory state of the body,and also can reduce the serum SF level with higher safety.