至灵胶囊联合他克莫司胶囊治疗膜性肾病疗效观察及对抗M型磷脂酶A2受体抗体的影响

Curative Effect of Zhiling Capsules Combined with Tacrolimus Capsules on Membranous Nephropathy and Its Effect on Anti-M Type Phospholipase A2 Receptor Antibody

目的:观察至灵胶囊联合他克莫司胶囊治疗膜性肾病(MN)的疗效及对抗M型磷脂酶A2受体(PLA2R)抗体的影响。方法:选取98例MN患者,按随机数字表法分为对照组及观察组各49例。对照组给予他克莫司胶囊治疗,观察组在对照组基础上加用至灵胶囊口服。2组均连续治疗4周。比较2组临床疗效及不良反应发生率,比较2组治疗前后肾功能[血浆白蛋白(Alb)、血肌酐(SCr)、尿微量白蛋白(MAU)、血尿素氮(BUN)、24 h尿蛋白定量(24 hUP)]、血脂[总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)]、抗PLA2R抗体水平的变化。结果:治疗后,观察组临床疗效总有效率为93.88%,对照组为79.59%,2组比较,差异有统计学意义(P<0.05)。治疗后,2组SCr、MAU、BUN、24 hUP指标值较治疗前降低,Alb指标值均较治疗前升高,差异均有统计学意义(P<0.05);观察组SCr、MAU、BUN、24 hUP指标值均低于对照组,Alb指标值高于对照组,差异均有统计学意义(P<0.05)。治疗后,2组TC、TG、LDL-C水平均较治疗前下降,观察组上述3项水平均低于对照组,差异均有统计学意义(P<0.05)。治疗后,2组抗PLA2R抗体水平均较治疗前下降(P<0.05),观察组低于对照组(P<0.05)。对照组不良反应发生率为14.29%,观察组为4.08%,2组不良反应发生率比较,差异有统计学意义(P<0.05)。结论:至灵胶囊联合他克莫司胶囊治疗MN可有效提高临床疗效,改善肾功能,降低患者血脂、抗PLA2R抗体水平,用药安全性较高。

Objective:To observe the curative effect of the therapy of Zhiling Capsules combined with Tacrolimus Capsules on membranous nephropathy(MN) and its effect on anti-M type phospholipase A2receptor(PLA2R) antibody. Methods: A total of 98 patients with MN were selected and divided into the control group and the observation group according to the random number table method,with 49 cases in each group. The control group was given Tacrolimus Capsules,and the observation group was additionally given oral administration of Zhiling Capsules based on the treatment of the control group. Both groups were treated for four weeks continuously. The clinical effects and incidence of adverse reactions were compared between the two groups. Before and after treatment,the changes of levels of kidney function,including plasma albumin(Alb), serum creatinine(SCr), microalbuminuria(MAU), blood urea nitrogen(BUN) and24-hour urine protein(24 hUP), blood lipid, including total cholesterol(TC), triglyceride(TG) and lowdensity lipoprotein cholesterol(LDL-C),and anti-PLA2R antibody were compared between the two groups.Results: The total clinical effective rate was 93.88% in the control group, and was 79.59% in the observation group, the difference being significant(P<0.05). After treatment, the levels of SCr, MAU,BUN and 24 hUP in the two groups were decreased when compared with those before treatment,and the levels of Alb were increased,differences being significant(P<0.05);the levels of SCr,MAU,BUN and24 hUP in the observation group were lower and the level of Alb in the observation group was higher than those in the control group,differences being significant(P<0.05). After treatment,the levels of TC,TG and LDL-C in the two groups were decreased when compared with those before treatment,and the above three levels in the observation group were lower than those in the control group, differences being significant(P<0.05). After treatment,the levels of anti-PLA2R antibody in the two groups were decreased when compared with those before treatment(P<0.05),and the above level in the observation group was lower than that in the control group(P<0.05). The incidence of adverse reactions was 14.29% in the control group and 4.08% in the observation group,the difference being significant(P<0.05). Conclusion:The therapy of Zhiling Capsules combined with Tacrolimus Capsules for MN can effectively enhance the clinical effect,improve the kidney function,and reduce the levels of blood lipid and anti-PLA2R antibody,with high medication safety.