雷公藤多苷片联合小剂量泼尼松治疗原发性肾病综合征患者的疗效及对炎症因子的影响

Effect of Tripterygium Glycoside Tablets Combined with Low-dose Prednisone onPatients with PNS and the Inflammatory Factors

目的观察雷公藤多苷片联合小剂量泼尼松治疗原发性肾病综合征(Primary nephrotic syndrome,PNS)患者的疗效及对炎症因子的影响。方法选取2018年1月—2021年12月期间南京中医药大学附属医院收治的PNS患者90例,采用随机数字表法分为对照组与观察组,每组各45例。两组患者均给予常规治疗,对照组给予小剂量泼尼松治疗,观察组在此基础上增加雷公藤多苷片。治疗6个月后,观察比较两组患者临床疗效、不良反应发生情况,治疗前后临床相关指标[血浆白蛋白、尿素氮(Blood urea nitrogen,BUN)、24 h尿蛋白及血肌酐(Serum creatinine,Scr)]、炎症因子水平[白介素-1(Interleukin-1,IL-1)、白介素-6(Interleukin-6,IL-6)、白介素-10(Interleukin-10,IL-10)及肿瘤坏死因子-α(Tumor necrosis factor-α,TNF-α)]。结果治疗后两组患者血浆白蛋白水平较治疗前升高,BUN、24 h尿蛋白及Scr水平较治疗前降低,差异有统计学意义(P<0.05);且观察组各项指标水平均较对照组明显好转,差异有统计学意义(P<0.05)。治疗后两组患者IL-1、IL-6、IL-10及TNF-α水平较治疗前降低,差异有统计学意义(P<0.05);且观察组IL-1、IL-6、IL-10及TNF-α水平均较对照组明显降低,差异有统计学意义(P<0.05)。治疗后观察组治疗总有效率91.11%(41/45)明显高于对照组71.11%(32/45),差异有统计学意义(P<0.05)。治疗期间,观察组不良反应发生率6.67%(3/45)明显低于对照组22.22%(10/45),差异有统计学意义(P<0.05)。结论雷公藤多苷片联合小剂量泼尼松治疗PNS可有效改善肾功能,减少炎症反应及不良反应发生率,临床上值得推广应用。

Objective To observe the effect of Tripterygium Glycoside Tablets(TGT)combined with low-dose prednisone on patients with primary nephrotic syndrome(PNS)and the inflammatory factors.Methods A total of 90 patients with PNS who were treated in Affiliated Hospital of Nanjing University of Chinese Medicine from January 2018 to December 2021 were included and randomized into control group(n=45)and observation group(n=45)with the random number table method.The control group was treated with Conventional treatment and low-dose prednisone,and the observation group with Conventional treatment,low-dose prednisone,and TGT.The treatment lasted six months for both groups.Then the clinical efficacy,incidence of adverse reactions,clinical indexes[plasma albumin,blood urea nitrogen(BUN),24 h urine protein,serum creatinine(Scr)]and levels of inflammatory cytokines[interleukin-1(IL-1),interleukin-6(IL-6),interleukin-10(IL-10),and tumor necrosis factor-α(TNF-α)]before and after treatment were compared between the two groups.Results After treatment,the level of plasma albumin increased,and the levels of BUN,24 h urine protein,and Scr decreased compared with those before treatment in both groups(P<0.05).The indexes of the observation group were significantly better than those of the control group(P<0.05).After treatment,the levels of IL-1,IL-6,IL-10,and TNF-αin the two groups were lower than those before treatment(P<0.05),and the levels in the observation group were lower than those in the control group(P<0.05).The total effective rate in the observation group was 91.11%(41/45),as compared with the 71.11%(32/45)in the control group(P<0.05).The incidence of adverse reactions in the observation group was 6.67%(3/45),lower than that[22.22%(10/45)]in the control group(P<0.05).Conclusion The combination of TGT and low-dose prednisone can improve renal function and reduce the incidence of inflammatoryreaction and adverse reactionsin the treatment of PNS,which is worthy of further promotionin clinical practice.