加减五苓散联合他克莫司治疗肾病综合征临床研究

Clinical Study on Modified Wulingsan Decoction Combined with Tacrolimussfor Nephrotic Syndrome

目的:观察加减五苓散联合他克莫司治疗肾病综合征的临床疗效。方法:采用随机数字表法将120例肾病综合征患者分成对照组与治疗组各60例。2组均给予基础治疗,对照组联用他克莫司,治疗组给予加减五苓散联合他克莫司治疗。比较2组临床疗效及治疗前后中医证候积分、T淋巴细胞亚群、肾功能指标[血尿素氮(BUN)、24 h尿蛋白定量、血肌酐(SCr)]及血清骨形态发生蛋白-7 (BMP-7)、结缔组织生长因子(CTGF)、转化生长因子-β1 (TGF-β1)水平。结果:治疗后,治疗组总有效率高于对照组(P<0.05)。治疗后,2组中医证候积分、CD8^(+)及血清BUN、24 h尿蛋白定量、SCr、CTGF、TGF-β1水平均较治疗前降低(P<0.05),血清BMP-7、CD4^(+)水平及CD4^(+)/CD8^(+)升高(P<0.05);治疗组治疗后中医证候积分、CD8^(+)及血清BUN、24 h尿蛋白定量、SCr、CTGF、TGF-β1水平均低于对照组(P<0.05),血清BMP-7、CD4^(+)水平及CD4^(+)/CD8^(+)高于对照组(P<0.05)。结论:加减五苓散联合他克莫司治疗肾病综合征疗效显著,能够提高患者免疫功能,改善肾功能。

Objective:To observe the clinical effect of modified Wulingsan Decoction combined with Tacrolimus on nephrotic syndrome.Methods:A total of 120 cases of patients with nephrotic syndrome were divided into the control group and the treatment group according to the random number table method,with 60 cases in each group.Both groups were given basic treatment;the control group was additionally treated with Tacrolimus,and the treatment group was additionally treated with modified Wulingsan Decoction combined with Tacrolimus.Traditional Chinese medicine(TCM)syndrome scores,T lymphocyte subsets,kidney function indexes blood urea nitrogen(BUN),24-hour urinary protein quantity,serum creatinine(SCr)and the levels of bone morphogenetic protein-7(BMP-7),connective tissue growth factor(CTGF),transforming growth factor-β1(TGF-β1)in serum before and after treatment as well as the clinical effects were compared between the two groups.Results:After treatment,the total effective rate in the treatment group was higher than that in the control group(P<0.05).After treatment,TCM syndrome scores,and the levels of CD8^(+),BUN,24-hour urinary protein quantity,SCr,CTGF,and TGF-β1 in serum in the two groups were decreased when compared with those before treatment(P<0.05),and the levels of BMP-7 and CD4^(+)in serum,and CD4^(+)/CD8^(+)were increased(P<0.05).After treatment,TCM syndrome score and the levels of CD8^(+),BUN,24-hour urinary protein quantity,SCr,CTGF,and TGF-β1 in serum in the treatment group were lower than those in the control group,and the levels of BMP-7 and CD4^(+)in serum and CD4^(+)/CD8^(+)were higher than those in the control group(P<0.05).Conclusion:Modified Wulingsan Decoction combined with Tacrolimus has a significant curative effect in the treatment of nephrotic syndrome,which can improve the immune function and kidney function of patients.