免疫抑制剂联用中成药对难治性肾病综合征肾功能、血脂水平的影响

Effect of Immunosuppressant Combined with Chinese Patent Medicine on Renal Function and Blood Lipid Level in Refractory Nephrotic Syndrome

目的探讨免疫抑制剂联用中成药对难治性肾病综合征(RNS)肾功能、血脂水平的影响。方法回顾性分析2019年1月至2023年6月赣南医科大学第一附属医院收治的118名RNS患者病例,根据治疗方案不同,分为环磷酰胺组(A组)、环磷酰胺+肾康栓组(B组)、环磷酰胺+黄葵胶囊组(C组)、环孢素组(D组)、环孢素+肾康栓组(E组)及环孢素+黄葵胶囊组(F组)。依据肾功能、血脂水平及药品不良反应作为评价指标,分别对环磷酰胺、环孢素联用中成药的肾功能、血脂水平变化进行分析。结果治疗后,各组24 h尿蛋白定量(24 h-UTP)、人血白蛋白(ALB)、血清肌酐(CRE)、血尿素氮(UREA)、总胆固醇(TC)、甘油三脂(TG)、低密度脂蛋白胆固醇(LDL-C)均显著改善(P<0.05)。C组较于A组24 h-UTP下降,差异有统计学意义(P<0.05);E组较于D组TC下降差异有统计学意义(P<0.05);F组较于D组24 h-UTP、TC下降,差异有统计学意义(P<0.05)。结论免疫抑制剂环磷酰胺、环孢素能够有效治疗RNS的患者,联用黄葵胶囊降低蛋白尿排泄及高脂水平;联用肾康栓改善高脂水平。

Objective To investigate the effects of immunosuppressant combined with Chinese patent medicine on renal function and lipid levels in patients with refractory nephrotic syndrome(RNS).Methods Retrospective analysis in January 2019 to June 2023 treated 118 cases of patients with RNS from The First Affiliated Hospital of Gannan Medical University,according to the different treatment,divided into cyclophosphamide group(group A),cyclophosphamide+shenkang suppositories group(group B),cyclophosphamide+huangkui capsules group(group C),cyclosporine group(group D),cyclosporine+shenkang suppositories group(group E)and cyclosporine+huangkui capsules group(group F).According to the evaluation indexes of renal function,blood lipid level and adverse drug reactions,the changes of renal function and blood lipid level of cyclophosphamide or cyclosporine combined with Chinese patent medicine were analyzed.Results After treatment,24 h-UTP,ALB,CRE,UREA,TC,TG and LDL-C were significantly improved in all groups(P<0.05).24 h-UTP decreased significantly in group C compared with A group(P<0.05).The decrease of TC in group E was significantly higher than that in D group(P<0.05).Compared with D group,the decrease of 24 h-UTP and TC in group F were statistically significant(P<0.05).Conclusion Immunosuppressant cyclophosphamide and cyclosporine can effectively treat patients with RNS,and combined with huangkui capsules can reduce proteinuria excretion and high lipid level.Immunosuppressive agents combined with shenkang suppositories improve high lipid level.