参芪地黄汤加减联合缬沙坦胶囊治疗慢性肾小球肾炎的效果及对肾功能和免疫功能的影响

Effect of modified Shenqi Dihuang decoction combined with valsartan capsules on chronic glomerulonephritis and its influence on renal function and immune function

目的观察参芪地黄汤加减联合缬沙坦胶囊治疗慢性肾小球肾炎(CGN)的效果及对肾功能和免疫功能的影响。方法选取2021年3月—2023年3月于深圳市盐田区人民医院诊治的CGN患者80例,根据单双号随机分为观察组40例和对照组40例。对照组给予缬沙坦胶囊治疗,观察组给予参芪地黄汤加减联合缬沙坦胶囊治疗,2组均治疗8周。比较2组疗效,治疗前后肾功能指标[血肌酐(SCr)、血尿素氮(BUN)、24 h尿蛋白定量(24 h-Upro)]、免疫指标(CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+))水平及不良反应。结果观察组治疗总有效率为95.00%,高于对照组的77.50%(χ^(2)=5.165,P=0.023);治疗8周后,2组SCr、BUN水平、24 h-Upro及CD8^(+)低于治疗前,CD4^(+)、CD4^(+)/CD8^(+)高于治疗前,且观察组低/高于对照组(P<0.05或P<0.01);观察组与对照组不良反应总发生率比较差异无统计学意义(5.00%vs.10.00%,χ^(2)=0.180,P=0.671)。结论参芪地黄汤加减联合缬沙坦治疗CGN效果较好,可有效调节T淋巴细胞水平,改善肾功能,且安全性高。

Objective To observe the clinical efficacy of modified Shenqi Dihuang decoction combined with valsartan capsules in the treatment of chronic glomerulonephritis(CGN)and the effects on renal function and immune function.Methods A total of 80 CGN patients diagnosed and treated in Shenzhen Yantian District People′s Hospital from March 2021 to March 2023 were randomly divided into observation group(40 cases)and control group(40 cases)according to odd-even numbers.Control group was treated with valsartan capsules,observation group was treated with modified Shenqi Dihuang decoction combined with valsartan capsules,both groups were treated for 8 weeks.The therapeutic effects,and the renal function indexes[serum creatinine(SCr),blood urea nitrogen(BUN),24 h urinary protein quantity(24 h-Upro)],immune indexes(CD4^(+),CD8^(+),CD4^(+)/CD8^(+))levels before and after treatment,and adverse reactions were compared between two groups.Results The total effective rate of the observation group was 95.00%,which was higher than 77.50%of the control group(χ^(2)=5.165,P=0.023).After 8 weeks of treatment,SCr,BUN,24 h-Upro and CD8^(+)in two groups were lower than before treatment,CD4^(+),CD4^(+)/CD8^(+)were higher than before treatment,and observation group was lower/higher than control group(P<0.05 or P<0.01).There was no significant difference in the total incidence of adverse reactions between the observation group and the control group(5.00%vs.10.00%,χ^(2)=0.180,P=0.671).Conclusion Modified Shenqi Dihuang decoction combined with valsartan has a good effect in the treatment of CGN,which can effectively regulate T lymphocyte level and improve renal function with high safety.