肾安汤联合激素及免疫抑制剂治疗狼疮性肾炎30例

Clinical effect of Shen’an decoction combined with hormone and immunosuppressant in treatment of lupus nephritis: An analysis of 30 cases

目的:探讨肾安汤联合激素及免疫抑制剂治疗狼疮性肾炎(LN)的临床疗效。方法:将60例LN患者采用随机按数字表法随机分为治疗组和对照组,每组各30例。对照组采用口服醋酸泼尼松片和静脉滴注环磷酰胺治疗,治疗组在对照组的基础上加服肾安汤治疗,2组疗程均为6个月。观察比较2组治疗前及治疗后2、4、6个月的SLEDAI评分,24h尿蛋白定量,血尿素氮(BUN)、血清肌酐(SCr)、血沉及免疫相关指标(Ig G、C3、C4)情况。结果:总有效率治疗组为96. 67%,对照组为76. 67%,2组比较,差异有统计学意义(P <0. 05)。治疗后治疗组24h尿蛋白定量、BUN和SCr水平均低于对照组,差异有统计学意义(P <0. 05)。治疗后2、4、6个月2组SLEDAI评分均逐渐下降(P <0. 01),在治疗后4、6个月,治疗组SLEDAI评分低于对照组,差异有统计学意义(P <0. 05)。治疗后治疗组血沉及免疫指标Ig G均低于对照组(P <0. 05);2组补体C3、C4水平均比治疗前高,治疗后治疗组补体C3、C4水平均高于对照组(P <0. 05)。结论:肾安汤联合激素及免疫抑制剂治疗狼疮性肾炎可以有效改善患者的症状,控制病情,减轻不良反应。

Objective:To investigate the clinical effect of Shen’an decoction combined with hormone and immunosuppressant in treatment of lupus nephritis(LN).Methods:A total of 60 patients with LN were divided into treatment group and control group using a random number table,with 30 patients in each group.The patients in the control group were given oral prednisone acetate tablets and intravenous drip of cyclophosphamide,and those in the treatment group were given Shen’an decoction in addition to the treatment in the control group.The course of treatment was 6 months for both groups.The two groups were compared in terms of SLEDAI score,24-hour urinary protein,blood urea nitrogen(BUN),serum creatinine(SCr),erythrocyte sedimentation rate,and immune indices(Ig G,C3,and C4)before treatment and at 2,4,and 6 months after treatment.Results:There was a significant difference in overall response rate between the treatment group and the control group(96.67%vs 76.67%,P<0.05).After treatment,the treatment group had significantly lower24-hour urinary protein,BUN,and SCr than the control group(P<0.05).At 2,4,and 6 months after treatment,both groups had a gradual reduction in SLEDAI score(P<0.01),and at 4 and 6 months after treatment,the treatment group had a significantly lower SLEDAI score than the control group(P<0.05).After treatment,the treatment group had significantly lower erythrocyte sedimentation rate and Ig G than the control group(P<0.05);both groups had significant increases in the levels of C3 and C4 after treatment,and the treatment group had significantly higher levels than the control group after treatment(P<0.05).Conclusion:In the treatment of LN,Shen’an decoction combined with hormone and immunosuppressant can effectively improve patients’symptoms,control disease conditions,and alleviate adverse events.