中药复方联合雷公藤甲素对原发性肾病综合征患者尿蛋白与脂蛋白的影响

Effects of Compound Prescription of Chinese Drugs Combined with Tripolide on Urinary Protein and Lipoprotein in the Patient of Primary Nephrotic Syndrome

目的:探讨中药复方联合雷公藤甲素对原发性肾病综合征(PNS)尿蛋白和脂蛋白的影响。方法:建立中药复方联合雷公藤甲素治疗组(A组)32例,强的松联合辛伐他丁、潘生丁对照组(B组)30例。比较两组病例临床综合疗效、24h尿蛋白排泄率(Upro)、血浆白蛋白(A)、低密度脂蛋白胆固醇(LDL-C)、氧化低密度脂蛋白(ox-LDL)。结果:2组临床综合疗效差异无显著性。对Upro、LDL、ox-LDL等改善作用,A组优于B组(P<0.05);xo-LDL与尿蛋白呈正相关。结论:中药复方联合雷公藤甲素方案有可能替代激素改善部分PNS尿蛋白漏出。ox-LDL既可反映脂质对肾固有细胞的损伤,又可间接推测肾小球高滤过。中药复方可能是从调控LDL、ox-LDL生成或降解来保护肾固有细胞。

Objective: To explore effects of compound prescription of Chinese drugs combined with tripolide on urinary protein and lipoprotein in the patient of primary nephrotic syndrome (PNS) . Methods: Group A (32 cases) were treated by Chinese drugs combined with tripolide and group B (30 cases) by combination of prednisone and persantine as controls. Their comprehensive therapeutic effects. 24h urinary protein (Upro) and albumin. lower density lipid protein (LDL) and oxide LDL (ox-LDL) contents were compared. Results: There was no significant difference between the two groups in comprehensive thertapeutic effect, and the improving action on Upro. LDL and ox-LDL in group A was superior to those in group B; ox-LDL and Upro contents showed positive correlativity. Conclusion: The com- pound prescription of Chinese drugs combined with tripolide can replace hormones in treatment of PNS and improve leakage of urinary protein in a part of patients of PNS. Ox-LDL can reflect the injuring action of lipids on inherent cells of the kidney and indirectly infer the high glomerular filtration. The prescription protects the inherent cells of the kidney possibly through regulating production or degradation of LDL and ox-LDL.