中西医结合治疗难治性肾病综合征疗效观察

OBSERVATION OF THERAPEUTIC EFFECT ON REFRACTORY NEPHRITIC SYNDROME THROUGH INTEGRATED TREATMENT OF TCM AND WM

目的 :观察中西医结合治疗难治性肾病综合征的疗效。方法 :将68例门诊及住院患者分为两组 ,观察组36例 ,分为肝肾阴虚型和脾肾阳虚型 ,采用中医辨证结合激素、潘生丁、依那普利治疗 ,对照组仅采用西药治疗。观察两组治疗前、后血清白蛋白、胆固醇、甘油三酯、血尿素、血肌酐氮、血及尿微球蛋白、24h尿蛋白变化及不良反应率和复发率。结果 :观察组总有效率为94 4 % ,对照组为75 0% ,观察组疗效优于对照组(Ridit分析 ,u=2 59 ,P<0 05) ;两组治疗后血清白蛋白升高 ,胆固醇、甘油三酯、尿素氮、血肌酐、血及尿微球蛋白、24h尿蛋白均下降(均P<0 01) ,除尿微球蛋白、血肌酐外 ,观察组较对照组改善明显(均P<0 05) ;不良反应率及复发率观察组均较对照组低(均P<0 01)。结论 :中西医结合治疗难治性肾病综合征有较好疗效。

Objective: To observe the curative effect on refractory nephritic syndrome (RNS) through integrated treatment of TCM and WM.Methods: 68 in and out_patients with RNS were randomly divided into the integrated TCM and WM Treatment Group (36 cases ) and the WM Control Group (32 cases). Inside the treatment group, the cases were divided into the type of deficiency of liver-yin and kidney-yin and the type of insufficiency of both the spleen and the kidney. This group was treated with both Chinese herbs and western medicine, while the control group was only treated with western medicine. For the two groups, the observation was made to see the changes of serum albumin(ALB), cholesterol(CHOL), triglyceride (TG), blood ureanitrogen ( BUN ), serum creatinine(Scr), blood β2 _ MG(Bβ2 _ MG), urine B_MG (Uβ2 _ MG) and 24 hours urine protein quantity(24hUPQ) before and after the treatment. Meanwhile, side effects and recurrence rate was also observed.Results: The total effective rate in the treatment group reached 94.4%, significantly higher than that in the control group (75 %, P<0.05). In both groups, after the treatment, ALB was increased, but CHOL, TG, BUN, Scr,Bβ2 _ MG, Uβ2 _ MG and 24h UPQ were decreased(P<0.01). In the treatment group, except Uβ2 _ MG and Scr, the improvement in other items were observed obviously when compared with the control group(P<0.05) and the side effects and recurrence rate were found lower in the treatment group (P<0.01). Conclusions: Better curative effects can be achieved for refractory nephritic syndrome through the integrated treatment of TCM and WM.