填精健脾逐水法联合激素治疗原发性肾病综合征

Replenishing Essence, Invigorating Spleen and Removing Water Combined with Hormone Therapy in the Treatment ofPrimary Nephrotic Syndrome

目的探讨填精健脾逐水法联合足量激素治疗对原发性肾病综合征患者的炎性水平及纤溶指标的影响。方法选取我院2016年1月-2017年1月期间收治的120例原发性肾病综合征患者作为研究对象,按照随机数字表法分为观察组和对照组,各60例。对照组采用醋酸泼尼松片治疗,观察组在此基础上采用填精健脾逐水法治疗,总疗程90 d。分别对2组临床疗效、治疗前后的中医证侯积分、炎性水平及纤溶指标进行客观比较。结果观察组和对照组的临床总有效率分别为95.00%和86.67%,差异有统计学意义(P <0.05);治疗后,观察组中医症候积分明显低于对照组和治疗前,差异有统计学意义(P <0.05);2组治疗后的TNF-α、hs-CRP和IL-6等炎性水平相关因子,以及D-D、FIB及MPAR等纤溶指标水平明显低于治疗前,且观察组治疗后的降低水平更低于对照组,差异有统计学意义(P <0.05)。结论填精健脾逐水法联合足量激素治疗原发性肾病综合征患者的近期疗效明确,有助于缓解患者的不良临床症状,且在一定程度上降低炎性细胞水平,调节机体纤溶指标。

Objective To investigate the effect of replenishing essence,invigorating spleen and removing water and hormone therapy on inflammatory level and fibrinolytic parameters in patients with primary nephrotic syndrome.Methods 120 patients with primary nephrotic syndrome treated in our hospital from January 2016 to January 2017 were selected as the subjects and divided into the observation group(n=60)and the control group(n=60)according to the random number table.The patients in the control group were treated with Prednisone Acetate tablets,on this basis,the observation group was treated by the method of replenishing essence,invigorating spleen and removing water.The clinical efficacy,the scores of TCM syndrome,inflammatory level and fibrinolytic index of the two groups were compared objectively.Results The total clinical effective rates of the observation group and the control group were 95.00%and 86.67%respectively,and the difference is statistically significant(P<0.05).After treatment,the symptom score of the patients in the observation group was significantly lower than that in the control group and before the treatment(P<0.05).The levels of inflammatory factors,such as TNF-α,hs-CRP and IL-6,and fibrinolytic indexes such as D-D,FIB and MPAR after treatment in the two groups were significantly lower than those before treatment,and the level of decrease in the observation group after treatment was even lower than that in the control group.The difference is statistically significant(P<0.05).Conclusion The short term effect of the combination of replenishing essence,invigorating spleen and removing watermethod combined with hormonetherapy in the treatment of patients with primary nephrotic syndrome is clear.It can help alleviate the adverse clinical symptoms,and reduce the level of inflammatory cells to some extent,and adjust the body fibrinolysis index.