黄芪生地辅助环磷酰胺-激素疗法对狼疮性肾炎感染患者炎症状态的影响研究  

Influence of inflammatory state of Radix Astragali and Radix Rehmanniae auxiliary cyclophosphamide-hormone therapy on lupus nephritis

作　　者：方和敬 李霜青[1] 应俊[1] 王政通[1] 黄坚[1] 

机构地区：[1]金华市中心医院肾内科,浙江金华321000

出　　处：《中华医院感染学杂志》2016年第19期4389-4391,共3页Chinese Journal of Nosocomiology

基　　金：浙江省卫生厅医药卫生计划基金资助项目(2013KYB014)

摘　　要：目的分析黄芪生地辅助环磷酰胺-激素疗法对狼疮性肾炎(LN)感染患者炎症状态的影响,探讨其疗效及安全性。方法选取医院2012年6月-2015年6月收治72例LN合并感染患者,按照随机数字表分为观察组及对照组,各36例,均应用环磷酰胺-激素疗法治疗,观察组加用黄芪生地,比较两组患者临床疗效、不良反应及实验室指标变化。结果两组患者治疗后总有效率观察组为97.2%,显著高于对照组的72.2%,差异有统计学意义(P<0.05);两组患者血沉(ESR)、C-反应蛋白(CRP)、免疫球蛋白(IgG)、24h尿蛋白定量(24hUPG)均较治疗前显著降低,补体C3均显著升高,观察组患者24h尿蛋白定量降低更为明显,差异有统计学意义(P<0.05);观察组患者治疗后激素用量显著低于对照组,激素撤减量高于对照组,差异有统计学意义(P<0.05);中医证候积分及SLEDAI积分均较治疗前显著降低,观察组中医证候积分降低更为明显,差异有统计学意义(P<0.05);观察组患者失眠、血压增高、虚汗、体质量增加等不良反应发生率显著低于对照组,差异有统计学意义(P<0.05)。结论黄芪生地辅助环磷酰胺-激素疗法治疗LN感染患者,能够有效降低激素用量,提高治疗安全性,且能够进一步改善患者炎症状态,保证临床疗效,值得推荐。OBJECTIVE To analyze the influence of inflammatory state of Radix Astragali and Radix Rehmanniae auxiliary cyclophosphamide-hormone therapy on lupus nephritis（LN）,so as to discuss the efficacy and safety.METHODS A total of 72 patients with LN concurrent infection were selected in our hospital from Jun.2012 to Jun.2015 and randomly divided into observation group and control group according to the random number table,36 cases in each group.Both groups using cyclophosphamide-hormone therapy,the observation group plus Radix Astragali and Radix rehmanniae,to compare the clinical efficacy,adverse reactions and laboratory indexes in the two groups.RESULTS The total effective rate of observation group was 97.2%after treatment,significantly higher than control group（72.2%）（P〈0.05）.Two groups of patients after treatment erythrocyte sedimentation rate（ESR）,C-reactive protein（CRP）,immune globulin（IgG）,and 24 hurine protein quantitation（24hUPG）were lower than before,alexin C3 significantly increased,24 hUPG in observation group decreased more significantly（P〈0.05）.After treatment,the hormone dosage was significantly lower in observation group than in control group（P〈0.05）.The traditional Chinese medicine（TCM）score and SLEDAI score decreased significantly than before the treatment,the TCM score in observation group decreased even more significantly（P〈0.05）.The insomnia,increased blood pressure,sweating,weight gain and other adverse reactions in observation group were significantly lower than those in control group（P〈0.05）.CONCLUSION Radix Astragali and Radix Rehmanniae auxiliary cyclophosphamide-hormone therapy for LN can effectively reduce the amount of hormone,improve the safety of the treatment,and further improve the inflammatory state of patients to ensure the clinical efficacy,which is worth recommending.

关 键 词：黄芪 生地 环磷酰胺 糖皮质激素 狼疮性肾炎 炎症状态 疗效 安全性 

分 类 号：R593.242[医药卫生—内科学]