温肾利水方联合免疫抑制剂治疗难治性肾病综合征疗效观察  

Observation of Efficacy of Decoction for Warming Kidney and Promoting Diuresis Combined with Immunosuppressive Agents on Refractory Nephrotic Syndrome

作　　者：王延辉 沈蓓莉 曲青山[1] 刘瑞勇[1] 刘变玲[1] WANG Yan-hui;SHEN Bei-li;QU Qing-shan;LIU Rui-yong;LIU Bian-ling(Zhengzhou People＇s Hospital, Zhengzhou, Henan, China,45000)

机构地区：[1]郑州人民医院,河南郑州450000

出　　处：《河南中医》2018年第6期913-916,共4页Henan Traditional Chinese Medicine

基　　金：国家中医药管理局基地业务建设(编号:JDZX2015093)

摘　　要：目的:观察温肾利水方联合免疫抑制剂治疗难治性肾病综合征(Refractory nephrotic syndrome,RNS)的临床疗效。方法:选取2013年1月至2016年6月在本院就诊的RNS患者40例为研究对象,按照随机数字表法分为治疗组和对照组,每组20例。对照组患者给予替换免疫抑制剂(环磷酰胺、环孢素或他克莫司)治疗,治疗组在原免疫抑制剂治疗的基础上加用温肾利水方治疗,疗程3个月,患者每月随访1次,检测两组患者24 h尿蛋白定量、血清白蛋白(albumin,ALB),血肌酐(serum creatinine,Scr)。结果:治疗3个月后,治疗组有效率为80%,对照组有效率为65%,治疗组优于对照组,但差异无统计学意义(P>0.05);两组治疗1、3个月后的24 h尿蛋白定量及治疗3个月后ALB均显著改善,差异有统计学意义(P<0.05);治疗组治疗3个月后ALB、肾小球滤过率(glomerularfiltration rate,GFR)水平优于对照组,差异有统计学意义(P<0.05);治疗组不良反应发生率为12%,对照组不良反应发生率为55%,对照组不良反应发生率高于治疗组,但无显著差异。结论:温肾利水方联合免疫抑制剂治疗难治性肾病综合征疗效显著,减轻药物不良反应。Objective：To observe the clinical curative effect of Decoction for Warming Kidney and Promoting Diuresis combined with immunosuppressive agents on refractory nephrotic syndrome（ RNS）. Methods：Forty patients with RNS treated in our hospital from January 2013 to June 2016 were selected and divided into the treatment group and the control group according to random number table,with 20 cases in each group. The patients in the control group were treated with replacement immunosuppressive agents（ cyclophosphamide,cyclosporin or tacrolimus）. The ones in the treatment group were treated with Decoction for Warming Kidney and Promoting Diuresis on the basis of the original immunosuppressive therapy. The treatment course lasted 3 months,and the patients were followed up once a month. The 24 h urine protein,serum albumin（ ALB）,and serum creatinine（ Scr） were detected in the two groups. Results：After 3 months＇ treatment,the effective rate of the treatment group was 80%,while that of the control group was 65%. The treatment group was better than the control group,but the difference was not statistically significant（P〉0. 05）. 24 h urinary protein quantitation after one month＇s and 3 months＇ treatment and ALB after3 months＇ treatment in the two groups were significantly improved,and all the differences were statistically significant（ P〈0. 05）. The levels of ALB and GFR in the treatment group were better than those of the control group after 3 months＇ treatment. The differences were statistically significant（ P〈0. 05）. The incidence of adverse reactions in the treatment group was 12%,while that in the control group was55%,and the incidence of adverse reactions in the control group was higher than that in the treatment group,but there was no statistical difference. Conclusion：Decoction for Warming Kidney and Promoting Diuresis combined with immunosuppressive agents has a remarkable clinical curative effect on RNS,and can reduce the adverse reaction of drugs.

关 键 词：难治性肾病综合征 温肾利水方 免疫抑制剂 24 h尿蛋白定量 血清白蛋白 血肌酐 

分 类 号：R259.92[医药卫生—中西医结合]