肝肾宁治疗乙型肝炎病毒相关性肾炎临床观察及对补体系统的影响  

Clinical observation of Ganshenning in the treatment of hepatitis B virus associated glomerulonephritis and its effect on complement system

作　　者：邢晓静[1] XING Xiaojing(Department of Nephrology,Shijiazhuang Hospital of Traditional Chinese Medicine,Shijiazhuang,Hebei 050031)

机构地区：[1]河北省石家庄市中医院肾病科,河北石家庄050031

出　　处：《河北中医》2020年第2期192-196,共5页Hebei Journal of Traditional Chinese Medicine

基　　金：河北省中医药管理局2018年度中医药类科研计划课题(编号:2018221)。

摘　　要：目的观察肝肾宁治疗乙型肝炎病毒相关性肾炎(HBV-GN)的临床疗效。方法将65例HBV-GN患者按照随机数字表法分为2组。对照组35例予西医常规治疗,治疗组30例在对照组治疗基础上加肝肾宁治疗。2组均治疗6个月。比较2组疗效;比较2组治疗前后肝功能指标白蛋白(Alb)、总蛋白(TP)、丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)变化;比较2组治疗前后补体(C)3、C4变化;比较2组治疗前后乙型肝炎病毒脱氧核糖核酸(HBV-DNA)、24 h尿蛋白定量变化。结果治疗组总有效率83.33%(25/30),对照组总有效率72.41%(21/29),治疗组疗效优于对照组(P<0.05)。2组治疗后Alb、TP均较本组治疗前升高(P<0.05),ALT、AST均较本组治疗前降低(P<0.05),且治疗组治疗后Alb、TP均高于对照组(P<0.05),ALT、AST均低于对照组(P<0.05)。2组治疗后C3、C4均较本组治疗前升高(P<0.05),且治疗组升高更明显(P<0.05)。2组治疗后HBV-DNA均较本组治疗前降低(P<0.05),且治疗组降低更明显(P<0.05)。2组治疗后24 h尿蛋白定量均较本组治疗前降低(P<0.05),且治疗组降低更明显(P<0.05)。结论肝肾宁治疗HBV-GN临床疗效显著,毒副作用少,能改善肝功能,提高血清C3、C4水平,其机制可能与清除免疫复合物,减少补体消耗,提高机体免疫功能有关。Objective To observe the effect of Ganshenning on hepatitis B virus associated glomerulonephritis(HBV-GN).Methods 65 patients with HBV-GN were divided into two groups according to the random number table method.35 cases in control group were treated by western medicine.30 cases in treatment group were treated by Ganshenning on the basis of the control group.Both groups were treated for 6 months.The efficacy of two groups were compared.The changes of albumin(Alb),total protein(TP),alanine aminotransferase(ALT),aspartate amino transferase(AST)were compared before and after treatment.The changes of complement(C)3 and C4 were compared before and after treatment.The changes of hepatitis B virus DNA(HBV-DNA)and 24 h urine protein quantitative of were compared before and after treatment.Results The total effective rate was 83.33%(25/30)in the treatment group and 72.41%(21/29)in the control group,the therapeutic effect of the treatment group was better than that of the control group(P<0.05).After treatment,Alb and TP in the two groups were higher than those in the group before treatment(P<0.05),ALT and AST were lower than those in the group before treatment(P<0.05),Alb and TP in the treatment group were higher than those in the control group(P<0.05),ALT and AST in the treatment group were lower than those in the control group(P<0.05).After treatment,C3 and C4 in the two groups were higher than those in the group before treatment(P<0.05),and the treatment group was more significantly higher(P<0.05).After treatment,HBV-DNA in the two groups was lower than that in the group before treatment(P<0.05),and the treatment group was significanty lower(P<0.05).After treatment,the 24 h urine protein quantitative in the two groups was lower than that in the group before treatment(P<0.05),and the treatment group was significantly lower(P<0.05).Conclusion Ganshenning has a significant clinical effect in the treatment of HBV-GN,and has few side effects.It can increase the level of serum complement C3 and C4.The mechanism may be related

关 键 词：乙型肝炎病毒 肾炎 中药疗法 

分 类 号：R692.39[医药卫生—泌尿科学] R373.21[医药卫生—外科学]