雷公藤总甙联合他克莫司和糖皮质激素治疗难治性肾病综合征疗效观察  

Effect of tripterygium glycosides combined with tacrolimus and glucocorticoid in the treatment of refractory nephrotic syndrome

作　　者：王琳 王琳娜[2] 庞欣欣[2] 崔应麟[2] WANG Lin;WANG Linna;PANG Xinxin;CUI Yinglin(Department of General Practice,Zhengzhou Yihe Hospital,Zhengzhou 450047,Henan Province,China;Department of Nephrology,Henan Provincial Hospital of Traditional Chinese Medicine,Zhengzhou 450002,Henan Province,China)

机构地区：[1]郑州颐和医院全科医学科,河南郑州450047 [2]河南省中医院肾病科,河南郑州450002

出　　处：《新乡医学院学报》2020年第6期588-591,共4页Journal of Xinxiang Medical University

基　　金：河南省高等学校重点科研项目(编号:18A320029);河南省中医药科学研究专项课题(编号:2017ZY2070)。

摘　　要：目的探讨雷公藤总甙联合他克莫司和糖皮质激素治疗难治性肾病综合征(RNS)的临床效果。方法选择2017年1月至2018年12月郑州颐和医院、河南省中医院收治的93例RNS患者为研究对象,随机分为A组(n=31)、B组(n=28)和C组(n=34)。A组患者给予甲泼尼龙片和雷公藤总甙片联合治疗,B组患者给予甲泼尼龙片和他克莫司胶囊联合治疗,C组患者给予甲泼尼龙片、他克莫司胶囊和雷公藤总甙片联合治疗。分别于治疗前和治疗3、6个月检测3组患者血清白蛋白(ALB)、丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)、血清肌酐(SCr)及24 h尿蛋白(UTP),治疗6个月时评估3组患者的临床疗效。结果 3组患者治疗前后血清ALT、AST、SCr水平均无显著变化(P> 0.05);治疗前3组患者血清ALB水平和24 h UTP比较差异无统计学意义(P> 0.05)。A组患者治疗前及治疗3、6个月血清ALB水平和24 h UTP水平比较差异均无统计学意义(P> 0.05)。B组患者治疗3个月与治疗前血清ALB水平比较差异无统计学意义(P> 0.05),治疗6个月时血清ALB水平高于治疗3个月和治疗前(P <0.05);B组患者治疗3、6个月时24 h UTP低于治疗前,治疗6个月时24 h UTP低于治疗3个月(P <0.05)。C组患者治疗3、6个月时血清ALB水平高于治疗前,治疗6个月时血清ALB水平高于治疗3个月(P <0.05);C组患者治疗3、6个月时24 h UTP低于治疗前(P <0.05),治疗3、6个月时24 h UTP比较差异无统计学意义(P> 0.05)。治疗3个月时,B组和C组患者血清ALB水平高于A组(P <0.05),但B组与C组患者血清ALB水平比较差异无统计学意义(P> 0.05)。治疗3个月时,B组和C组患者24 h UTP低于A组,C组患者24 h UTP低于B组(P <0.05)。治疗6个月时,B组和C组患者血清ALB水平高于A组,24 h UTP低于A组(P <0.05);C组患者血清ALB水平高于B组,24 h UTP低于B组(P <0.05)。C组患者临床疗效优于A组和B组,B组患者临床疗效优于A组(P <0.05)。结论雷公藤总甙�Objective To investigate the clinical effect of tripterygium glycosides combined with tacrolimus and glucocorticoid in the treatment of refractory nephrotic syndrome(RNS).Methods A total of 93 patients with RNS admitted to Zhengzhou Yihe Hospital and Henan Provincial Hospital of Traditional Chinese Medicine from January 2017 to December 2018 were selected as the study objects,and they were randomly divided into group A(n=31),group B(n=28)and group C(n=34).The patients in group A were treated with methylprednisolone tablets and tripterygium glycosides tablets,and the patients in group B were treated with methylprednisolone tablets and tacrolimus capsules,while the patients in group C were treated with methylprednisolone tablets,tacrolimus capsules and tripterygium glycosides tablets.The levels of serum albumin(ALB),alanine transaminase(ALT),aspartate transaminase(AST),creatinine(SCr),and 24 hours urinary total protein(24 h UTP)were detected before and at 3,6 months after treatment.The clinical effect of the patients in the three groups was evaluated at 6 months of treatment.Results There was no significant changes in the level of serum ALT,AST and SCr before and after treatment in the three groups(P>0.05).There was no significant difference in serum ALB level and 24 h UTP among the three groups before treatment(P>0.05).There was no significant difference in serum ALB level and 24 h UTP among the time points of prior treatment,3 and 6 months after treatment in group A(P>0.05).In group B,there was no significant difference in serum ALB level at 3 months of treatment and before treatment(P>0.05),the serum ALB level at 6 months of treatment was higher than that at 3 months of treatment and before treatment(P<0.05),the 24 h UTP at 3 and 6 months of treatment was lower than that before treatment,and the 24 h UTP at 6 months of treatment was lower than that at 3 months of treatment(P<0.05).In group C,the serum ALB level at 3 and 6 months of treatment was higher than that before treatment,and the serum ALB level at 6 mont

关 键 词：难治性肾病综合征 雷公藤多甙 糖皮质激素 他克莫司 

分 类 号：R692[医药卫生—泌尿科学]