雷公藤多苷联合来氟米特及小剂量激素治疗特发性膜性肾病的临床效果  

Clinical effect of tripterygium glycosides combined with leflunomide and low-dose hormones in the treatment of idiopathic membranous nephropathy

作　　者：姜晓华 JIANG Xiaohua(Department of Endocrinology,Lingyuan Central Hospital,Liaoning Province,Lingyuan 122500,China)

机构地区：[1]辽宁省凌源市中心医院内分泌科,122500

出　　处：《临床合理用药杂志》2023年第1期21-23,27,共4页Chinese Journal of Clinical Rational Drug Use

摘　　要：目的 观察雷公藤多苷联合来氟米特及小剂量激素治疗特发性膜性肾病的临床效果。方法 选择2017年7月—2020年6月凌源市中心医院收治的特发性膜性肾病患者58例,依据随机数字表法分为观察组和对照组,每组29例。观察组采用雷公藤多苷联合来氟米特及小剂量激素治疗,对照组采用环磷酰胺治疗,2组均治疗6个月。比较2组患者临床疗效、治疗前后生化指标及不良反应。结果 治疗6个月后,观察组患者临床治疗总有效率为89.66%,高于对照组的65.52%(χ^(2)=4.858,P=0.028);治疗6个月后,2组患者血清白蛋白(Alb)水平均高于治疗前,总胆固醇(TC)、三酰甘油(TG)、内皮素-1(ET-1)、24 h尿蛋白水平均低于治疗前,且观察组升高/降低幅度大于对照组(P<0.01),2组患者治疗前后血肌酐水平比较差异无统计学意义(P>0.05);对照组与观察组患者不良反应总发生率比较差异无统计学意义(13.79%vs. 20.69%,χ^(2)=0.483,P=0.487)。结论 雷公藤多苷联合来氟米特及小剂量激素治疗特发性膜性肾病的临床效果较好,可有效调节血清生化指标,且安全性高,值得临床应用推广。Objective To observe the clinical effect of tripterygium glycosides combined with leflunomide and low-dose hormones in the treatment of idiopathic membranous nephropathy. Methods Fifty-eight patients with idiopathic membranous nephropathy admitted to Lingyuan Central Hospital from July 2017 to June 2020 were selected. According to the random number table method, they were divided into observation group and control group, with 29 cases in each group. The observation group was treated with tripterygium glycosides combined with leflunomide and low-dose hormone therapy, the control group was treated with cyclophosphamide, and both groups were treated for 6 months. The clinical efficacy, biochemical indexes before and after treatment and adverse reactions were compared between the two groups. Results After 6 months of treatment, the total effective rate of clinical treatment in the observation group was 89.66%, which was higher than 65.52% in the control group(χ^(2)=4.858, P=0.028);After 6 months of treatment, the levels of serum albumin(Alb) in both groups were higher than those before treatment, and levels of total cholesterol(TC), triacylglycerol(TG), endothelin-1(ET-1) and 24 h urine protein were all lower than before treatment, and the increase/decrease in the observation group were greater than those in the control group(P<0.01), and there were no significant difference in serum creatinine levels between the two groups before and after treatment(P>0.05);There was no significant difference in the total incidence of adverse reactions between the control group and the observation group(13.79% vs. 20.69%, χ^(2)=0.483, P=0.487). Conclusion Tripterygium wilfordii polyglycosides combined with leflunomide and low-dose hormones has good clinical effects in the treatment of idiopathic membranous nephropathy, can effectively regulate serum biochemical indicators, and has high safety, which is worthy of clinical application and promotion.

关 键 词：特发性膜性肾病 雷公藤多苷 来氟米特 小剂量激素 临床效果 生化指标 

分 类 号：R692[医药卫生—泌尿科学]